Serum amyloid a as a surrogate marker for mucosal and histologic inflammation in patients with Crohn's disease

Andres J. Yarur, Maria A. Quintero, Anjali Jain, Frank Czul, Jamie S Barkin, Maria T Abreu

Research output: Contribution to journalArticle

10 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)158-164
Number of pages7
JournalInflammatory Bowel Diseases
Volume23
Issue number1
DOIs
StatePublished - Jan 1 2017

Fingerprint

Serum Amyloid A Protein
Amyloid
Crohn Disease
Biomarkers
Inflammation
C-Reactive Protein
Serum
Interleukin-6
Cytokines
Vascular Cell Adhesion Molecule-1
Acute-Phase Proteins
Cell Adhesion Molecules
Intercellular Adhesion Molecule-1
Colonoscopy
Interleukin-8
Interleukin-1
ROC Curve
Cross-Sectional Studies
Demography
Phenotype

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 journalArticle

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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.

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