P257 Evaluation of serum ICAM-1 and VCAM-1 as biomarkers for disease progression in Crohn's disease
Bar Orr I.*1, Martin de Carpi J.2, Amil Dias J.3, Levine A.4, Nuti F.5, Lionetti P.6, Escher J.7
1E.Wolfson Medical Center, Pediatric Gastroenterology, Holon, Israel 2Hospital Sant Joan de, Department of Pediatric Gastroenterology, Barcelona, Spain 3Hospital, S. Joao, Department of Pediatrics, Porto, Portugal 4Wolfson Medical center, Sackler School of Medicine, Pediatric Gastroenterology and Nutrition Unit, Tel Aviv, Israel 5Sapienza University of Rome, Department of Public Health and Infectious Diseases, Rome, Italy 6Meyer Children's Hospital, University of Florence, Department of Neuroscience, Psychology, Drug Research and Child Health, Florence, Italy 7Erasmus MC-Sophia Children's Hospital, Department of Pediatric Gastroenterology, Rotterdam, Netherlands
Determining the severity and progression of bowel damage is crucial when evaluating different treatment strategies for inflammatory bowel disease (IBD). The identification of biomarkers that could predict disease progression would be of significant clinical value. Cell adhesion molecules (VCAM-1, ICAM-1) have been shown to be increased in IBD patients, recently found to signify an upcoming flare. Our study investigated whether they could serve as biomarkers and used as predictors of early complicated disease or requirement for surgery.
The GROWTH CD study (Growth, Relapses and Outcomes With THerapy) is geared to predict early outcomes such as complications and surgery by 24 months in children with treatment naïve new onset CD. Patients with early onset of complications or need for surgery would be considered the highest risk patients. Newly diagnosed children underwent colonoscopy, gastroscopy and imaging, and were phenotyped by the Paris classification and followed at baseline, 8, 12, 26, 52, 78 and 104 weeks. We used the GROWTH CD registry to elucidate the significance of serum VCAM-1 and ICAM-1 at baseline or after therapy (week 12) in predicting complications rate (fibrostricturing disease, penetrating disease or perianal abscess) or need for surgery by 2 years.
201 children were followed prospectively for 2 years in the GROWTH CD study, of whom serum ICAM-1 and VCAM-1 levels were obtained at day 1. For ICAM-1 18/56 (32%) with an elevated serum level had a complication along the follow-up period, compared with 41/145 (28%; p=0.607) who had normal levels and also had a complications. In the case of VCAM-1 the rate was slightly higher with 10/27 (37%) with high levels having a complication, as compared to 49/174 (28%; p=0.368) with normal levels having a complication later in the course of disease.
Baseline and post treatment serum levels of ICAM-1 and VCAM-1 in patients with IBD were not effective as biomarkers for early complications and a need for surgery.