P288 Gut barrier failure biomarkers in IBD: Is there anything new beyond „The Wall’?
N. Sipeki MD1, P. Kovats1, B. Balogh1, Z. Shums2, G.L. Norman2, P. Antal-Szalmas3, M. Papp1
1Division of Gastroenterology, Department of Internal Medicine, University of Debrecen, Debrecen, Hungary, 2Inova Diagnostics, Inc., San Diego, USA, 3Department of Laboratory Medicine, University of Debrecen, Debrecen, Hungary
Several defects in the many specialised components of mucosal barrier have been reported in inflammatory bowel disease (IBD). These alterations may represent a primary dysfunction in Crohn’s disease(CD), but they may also perpetuate chronic mucosal inflammation in ulcerative colitis(UC). Changes in intestinal permeability can predict IBD course.
We aim to determine the predictive potential of a panel of serological markers that reflect either mechanical or immunological gut barrier dysfunction regarding determination of disease phenotype, therapeutic strategy and long-term disease course in a prospective referral adult IBD patient cohort.
Sera of 266 CD (m/f:112/154, median age:25 years, B1:80.1%, P1:18.0%) and 187 UC (m/f:86/101, median age:33 years, extensive colitis:28.3%) patients were assayed for intestinal fatty acid-binding protein(I-FABP) and various immunoglobulin A (IgA) molecules, anti-F-actin[AAA IgA/IgG] and anti-gliadin[AGA IgA/IgG]) by enzyme-linked immunosorbent assay (ELISA) along with 155 healthy controls (HCONT). Clinical data were available on unfavourable disease outcome as well as disease activity and medical treatment during the prospective follow-up (median: 143 and 135 mths for CD and UC respectively).
In UC, median I-FABP level was significantly lower than in HCONT(177.2 vs. 244.3 pg/ml;
The presence of AAA and AGA reflects the ongoing mucosal damage in IBD rather than has a value in predicting the disease course.