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P182. Fecal MMP‑9: A new noninvasive differential diagnostic and activity marker in ulcerative colitis

A. Annahazi1, T. Molnar1, K. Farkas1, A. Rosztoczy1, F. Izbeki1, K. Gecse1, O. Inczefi1, F. Nagy1, I. Foldesi1, M. Szucs2, M. Dabek3, L. Ferrier3, V. Theodorou3, L. Bueno3, T. Wittmann1, R. Roka1

1University of Szeged, First Department of Medicine, Szeged, Hungary; 2University of Szeged, Department of Medical Physics and Informatics, Szeged, Hungary; 3Toxalim UMR 1331 INRA/INP/UPS, Neuro-Gastroenterology & Nutrition Unit, Toulouse, France

Background: Ulcerative colitis (UC) is characterized by frequent relapses, with the presence of colorectal inflammation and mucosal lesions. Matrix-metalloprotease 9 (MMP‑9) is elevated in colonic biopsies, urine and blood plasma of UC patients. MMP‑9 has been suggested as a predictor of UC in the urine of children, however, 20% of the controls were tested positive. So far, fecal MMP‑9 levels have never been measured. Our aims were: (i) to compare fecal MMP‑9 levels in UC patients to control subjects and a functional GI disorder characterized by diarrhea (IBS‑D), (ii) to test the correlation between UC disease activity and fecal levels of MMP‑9, (iii) to correlate fecal MMP‑9 levels with a known fecal marker of UC activity, calprotectin.

Methods: UC (n = 47), IBS‑D (n = 23) patients and control subjects (n = 24) provided fecal samples for MMP‑9 analysis. In UC patients, disease severity was evaluated by the Mayo score. Fecal MMP‑9 and calprotectin levels were measured by ELISA and lateral flow assay, respectively.

Results: MMP‑9 was undetectable or ≤0.22 ng/mL in the feces of all controls and IBS‑D patients. In UC patients, fecal MMP‑9 levels significantly correlated with the overall Mayo score (p < 0.001), the endoscopic score (p < 0.001) and the serum CRP levels (p = 0.002). Additionally, in UC patients fecal MMP‑9 levels showed a significant correlation with the known disease activity marker, fecal calprotectin (p = 0.014).

Conclusions: These results highlight fecal MMP‑9 as a useful tool in the differential diagnosis of diarrheic disorders and in the noninvasive evaluation of disease activity and mucosal healing in ulcerative colitis.