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P048. Relation between angio- and lymphangiogenic factor levels and the behaviour, activity, treatment and acute phase reactants (APR) in patients with inflammatory bowel disease (IBD)

P.M. Linares1, A. Algaba2, M.E. Fernández-Contreras1, I. Guerra2, M. Chaparro1, J.L. Rodríguez-Agulló2, J.P. Gisbert1, F. Bermejo2

1La Princesa University Hospital, Madrid, Spain; 2Fuenlabrada University Hospital, Fuenlabrada, Spain

Aim: To correlate angio- and lymphangiogenic factor (ALF) levels, in serum and colonic mucosa culture supernatant (MCS) with the behaviour, treatment, APR and clinical activity in patients with IBD.

Methods: Case–control study in 81 patients (21 healthy volunteers, 30 ulcerative colitis (UC) and 30 Crohn's disease (CD)). The extension and behaviour of the IBD were determined by the Montreal classification. Disease activity was assessed by CDAI (CD) and Truelove-Witts (UC) indexes. The APR were determined by leukocytes, platelet count, haemoglobin, C-reactive protein (CRP) and granulocyte sedimentation velocity (GSV) levels. The ALF concentrations in serum and MCS were determined by ELISA assay.

Results: Mean age of patients was 42±11 years, 58% women. The mean disease duration was 10±8 years. 87% of the patients were under IBD treatment: 50% mesalazine, 39% azathioprine/mercaptopurine, 19% infliximab/adalimumab, 14% classic corticoids and 2% budesonide/metrotexate. 76% of patients with UC had distal colitis, 17% pancolitis and 7% proctitis. 43% of the patients with CD had ileocolonic location, 30% colonic and 23% ileal location. According to the CDAI index, 59% of the patients with CD did not have activity, 22% had mild flare and 19% moderate flare. For the UC patients, following the Truelove-Witts index, 67% had no activity, 30% mild activity and 3% moderate activity.

There were significant correlations between CDAI and VEGFA, D, PlGF, Ang2, Ang1 and Tie2 in MSC, and between Truelove-Witts index and Ang2, Tie2 in serum and Ang2, Tie2 and PlGF in MCS concentrations. Among the APR, significant correlations were found between: CRP, PLGF and Ang1 in serum and PlGF and Tie2 in MCS. Leukocytes correlated significantly with VEGFA, C and Ang1 in serum and VEGFA in MCS. There were also significant correlations between haemoglobin and VEGFR1 and between platelets and VEGFA, C, Ang1 and PlGF in serum, and Ang1 and Ang2 in MSC.

Significant differences in the VEGFC, Ang2 and Tie2 serum and VEGFA, D, R2, R3 and PlGF in MCS concentrations were observed with respect to the treatment with mesalazine, budesonide, corticosteroids and azathioprine (p < 0.05). Levels of PlGF, Ang1 and Ang2 in MCS are significantly higher when levels of CRP, haemoglobin and platelets were above the normal ranges. There were no significant differences depending on the GSV, leukocytes, disease extension, smoking habit, extra intestinal manifestations and time from diagnosis.

Conclusions:

  • Angio- and lymphangiogenic factors in MCS are altered with the clinical activity of the IBD and with the treatment administered, and therefore could be appropriate markers for disease prognosis.
  • PlGF, Ang1 and Ang2 concentrations in MCS are higher in patients with increased APR (CRP, haemoglobin and platelets).