Serum biomarkers confirming stable remission in inflammatory bowel disease

Christoph Kessel,Markus Brueckner,Jan Däbritz,Miha Lavric,Dirk Foell,Toni Weinhage,Sebastiaan J Vastert,Sytze De Roock,Jakob Weber

doi:10.1038/s41598-021-86251-w

Abstract

Crohn's disease (CD) and ulcerative colitis (UC) have a chronic-remittent course. Optimal management of inflammatory bowel diseases (IBD) relies on early intervention, treat-to-target strategies and a tight disease control. However, it is challenging to assess the risk of relapses in individual patients. We investigated blood-based biomarkers for the confirmation of disease remission in patients with IBD. We retrospectively analyzed samples of 40 IBD patients (30 UC, 10 CD) enrolled in a tight-control follow-up study. Half of the patients had a flare during follow up. Serum was analyzed for S100A12 as well as S100A8/A9 and for 50 further biomarkers in a bead-based multiplex assay. The concentrations of 9 cytokines/chemokines and S100A8/A9 significantly differed in IBD patients with unstable remission (before flares) when compared to IBD patients with stable remission. Although the number of patients was small, ROC curve analyses revealed a number of biomarkers (IL-1β, IL-1RA, IL-8, IL13, IL-15, IL-21, IL-25, IFN-β, CXCL9, CXCL10, CXCL11, Galectin-1, G-CSF and S100A8/A9) that were elevated in patients with later occurring relapses. While earlier studies on peripheral biomarkers in IBD are limited to only few analytes, our study using a broad screening approach identified serum biomarkers with the potential to indicate unstable disease control in IBD, which may help to steer individual therapies to maintain remission.

Highlights

Biomarkers would be helpful in evaluating the risk for r elapses[11,12,13]
The effect of tight control management on Crohn’s disease (CALM) trial has demonstrated that treatment escalation based on symptoms combined with elevated serum CRP and/ or fecal calprotectin was better than symptom-based escalation alone[18]
In a previously published prospective 36-month multicenter study, we demonstrated the utility of fecal biomarkers to predict the flare risk in inflammatory bowel disease (IBD) patients after reaching inactive disease[25,26]

Summary

Introduction

Even though some biomarkers measured in blood or stool have been shown to offer variable degree of utility in monitoring gastrointestinal tract inflammation in IBD, in clinical practice there is still an unmet need for biomarkers that could assess the stability of disease remission and the risk of r elapse[14,15,16,17]. A need exists for blood-based biomarkers that accurately detect disease activity in IBD. In a previously published prospective 36-month multicenter study, we demonstrated the utility of fecal biomarkers to predict the flare risk in IBD patients after reaching inactive disease[25,26]. We aimed at identifying biomarker panels to identify patients who may need an optimized and/or intensified maintenance therapy to avoid disease flares

Methods

Results

Conclusion