OP007 Detection of mucosal healing with a serum marker panel in adalimumab-treated patients with ulcerative colitis
M. de Bruyn1,2*, R. Ringold3, E. Martens2, M. Ferrante1,4, G. Van Assche1,4, G. Opdenakker2, A. Dukler3, S. Vermeire1,4
1Translational Research Center for GastroIntestinal Disorders (TARGID), Chronic Diseases, Metabolism and Ageing (CHROMETA), Leuven, Belgium, 2Rega Institute for Medical Research, Microbiology and Immunology, Leuven, Belgium, 3Kepler Diagnostics, Inc., Simi Valley, USA, 4University Hospitals Leuven, Gastroenterology and Hepatology, Leuven, Belgium
Surrogate markers that accurately detect mucosal healing (MH) in patients with ulcerative colitis (UC) are urgently needed. After infliximab therapy, neutrophil gelatinase B-associated lipocalin in complex with matrix metalloproteinase-9 (NGAL-MMP-9), cathelicidin LL-37 and chitinase 3-like 1 (CHI3L1), together with C-reactive protein (CRP) and neutrophil count were significantly associated with MH. We investigated whether these five markers were also associated with MH after treatment with adalimumab (ADM).
Serum samples were obtained from 31 UC patients (58% female, median age 35.6 years) both at baseline and after a median (IQR) of 14 (10–25) weeks. All patients had endoscopic disease activity prior to treatment (Mayo endoscopic subscore/MES ≥2) and MH was defined at follow-up endoscopy as MES ≤1. NGAL-MMP-9, LL-37, and CHI3L1 were measured with ELISA. Binary logistic regression analysis was used to combine multiple markers. ROC analysis was used to test the performance of individual and combined markers. Non-parametric tests were performed, and
Twenty-one patients (68%) achieved MH with ADM therapy. Compared with baseline, NGAL-MMP-9 levels significantly decreased in patients with MH (96.9 vs. 214.1 ng/ml,
Neutrophil-related markers (NGAL-MMP-9, LL-37, and CHI3L1) as well as CRP and neutrophil count were significantly associated with MH after treatment with ADM. These data are in concordance with our previous findings in infliximab-treated patients. We therefore suggest a broad clinical utility of this panel for monitoring MH in UC patients under anti-TNF treatment.