Surrogate markers of intestinal inflammation are predictive of relapse in patients with inflammatory bowel disease
Open accessAbstract
Background & aims Prediction of relapse of inflammatory bowel disease has important implications for therapeutic strategies. We assessed whether measurement of intestinal permeability and inflammation could predict relapse of inflammatory bowel disease (IBD).Methods Forty-three patients with Crohn's disease (CD) and 37 with ulcerative colitis (UC) in clinical remission provided a stool sample to be assayed for calprotectin (a neutrophil-specific marker), and patients with CD additionally underwent a small intestinal permeability test. Relapse was defined using clinical disease activity indices.Results Twenty-five (58%) patients with CD and 19 (51%) with UC had a relapse over the 12-month period. Median calprotectin levels in the relapse groups (122 mg/L for CD, 123 mg/L for UC; normal <10 mg/L) differed significantly (P<0.0001) from those of the nonrelapse groups (41.5 mg/L for CD, 29.0 mg/L for UC). At 50 mg/L, the sensitivity and specificity of calprotectin for predicting relapse in all patients with IBD were 90% and 83%, respectively. Permeability in the CD patients who relapsed (median, 0.075; normal <0.04) differed significantly (P = 0. 004) from that in the nonrelapse group (median, 0.038). At the level of 0.05, the sensitivity and specificity of permeability in predicting relapse were 84% and 61%, respectively.Conclusions Fecal calprotectin predicts clinical relapse of disease activity in patients with CD and UC, whereas small intestinal permeability is a useful predictor of relapse in patients with small intestinal CD.
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Other objective measures associated with disease activity for IBD, such as fecal calprotectin, gut permeability, or gut lavage fluid protein, have high sensitivity for the presence or absence of active disease.
“Other objective measures associated with disease activity for IBD such as fecal calprotectin 31 , gut permeability 32 or gut lavage fluid protein have high sensitivity for presence or absence of active disease 33 .”
From The Manitoba IBD Index: Evidence for a New and Simple Indicator of IBD Activity (2009) · cites this paper as [31]
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- Authors
- Tibble, J. A., Sigthorsson, G., Bridger, S., Fagerhol, M. K., & Bjarnason, I.
- Affiliations
- Oslo University Hospital (NO)
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2000-07
- Volume
- 119
- Issue
- 1
- Pages
- 15-22
- ISSN
- 0016-5085 (ISSN-L)
- OpenAlex
- W1987064800
- Cited by
- 759
- References
- 40
- Citations by year
- 2026: 7 · 2025: 10 · 2024: 13 · 2023: 18 · 2022: 21 · 2021: 23 · 2020: 21 · 2019: 24 · 2018: 33 · 2017: 38 · 2016: 49 · 2015: 38 · 2014: 43 · 2013: 42 · 2012: 36
- FWCI
- 11.27
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
- Health Sciences › Medicine › Epidemiology › Microscopic Colitis
- Keywords
- inflammatory bowel disease, Crohn's disease, ulcerative colitis, recurrence prediction, fecal calprotectin, intestinal permeability, small intestinal permeability, intestinal inflammation, surrogate markers, clinical remission
- MeSH terms
- Adolescent, Adult, Aged, Colitis, Ulcerative, Crohn Disease, Enteritis, Feces, Female, Humans, Intestinal Mucosa, Male, Membrane Glycoproteins, Middle Aged, Permeability, Prognosis, Recurrence, Sensitivity and Specificity, Biomarkers, Neural Cell Adhesion Molecules, Leukocyte L1 Antigen Complex
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