Abstract
Abstract Background The treatment of ulcerative colitis (UC) has advanced significantly with the introduction of targeted medications, such as IL-23-Inhibitors. However, treatment success in inflammatory bowel diseases (IBD) varies and requires reliable biomarkers to assess therapeutic efficacy. Tryptophan (Trp), an essential amino acid, plays a central role in gut metabolism and immune modulation. Recent studies have shown that Trp metabolism is associated with inflammatory processes and correlates with IBD activity. Aim of the Study We hypothesized that Trp can serve as a reliable marker for assessing treatment success in patients with UC undergoing Mirikizumab therapy. To test this, Trp levels were correlated with established laboratory parameters (leukocytes, C-reactive protein in serum (CRP), fecal Calprotectin (fCal), as well as clinical parameters (IBD Disc). Methods Laboratory and clinical parameters during induction and maintenance therapy of four patients with UC who were treated with Mirikizumab were analyzed. Using SPSS, the Spearman correlation coefficient was used to examine the correlations between Trp and established markers. Results A significant negative correlation between Trp and CRP (n = 18, rs = −0.75, p < 0.001) suggests that lower Trp levels are associated with increased inflammatory activity. Correlations with leukocyte count (n = 18, rs = 0.27, p = 0.39), fCal (n = 10, rs = −0.33, p = 0.35), and the IBD Disk Score (n = 14, rs = −0.25, p = 0.40) were weak and not significant. Conclusion The significant correlation between Trp and CRP suggests that Trp could serve as a potential monitoring tool for assessing the inflammatory status in UC patients undergoing Mirikizumab therapy. However, Trp appears to have limited value as a standalone marker, and no cut-off levels have been established. Further prospective studies with larger sample sizes are necessary to confirm the clinical relevance of Trp as a biomarker for treatment response to Mirikizumab. References Harris, D. M. M., Szymczak, S., Schuchardt, S., Labrenz, J., Tran, F., Welz, L., Graßhoff, H., Zirpel, H., Sümbül, M., Oumari, M., Engelbogen, N., Junker, R., Conrad, C., Thaçi, D., Frey, N., Franke, A., Weidinger, S., Hoyer, B., Rosenstiel, P., … Aden, K. (2024). Tryptophan degradation as a systems phenomenon in inflammation-an analysis across 13 chronic inflammatory diseases. www.thelancet.com Nikolaus, S., Schulte, B., Al-Massad, N., Thieme, F., Schulte, D. M., Bethge, J., Rehman, A., Tran, F., Aden, K., Häsler, R., Moll, N., Schütze, G., Schwarz, M. J., Waetzig, G. H., Rosenstiel, P., Krawczak, M., Szymczak, S., & Schreiber, S. (2017). Increased Tryptophan Metabolism Is Associated With Activity of Inflammatory Bowel Diseases. Gastroenterology, 153(6). https://doi.org/10.1053/j.gastro.2017.08.028
Published Version
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