Can serum histone H4 levels predict mucosal healing in Crohn's disease?
Ibrahim Hakki Köker1, Bilge Sumbul Gultepe1, Sercan Kiremitçi1
1Department of Gastroenterology, Medicine Faculty, Bezmialem Vakif University, Fatih, Istanbul, Turkey.
Insights
Serum histone H4 is elevated in Crohn's disease (CD) patients and may predict mucosal healing (MH). Higher levels indicate no MH or symptoms, suggesting its potential as a biomarker.
Area of Science:
- Gastroenterology
- Inflammation Biomarkers
- Crohn's Disease Research
Background:
- Mucosal healing (MH) is a key treatment goal in Crohn's disease (CD) management.
- Histone H4 levels are known to increase during chronic inflammation.
Purpose of the Study:
- To investigate serum histone H4 as a predictor of mucosal healing in ileocecal CD.
- To compare histone H4 levels between CD patients and healthy controls.
- To correlate histone H4 levels with endoscopic findings and symptoms in CD.
Main Methods:
- Included 44 ileocecal CD patients and 26 healthy controls.
- Assessed mucosal healing via ileocolonoscopy.
- Measured serum histone H4 levels before endoscopy.
- Compared histone H4, CRP, and ESR between groups.
Main Results:
- Serum histone H4 was significantly higher in CD patients versus controls (p=0.002).
- Higher histone H4 levels were observed in CD patients with no MH (p=0.028) and symptomatic patients (p=0.033).
- CRP and ESR did not differ significantly based on MH or symptoms.
Conclusions:
- Serum histone H4 shows potential as a biomarker for predicting mucosal healing in CD patients.
- Further validation in larger patient cohorts is recommended.
Introduction:
Mucosal healing (MH) has been a treatment target with the introduction of biological agents in Crohn's disease (CD). Histone H4 increases in chronic inflammation.
Aim:
Our goal was to investigate the role of serum histone H4 in predicting MH.
Material And Methods:
The study included 44 patients who applied to the endoscopy unit for ileocolonoscopic evaluation with the diagnosis of ileocecal CD and 26 healthy controls. After ileocolonoscopic evaluation, we divided the patients into 2 groups: those with and those without MH, according to the presence of endoscopic ulcer or erosion findings. Blood samples were taken from these patients to analyse serum histone H4 before the endoscopic procedure. We first compared serum histone H4 levels between CD patients and the healthy control group and then between those with and those without MH among the CD patients. Finally, we compared CRP, ESR, and serum histone H4 levels in patients with CD according to the presence of MH and symptoms.
Results:
Serum histone H4 levels were significantly higher in ileocolonic CD patients compared to the healthy control group (p = 0.002). Also, serum histone H4 levels were significantly higher in CD patients with no MH (p = 0.028) or symptomatic patients (p = 0.033). We did not find a significant difference in C-reactive protein and erythrocyte sedimentation rate levels between CD patients in the presence of MH (p = 0.281 and p = 0.203, respectively) or symptoms (0.779 and 0.652, respectively).
Conclusions:
Serum histone H4 might be a useful biomarker for MH prediction in ileocolonoscopic CD patients. Validation is needed for large numbers of patients.
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