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Surrogate Markers of Intestinal Inflammation in Paediatric Patients with Inflammatory Bowel Disease
Rayna Shentova1, Mila Baycheva1, Denitza Kofinova1
1Department of Gastroenterology and Hepatology, Prof. Ivan Mitev University Pediatric Hospital, Medical University of Sofia, Sofia, Bulgaria.
Insights
Faecal calprotectin effectively monitors intestinal inflammation in children with inflammatory bowel disease (IBD). This non-invasive biomarker correlates strongly with disease activity, offering a valuable alternative to frequent endoscopies.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Biomarker Discovery
Background:
- Endoscopic evaluation is standard for IBD monitoring but is invasive and challenging for frequent use in children.
- There is a need for non-invasive methods to assess disease activity in pediatric IBD patients.
- This study investigates inflammatory biomarkers as potential surrogates for endoscopic assessment.
Purpose of the Study:
- To evaluate the correlation between various inflammatory biomarkers and the degree of intestinal inflammation in pediatric patients with IBD.
- To identify reliable non-invasive markers for monitoring IBD activity in children.
- To compare the efficacy of different biomarkers in assessing disease severity.
Main Methods:
- A single-center study included 31 children with ulcerative colitis (UC) and 22 with Crohn's disease (CD).
- Blood and stool samples were analyzed for inflammatory markers including C-reactive protein, albumin, and fecal calprotectin.
- Endoscopic evaluation using validated scoring systems (Mayo Endoscopic Subscore, Simple Endoscopic Score for Crohn's Disease) assessed disease activity.
Main Results:
- Fecal calprotectin showed the strongest correlation with endoscopic disease activity in both UC (r=0.867) and CD (r=0.872) patients (p<0.001 for both).
- Albumin and C-reactive protein also correlated significantly with disease activity in UC patients.
- C-reactive protein and erythrocyte sedimentation rate demonstrated significant correlations in CD patients.
Conclusions:
- Fecal calprotectin is a valuable and reliable surrogate marker for intestinal inflammation in pediatric IBD.
- This non-invasive biomarker aids in monitoring disease activity, reducing the need for frequent invasive procedures.
- Fecal calprotectin offers a practical tool for managing pediatric IBD patients.
Background:
Endoscopic evaluation is the gold standard for monitoring the disease activity in inflammatory bowel disease (IBD) but the procedure is invasive and not appropriate for frequent use, especially in the paediatric population. The aim of the present study was to assess the correlation between the levels of several inflammatory biomarkers and the degree of intestinal inflammation in paediatric patients with IBD.
Materials And Methods:
A single center study including 31 children with ulcerative colitis (UC) and 22 children with Crohn's disease (CD) with different disease duration and activity. All participants provided blood samples to measure the levels of white blood cell count, platelets, C-reactive protein, erythrocyte sedimentation rate, albumin and fibrinogen, and faecal samples for measurement of faecal calprotectin and faecal alpha-1 antitrypsin. All participants underwent endoscopic evaluation. Endoscopic disease activity was assessed according to the Mayo Endoscopic Subscore and Simple Endoscopic Score for Crohn's Disease in UC and CD patients, respectively.
Results:
135 visits were included: 73 for UC patients and 62 for CD patients. In UC patients the strongest correlation was between the Mayo Endoscopic Subscore and the faecal calprotectin (r=0.867, p<0.001) followed by the albumin (r=0.523, p<0.001) and the C-reactive protein (r=0.487, p<0.001). In CD the strongest correlation was between the Simple Endoscopic Score for Crohn's disease and the faecal calprotectin (r=0.872, p<0.001) followed by the C-reactive protein (0.708, p<0.001) and the erythrocyte sedimentation rate (0.605, p<0.001).
Conclusions:
The faecal calprotectin is a valuable surrogate marker of intestinal inflammation that is useful for monitoring of a disease activity in paediatric patients with IBD.
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