The role of inflammatory biomarkers in patients with ulcerative colitis and concomitant arterial hypertension, possibilities of treatment

Abstract

Objective — to evaluate and compare inflammatory biomarkers (faecal calprotectin, serum zonulin) in patients with ulcerative colitis (UC) and concomitant arterial hypertension (AH) before and after use of the mesalazine medication (Pentasa, Ferring International Center, Switzerland). Materials and methods. The study involved 96 patients with UC aged 18 to 60 years. Patients underwent outpatient blood pressure measurement to assess the presence of arterial hypertension (AH). As a result, patients were allocated into two groups: group I consisted of patients with UC and concomitant AH (n=49; mean age 41.2±12.31 years, median age 38 years) and group II included patients with UC without concomitant AH (n=47; mean age 40.2±10.82 years, median age 41 years). All patients underwent physical examination. The diagnosis of UC was confirmed histologically with a preliminary colonoscopy. Endoscopic assessment of UC severity was performed according to the Mayo ulcerative colitis system. Clinically and endoscopically, patients were classified as having mild to moderate UC activity. The assessment of changes in inflammatory biomarkers (faecal calprotectin, serum zonulin levels) was performed in the groups both before treatment and after 6 weeks of mesalazine administration at a dose of 5.0 g/daily (4.0 g per os and 1.0 g per rectum). Faecal calprotectin levels were determined by enzyme‑linked immunosorbent assay (Bühlmann fCAL Elisa). Serum zonulin levels were determined by Elisa, IDK Zonulin Elisa (Immunodiagnostic AG, Germany). Statistical processing of the data was performed using licensed statistical packages «Statistica 10». Results. The average level of faecal calprotectin in group I was (367.05±148.23) mg/g, in group II - 319.57±146.65 mg/g. The difference of faecal calprotectin levels in groups I and II before and after treatment wasn’t significant (p=0.124 and р=0.263, respectively). The mean serum zonulin level in group I was 75.09±15.94 ng/ml, and in group II - 65.98±11.40 ng/ml. Serum zonulin levels after the treatment in group I were better than in group II, p=0.041. Serum zonulin is highly sensitive for assessing intestinal permeability in patients with UC and concomitant arterial hypertension. Conclusions. The use of the Pentasa medication by patients with UC proved to be effective owing to its active anti‑inflammatory effects on pathologically altered areas of the intestinal wall. Assessment of inflammation biomarkers, such as faecal calprotectin and serum zonulin, is safe, affordable, non‑invasive methods that can be used to monitor treatment of patients with UC and concomitant arterial hypertension. Pentasa can be used in patients both with isolated ulcerative colitis and in combination with hypertension