Abstract

inflammatory bowel disease (IBD). Only limited data are available about the diagnostic accuracy of fecal matrix metalloprotease (MMP)-9 in IBD. The aims of our prospective study was to assess the diagnostic accuracy of fecal MMP-9 in patients with active Crohn’s disease (CD), ulcerative colitis (UC) and pouchitis assessed by clinical, endoscopic and histological scores and to compare the diagnostic accuracy of fecal MMP-9 and fecal calprotectin (CP) in IBD. Methods: Stool and blood samples were collected in 52 CD, 34 UC and 33 ileal pouch-anal anastomosis patients before control endoscopy. Biopsies were taken for histology. The activities of CD, UC and pouchitis were defined with the use of clinical, endoscopic and histological activity scores (CDAI, partial Mayo score, PDAI, SES-CD, Mayo endoscopic subscore, D’Haens and Riley score). Fecal CP and MMP-9 levels were quantified by use of enzyme-linked immunosorbent assay. Results: Active CD, UC and pouchitis was detected in 33.9%, 58.8% and 30.3% of the patients. Significant correlation was shown between the clinical, endoscopic and histological activities and fecal MMP-9 concentration in UC and pouchitis. Fecal CP concentration did not correlate with the clinical, endoscopic and histological activities of either UC or pouchitis. In CD, fecal CP correlated with the clinical, endoscopic and histological activities of the disease, and although fecal MMP9 concentration did not show significant correlation with SES-CD, stronger correlation was observed than in case of CP considering the clinical and histological activities of CD. Conclusions: This is the first study assessing the diagnostic accuracy of MMP-9 in different types of IBD. Our results showed that fecal MMP-9 has an exclusively high specificity in the detection of active UC and pouchitis and it also correlates stronger than fecal CP with the clinical and histological activities of CD. Further studies are needed to confirm these results.

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