Abstract
Background: Serum amyloid A (SAA) is an acute-phase protein, but its role as a biomarker of disease activity in Crohn's disease is unclear. The aim of the study was to assess the correlation between SAA, inflammatory cytokines, and mucosal inflammation in patients with Crohn's disease and to investigate whether this marker might be useful in patients who do not have elevated C-reactive protein (CRP) levels despite having active disease. Methods: Cross-sectional study including patients with Crohn's disease who underwent colonoscopies for assessment of disease activity. Predictive variables were recorded at the time of the procedure and included demographics, phenotype of disease, medications, and collection of serum for cytokine analysis (SAA, CRP, intercellular adhesion molecule-1, vascular cell adhesion molecule-1, and interleukins 8, 1β, and 6). The primary outcome was the presence of mucosal healing (MH) (absence of macroscopic and microscopic inflammation). Results: Ninety-four patients were included. Sixty-eight (72.3%) had not achieved MH. SAA, CRP, intercellular adhesion molecule, and interleukin-6 levels were significantly lower in those patients with MH. SAA was the only test that performed well in the sensitivity/specificity analysis (receiver operating characteristic: 0.81, P = 0.046). A high SAA was able to identify 70% of the patients with a normal CRP but active inflammation. Conclusions: High circulating SAA levels can correlate with lack of MH and may be used as a surrogate marker for disease activity, even in those patients in whom CRP levels do not correlate with disease activity.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 158-164 |
| Number of pages | 7 |
| Journal | Inflammatory Bowel Diseases |
| Volume | 23 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 1 2017 |
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Keywords
- biomarkers
- Crohn's disease
- cytokines
- disease activity measurements
- mucosal healing
- serum amyloid
- ulcerative colitis
ASJC Scopus subject areas
- Immunology and Allergy
- Gastroenterology
Cite this
Serum amyloid a as a surrogate marker for mucosal and histologic inflammation in patients with Crohn's disease. / Yarur, Andres J.; Quintero, Maria A.; Jain, Anjali; Czul, Frank; Barkin, Jamie S; Abreu, Maria T.
In: Inflammatory Bowel Diseases, Vol. 23, No. 1, 01.01.2017, p. 158-164.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Serum amyloid a as a surrogate marker for mucosal and histologic inflammation in patients with Crohn's disease
AU - Yarur, Andres J.
AU - Quintero, Maria A.
AU - Jain, Anjali
AU - Czul, Frank
AU - Barkin, Jamie S
AU - Abreu, Maria T
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Background: Serum amyloid A (SAA) is an acute-phase protein, but its role as a biomarker of disease activity in Crohn's disease is unclear. The aim of the study was to assess the correlation between SAA, inflammatory cytokines, and mucosal inflammation in patients with Crohn's disease and to investigate whether this marker might be useful in patients who do not have elevated C-reactive protein (CRP) levels despite having active disease. Methods: Cross-sectional study including patients with Crohn's disease who underwent colonoscopies for assessment of disease activity. Predictive variables were recorded at the time of the procedure and included demographics, phenotype of disease, medications, and collection of serum for cytokine analysis (SAA, CRP, intercellular adhesion molecule-1, vascular cell adhesion molecule-1, and interleukins 8, 1β, and 6). The primary outcome was the presence of mucosal healing (MH) (absence of macroscopic and microscopic inflammation). Results: Ninety-four patients were included. Sixty-eight (72.3%) had not achieved MH. SAA, CRP, intercellular adhesion molecule, and interleukin-6 levels were significantly lower in those patients with MH. SAA was the only test that performed well in the sensitivity/specificity analysis (receiver operating characteristic: 0.81, P = 0.046). A high SAA was able to identify 70% of the patients with a normal CRP but active inflammation. Conclusions: High circulating SAA levels can correlate with lack of MH and may be used as a surrogate marker for disease activity, even in those patients in whom CRP levels do not correlate with disease activity.
AB - Background: Serum amyloid A (SAA) is an acute-phase protein, but its role as a biomarker of disease activity in Crohn's disease is unclear. The aim of the study was to assess the correlation between SAA, inflammatory cytokines, and mucosal inflammation in patients with Crohn's disease and to investigate whether this marker might be useful in patients who do not have elevated C-reactive protein (CRP) levels despite having active disease. Methods: Cross-sectional study including patients with Crohn's disease who underwent colonoscopies for assessment of disease activity. Predictive variables were recorded at the time of the procedure and included demographics, phenotype of disease, medications, and collection of serum for cytokine analysis (SAA, CRP, intercellular adhesion molecule-1, vascular cell adhesion molecule-1, and interleukins 8, 1β, and 6). The primary outcome was the presence of mucosal healing (MH) (absence of macroscopic and microscopic inflammation). Results: Ninety-four patients were included. Sixty-eight (72.3%) had not achieved MH. SAA, CRP, intercellular adhesion molecule, and interleukin-6 levels were significantly lower in those patients with MH. SAA was the only test that performed well in the sensitivity/specificity analysis (receiver operating characteristic: 0.81, P = 0.046). A high SAA was able to identify 70% of the patients with a normal CRP but active inflammation. Conclusions: High circulating SAA levels can correlate with lack of MH and may be used as a surrogate marker for disease activity, even in those patients in whom CRP levels do not correlate with disease activity.
KW - biomarkers
KW - Crohn's disease
KW - cytokines
KW - disease activity measurements
KW - mucosal healing
KW - serum amyloid
KW - ulcerative colitis
UR - http://www.scopus.com/inward/record.url?scp=85002057652&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85002057652&partnerID=8YFLogxK
U2 - 10.1097/MIB.0000000000000991
DO - 10.1097/MIB.0000000000000991
M3 - Article
C2 - 27930409
AN - SCOPUS:85002057652
VL - 23
SP - 158
EP - 164
JO - Inflammatory Bowel Diseases
JF - Inflammatory Bowel Diseases
SN - 1078-0998
IS - 1
ER -