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Published on: September 12, 2019
Serum concentrations of fibrosis markers in children with inflammatory bowel disease
Stanisław Pieczarkowski1, Kinga Kowalska-Deptuch2, Przemko Kwinta3
1Department of Pediatrics, Gastroenterology and Nutrition, Jagiellonian University Medical College Kraków, Poland.
Insights
N-terminal propeptide of type III procollagen (PIIINP) and YKL-40/CHI3L1 serum levels help monitor fibrosis in pediatric inflammatory bowel disease (IBD). PIIINP is a more accurate marker for fibrosis severity in Crohn
Area of Science:
- Pediatric Gastroenterology
- Biomarker Research
- Inflammatory Bowel Disease (IBD) Pathogenesis
Background:
- Inflammatory bowel disease (IBD) encompasses Crohn's disease (CD) and ulcerative colitis (UC), affecting children.
- Monitoring disease activity and fibrosis progression is crucial in pediatric IBD.
- Non-invasive biomarkers for fibrosis assessment are needed.
Purpose of the Study:
- To evaluate the utility of serum YKL-40/CHI3L1 and N-terminal propeptide of type III procollagen (PIIINP) in monitoring inflammation and fibrosis in pediatric IBD.
- To compare the fibrosis markers between CD and UC patients.
Main Methods:
- Serum concentrations of YKL-40/CHI3L1 and PIIINP were measured in 60 children with IBD (41 CD, 19 UC) at baseline and after 6-8 weeks of treatment.
- Statistical analysis, including the Kruskal-Wallis test, was used to compare marker levels.
Main Results:
- PIIINP concentrations were significantly higher in CD patients compared to UC patients at baseline and follow-up.
- Fibrosis severity, indicated by both YKL-40/CHI3L1 and PIIINP, increased in CD patients over 6-8 weeks.
- In UC patients, YKL-40/CHI3L1 and PIIINP levels decreased over the follow-up period.
Conclusions:
- Fibrosis is more severe in pediatric CD than in UC.
- PIIINP is a more accurate serum marker for differentiating fibrosis severity between CD and UC in children.
- YKL-40/CHI3L1 and PIIINP show potential for monitoring fibrosis in pediatric IBD.
Background And Study Aims:
The aim of the study was to assess the usefulness of serum concentrations of YKL-40/ CHI3L1 (a 40-kilodalton glycoprotein also referred to as chitinase 3 like- 1 - CHI3L1) and PIIINP (N-terminal propeptide of type III procollagen), markers of fibrosis, in the monitoring of inflammatory processes and fibrosis in children with inflammatory bowel disease (IBD).
Patients And Methods:
In 60 patients (41 with Crohn's disease (CD), 19 with ulcerative colitis (UC)) concentrations of investigated parameters were measured at baseline (day 0), after 3 and after 6-8 weeks of pharmacological treatment.
Results:
PIIINP concentrations were significantly higher in CD patients compared to UC (baseline results: median concentrations 1013.73 vs 78.30 ng/mL; P = 0.06 for the Kruskall-Wallis test; results at 6-8 weeks: 1076.48 vs 53.10 ng/mL, P = 0.01). Fibrosis was clearly present in patients with CD and its severity increased (reflected by both YKL-40/ CHI3L1 and PIIINP concentrations) in 6-8 weeks of follow up, regardless of the treatment used during that time. In patients with UC the levels of YKL-40/CHI3L1 and PIIINP were lower at baseline and further decreased after 6-8 weeks (median concentrations were respectively: 39.5 ng/mL vs 24.7 ng/mL and 78.3 ng/mL vs 53.1 ng/mL).
Conclusion:
Fibrosis was more severe in CD than in UC patients. The marker that more accurately reflected these differences was PIIINP.
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