Abstract
Background: Inflammatory bowel diseases (IBD), ulcerative colitis (UC), and Crohn’s disease (CD), represent systematic chronic conditions with a deficient intestinal absorption. We first attempt to investigate the serum bile acids (sBAs) profile in a large cohort of IBD patients to evaluate changes under anti-TNF alpha treatment. Methods: Forty CD and 40 UC patients were enrolled and BAs were quantified by high-pressure liquid chromatography-electrospray-tandem mass spectrometry (HPLC-ES-MS/MS). Up to 15 different sBAs concentrations and clinical biomarkers where added to a Principal Component Analysis (PCA) to discriminate IBD from healthy conditions and treatment. Results: PCA allowed a separation into two clusters within CD (biologic-free patients and patients treated with anti-TNF alpha drugs and healthy subjects) but not UC. The first included CD. CD patients receiving anti-TNF alpha have an increase in total sBAs (4.11 ± 1.23 μM) compared to patients not exposed. Secondary BAs significantly increase after anti-TNF alpha treatment (1.54 ± 0.83 μM). Furthermore, multivariate analysis based on sBA concentration highlighted a different qualitative sBAs profile for UC and CD patients treated with conventional therapy. Conclusion: According to our results, anti-TNF alpha in CD restores the sBA profile by re-establishing the physiological levels. These findings indicate that, secondary BAs might serve as an indirect biomarker of the healing process.
Highlights
Inflammatory bowel diseases (IBD), which include ulcerative colitis (UC) and Crohn’s disease (CD), represent chronic inflammatory conditions with a deficient intestinal absorption as well as an impaired hepatic spill over
Principal Component Analysis (PCA) allowed a separation into two clusters within CD but not UC
Multivariate analysis based on serum bile acids (sBAs) concentration highlighted a different qualitative sBAs profile for UC and CD patients treated with conventional therapy
Summary
Inflammatory bowel diseases (IBD), which include ulcerative colitis (UC) and Crohn’s disease (CD), represent chronic inflammatory conditions with a deficient intestinal absorption as well as an impaired hepatic spill over. These alterations lead to non-physiological concentration of bile acids (BAs) in peripheral blood, bile, and intestinal content [1]. Inflammatory bowel diseases (IBD), ulcerative colitis (UC), and Crohn’s disease (CD), represent systematic chronic conditions with a deficient intestinal absorption. We first attempt to investigate the serum bile acids (sBAs) profile in a large cohort of IBD patients to evaluate changes under anti-TNF alpha treatment. Up to 15 different sBAs concentrations and clinical biomarkers where added to a Principal Component Analysis (PCA) to discriminate IBD from healthy conditions and treatment
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