Related Experiment Videos
Acute phase proteins in chronic inflammatory bowel disease in childhood
Insights
Acute phase proteins (APP) show elevated levels in children with Crohn's Disease (CD) or ulcerative colitis (UC). C-reactive protein levels predict disease relapse and are valuable for assessing prognosis in pediatric inflammatory bowel disease.
Area of Science:
- Pediatric Gastroenterology
- Clinical Chemistry
- Immunology
Background:
- Inflammatory bowel disease (IBD), including Crohn's Disease (CD) and ulcerative colitis (UC), presents diagnostic and prognostic challenges in children.
- Acute phase proteins (APPs) are biomarkers of inflammation, but their utility in pediatric IBD requires further elucidation.
Purpose of the Study:
- To evaluate the diagnostic and prognostic value of serum acute phase proteins (APPs) in pediatric patients with Crohn's Disease (CD) and ulcerative colitis (UC).
- To assess the correlation between APP levels, disease activity, and long-term outcomes in pediatric IBD.
Main Methods:
- Serum levels of five APPs (C-reactive protein, alpha 1-acid glycoprotein, alpha 1-antitrypsin, C9, and Factor B) were measured in 18 children with CD or UC and compared to two control groups.
- APP levels were monitored over 18–28 months, correlating with clinical disease activity and patient outcomes, including relapse and remission.
Main Results:
- Significantly elevated levels of all five APPs were observed in pediatric IBD patients compared to controls, with good separation.
- APP levels generally reflected disease activity but were not reliable as standalone screening tests; combination use improved reliability.
- C-reactive protein elevation predicted future relapse, even in asymptomatic patients, while normal levels indicated remission.
Conclusions:
- Serum APP measurements, particularly C-reactive protein, are valuable prognostic indicators in pediatric IBD.
- C-reactive protein measurement is especially useful for assessing disease activity and prognosis in children with mild symptoms, where clinical assessment is challenging.
Abstract:
The serum levels of five acute phase proteins (APP) were measured in 18 children with Crohn's Disease (CD) or ulcerative colitis (UC) and in two control groups. The levels of C-reactive protein, alpha 1-acid glycoprotein, alpha 1-antitrypsin, C9, and Factor B were significantly raised in patients with CD and UC with good separation from controls, but they were not entirely reliable used as screening tests unless used in combination. The levels of APP were monitored for periods varying from 18 to 28 months in each patient and found to reflect the disease activity in both CD and UC. On seven occasions the APP levels did not match the clinically assessed disease activity, but when the serum levels were related to outcome of the disease, C-reactive protein was found to be elevated--whether or not there were symptoms of the disease--in all patients who later had a relapse, while normal values were found in those who had a long remission. These results suggest that the estimation of Creative protein is of prognostic value and that its measurement is particularly useful in children with mild symptoms in whom disease activity and prognosis are difficult to assess.