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P119. The diagnostic value of a new fecal marker matrix metalloprotease-9 in different types of inflammatory bowel diseases

K. Farkas1, Z. Sarodi1, A. Bálint1, I. Földesi1, G. Lázár2, Z. Simonka2, L. Tiszlavicz3, M. Szücs4, T. Nyári4, F. Nagy1, Z. Szepes1, R. Bor1, A. Annaházi1, R. Roka1, T. Wittmann1, T. Molnár1, 1University of Szeged, First Department of Medicine, Szeged, Hungary, 2University of Szeged, Department of Surgery, Szeged, Hungary, 3University of Szeged, Department of Pathology, Szeged, Hungary, 4University of Szeged, Department of Medical Physics and Informatics, Szeged, Hungary

Background

Inflammatory biomarkers that correlate with enteric inflammation would be beneficial for monitoring the course of disease and targeting treatment in patients with inflammatory bowel disease (IBD). Only limited data are available about the diagnostic accuracy of fecal matrix metalloprotease (MMP)-9 in IBD. The aims of our prospective study was to assess the diagnostic accuracy of fecal MMP-9 in patients with active Crohn's disease (CD), ulcerative colitis (UC) and pouchitis assessed by clinical, endoscopic and histological scores and to compare the diagnostic accuracy of fecal MMP-9 and fecal calprotectin (CP) in IBD.

Methods

Stool and blood samples were collected in 52 CD, 34 UC and 33 ileal pouch-anal anastomosis patients before control endoscopy. Biopsies were taken for histology. The activities of CD, UC and pouchitis were defined with the use of clinical, endoscopic and histological activity scores (CDAI, partial Mayo score, PDAI, SES-CD, Mayo endoscopic subscore, D'Haens and Riley score). Fecal CP and MMP-9 levels were quantified by use of enzyme-linked immunosorbent assay.

Results

Active CD, UC and pouchitis was detected in 33.9%, 58.8% and 30.3% of the patients. Significant correlation was shown between the clinical, endoscopic and histological activities and fecal MMP-9 concentration in UC and pouchitis. Fecal CP concentration did not correlate with the clinical, endoscopic and histological activities of either UC or pouchitis. In CD, fecal CP correlated with the clinical, endoscopic and histological activities of the disease, and although fecal MMP-9 concentration did not show significant correlation with SES-CD, stronger correlation was observed than in case of CP considering the clinical and histological activities of CD.

Conclusion

This is the first study assessing the diagnostic accuracy of MMP-9 in different types of IBD. Our results showed that fecal MMP-9 has an exclusively high specificity in the detection of active UC and pouchitis and it also correlates stronger than fecal CP with the clinical and histological activities of CD. Further studies are needed to confirm these results.