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P062. Serum cytokine profile is related with disease activity in ulcerative colitis patients

M.L.R. Perálvarez, V. García, C. Villar, R. González, E. Iglesias, P. Soto, A. Hervás, J. Muntané, F. Gómez-Camacho

Hospital Reina Sofía, Córdoba, Spain

Aims: To correlate several cytokines serum levels with clinical, endoscopic and histological activity of ulcerative colitis (UC) patients.

Methods: Transversal study including 21 healthy controls and 67 UC non selected patients. At the same moment clinical, endoscopic and histological disease activity was assessed using Truelove Witts modified score, Sninski and GEBOES scale respectively. Plasma samples were analyzed by Bio Plex multi assay technology (Bio Rad laboratories, USA) measuring IL1β, IL2, IL6, IL8, IL 10, IL13, IL17, IFNγ and TNFα. Statistical analysis was performed using SPSS 15.0 for Windows. All hypothesis tests were bilateral and considered statistically significant at p < 0.05.

Results: Disease activity of patients is summarized in table 1. Mean age was 43.3±12 years in UC group and 42±9.5 years in controls group. According to Montreal classification, the extent was proctitis in 12 (17.9%), distal colitis in 24 (35.8%) and pancolitis in 31 patients (46.3%). With respect to controls, the multivariate analysis identified that patients with UC showed overexpression of IL8 (OR = 1.37, CI95%=1.1–1.6, p = 0.002) and IL10 (OR = 3.88, CI95%=1.3–11.1, p = 0.012) and lower levels of IFNγ (OR = 0.95, CI95%=0.92–0.98, p = 0.002). This model had a global precision of 77.3%. Moderate and severe clinical activity implied higher concentrations of IL8 (14.3±10.2 and 20.7±13.5 pg/ml, p = 0.01) and IL10 (2.2±1.7 and 8.9±6 pg/ml, p = 0.01). Higher IL8 levels was also related with moderate-severe endoscopic activity (19.2±4.5 vs 11.8±5.4 pg/ml; p = 0.01). Higher histological activity (GEBOES 3–5) involved higher concentrations of IL8 (18.5±15.3 pg/ml vs. 9.3±4 pg/ml) (p = 0.001). Extent of the disease influenced IL8 concentration. In fact, IL8 mean in pancolitis patients was 20.3±13 pg/ml while in proctitis/distal colitis patients it was 13.7±10 pg/ml (p = 0.023). Untreated patients (new diagnosis) showed higher levels of IL 6 (23.1±22.6 and 9.1±8.7 pg/ml, p = 0.012) and IL8 (26.5±17.6 and 13.7±7.8 pg/ml, p = 0.03). Systemic corticosteroids treatment involved IL10 overexpression (10.3±7.1 pg/ml) compared with topic (1.6±1.4 pg/ml) and non corticosteroids group (2.2±1.5 pg/ml) (p = 0.003). There were no other significant correlations between cytokine expression and disease characteristics.

Conclusion: The serum cytokine profile measured by Bioplex technology can be useful in the diagnosis of UC and in identifying patients with moderate-severe disease. IL8 serum level may be a reliable biomarker in UC emerging as a therapeutic target to be considered for future biologic treatments.

Table 1: Disease activity of patients
Clinical activity (Truelove Witts modified)Endoscopic activity (Sninsky scale)Histologic activity (GEBOES scale)
  n (%)  n (%)  n (%)
Inactive (<11)15 (22.4%)Inactive9 (13.4%)Inactive (0)9 (13.3%)
Mild (11–15)26 (38.8%)Mild13 (19.4%)Mild (1–2)5 (7.3%)
Moderate (16–21)24 (35.8%)Moderate28 (41.8%)Moderate (3)27 (40.8%)
Severe (22–27)2 (3%)Severe17 (25.4%)Severe (4–5)26 (38.6%)