Vitamin D Status Is Associated with Intestinal Inflammation as Measured by Fecal Calprotectin in Crohn’s Disease in Clinical Remission

2015 ◽  
Vol 60 (8) ◽  
pp. 2427-2435 ◽  
Author(s):  
Tara Raftery ◽  
Megan Merrick ◽  
Martin Healy ◽  
Nasir Mahmud ◽  
Colm O’Morain ◽  
...  
Keyword(s):  
Vitamin D ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Clinical Remission ◽  
Intestinal Inflammation ◽  
Fecal Calprotectin ◽  
Vitamin D Status

scholarly journals Higher Predicted Vitamin D Status Is Associated With Reduced Risk of Crohn's Disease

2012 ◽  
Vol 142 (3) ◽  
pp. 482-489 ◽  
Author(s):  
Ashwin N. Ananthakrishnan ◽  
Hamed Khalili ◽  
Leslie M. Higuchi ◽  
Ying Bao ◽  
Joshua R. Korzenik ◽  
...  
Keyword(s):  
Vitamin D ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Vitamin D Status ◽  
Reduced Risk

scholarly journals Seasonality of vitamin D status and bone turnover in patients with Crohn's disease

2005 ◽  
Vol 21 (9) ◽  
pp. 1073-1083 ◽  
Author(s):  
D. McCarthy ◽  
P. Duggan ◽  
M. O'Brien ◽  
M. Kiely ◽  
J. McCarthy ◽  
...  
Keyword(s):  
Vitamin D ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bone Turnover ◽  
Vitamin D Status

scholarly journals P286 Ustekinumab for Crohn’s Disease: Two-Year Results of the Initiative on Crohn and Colitis (ICC) Registry, a Nationwide Prospective Observational Cohort Study

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S319-S320
Author(s):  
T Straatmijer ◽  
V B C Biemans ◽  
F Hoentjen ◽  
N K H de Boer ◽  
A G Bodelier ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Real World ◽  
Clinical Remission ◽  
Prospective Cohort ◽  
Upper Airway ◽  
Fecal Calprotectin ◽  
Regular Care ◽  
Observational Cohort

Abstract Background Ustekinumab is a monoclonal antibody that selectively targets p40, a shared subunit of the cytokines interleukin (IL)-12 and IL-23. It is registered for the treatment of Crohn’s disease (CD) and ulcerative colitis. We assessed the two-year efficacy and safety of ustekinumab in a real world, prospective cohort of CD patients. Methods CD patients who started ustekinumab in regular care were prospectively enrolled in the nationwide Initiative on Crohn and Colitis Registry. At week 0, 12, 24, 52 and 104, clinical remission (HBI ≤ 4 points), biochemical remission (fecal calprotectin (FC) ≤200 μg/g and/or CRP ≤5 mg/L), peri-anal fistula remission, extra-intestinal manifestations, ustekinumab dosage and safety outcomes were determined. Patients starting therapy less than two years ago were excluded for the current evaluation. The primary outcome was corticosteroid-free clinical remission at week 104. Results In total, 252 CD patient with at least two years of follow up were included. Of all included patients, the proportion of patients in corticosteroid-free clinical remission at week 12, 24, 52 and 104 was 32.3% (81/251), 41.4% (104/251), 39% (97/249) and 34.0% (84/247), respectively. Of the 97 patients in corticosteroid free clinical remission at week 52, 58 (59.8%) were still in corticosteroid-free clinical remission at week 104. In patients with combined clinical and biochemical disease activity at baseline (n=122), the corticosteroid-free clinical remission rates were 23.8% (29/122), 35.2% (43/122), 40.0% (48/120) and 32.8% (39/119) at week 12, 24, 52 and 104, respectively. The probability of remaining on ustekinumab treatment after 52 and 104 weeks was 64.3% and 54.8%, respectively. There were no predictive factors associated with corticosteroid-free clinical remission at week 104 on univariate and multivariate analysis. Most common adverse events were headache, skin reaction and musculoskeletal complaints. Two patients stopped ustekinumab due to an infection after 8 and 30 weeks of treatment (mild fever syndrome and moderate upper airway infection, respectively). The main reason for discontinuing treatment after 52 weeks was loss of response (66.7%). Conclusion Ustekinumab was effective and relatively safe in our real world, prospective cohort of CD patients. After 104 weeks of ustekinumab treatment, one third of patients were in corticosteroid-free clinical remission.

Mucosal Biomarker of Innate Immune Activation Predicts Response to Vedolizumab in Crohn’s Disease

2019 ◽  
Author(s):  
Mark T Osterman ◽  
Ilyssa O Gordon ◽  
Elisabeth M Davis ◽  
Matthew Ciorba ◽  
Sarah C Glover ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Clinical Response ◽  
Immune Activation ◽  
Clinical Remission ◽  
Response Rate ◽  
Intestinal Inflammation ◽  
Innate Immune ◽  
Clinical Response Rate ◽  
Innate Immune Activation

Abstract Objective Mucosal barrier dysfunction plays a crucial role in intestinal inflammation in Crohn’s disease (CD). Intestinal epithelial cell (IEC) death resulting from innate immune activation, termed pyroptosis, was recently found to be a cause of this barrier defect. The aim of this study was to determine the predictive value of pretreatment ileal biopsy pyroptosis as a biomarker for clinical response to vedolizumab in CD. Design Crohn’s disease patients ranging 18 to 80 years old from 5 IBD centers with pre-vedolizumab ileal biopsies during colonoscopy were enrolled. Biopsies were stained for activated caspases, and levels of ileal IEC pyroptosis levels were quantified. The primary outcome was clinical response 6 months after therapy, defined as a reduction of Harvey-Bradshaw Index (HBI) of ≥5 points from baseline. Secondary outcomes included clinical remission, defined as HBI <5, and endoscopic improvement, as measured by the Simple Endoscopic Score for Crohn’s Disease (SES-CD). Results One hundred CD patients (45 male, 55 female), median age 47 (19, 78) years, were included; clinical response rate was 60%, and clinical remission was 36%. The response rate in patients with ileal pyroptosis <14 positive cells per 1000 IECs was significantly higher than those above the threshold: 89% (25 of 28) vs 49% (35 of 72), odds ratio (OR) 8.8 (95% CI, 2.3–48.6; P < 0.001). Corresponding remission rates were 54% (15 of 28) vs 29% (21 of 72; OR 2.8 [1.03–7.59; P = 0.036]). For endoscopic improvement, ileal pyroptosis of 22 positive cells per 1000 IECs was the optimal threshold that determines the magnitude SES-CD change. Conclusions Ileal biopsy IEC pyroptosis was predictive of clinical response and endoscopic improvement to vedolizmab in CD patients.

Vitamin D status in children with inflammatory bowel disease

2021 ◽  
Vol 19 (1) ◽  
pp. 5-10
Author(s):  
I.Yu. Pronina ◽  
◽  
V.S. Tsvetkova ◽  
A.S. Potapov ◽  
E.L. Semikina ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Vitamin D ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Vitamin D Status ◽  
Vitamin D Levels ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Objective. To study vitamin D status in children with inflammatory bowel diseases (IBD) depending on the diagnosis, gender, age and a season of examination. Patients and methods. The study included 244 children (130 boys and 114 girls) aged 3 to 18 years. The patients were divided into 2 groups depending on the nosological form of disease: Crohn’s disease (CD) – 130 children, ulcerative colitis (UC) – 114 children. Blood vitamin D levels were determined by the method of competitive electrochemiluminescence. Results. Normal levels of vitamin D (>30 ng/ml) were found only in 11.1% of children with IBD (in 11.5% with CD and 10.5% with UC). Vitamin D status corresponded to deficiency levels in 65.9% of cases, of them 15.2% had deep deficiency (<10 ng/ml). Vitamin D status decreased with increasing age of the patients (ρ = -0.2686). No statistically significant differences were found in vitamin D levels that would be dependent on the season of examination, neither were they found in groups of patients with CD and UC. Conclusion. The study showed an extremely low vitamin D status in patients with IBD. The problem of assessing vitamin D levels in children with IBD and its monitoring as well as development of individual algorithms for supplementation remains topical. Key words: vitamin D, inflammatory bowel disease, Crohn’s disease, ulcerative colitis, children

scholarly journals Vitamin D metabolites are lower with active Crohn’s disease and spontaneously recover with development of remission

2019 ◽  
Vol 12 ◽  
pp. 175628481986514 ◽  
Author(s):  
Craig Haifer ◽  
Ian C. Lawrance ◽  
Jacqueline R. Center ◽  
Michael W. Clarke ◽  
Prue H. Hart ◽  
...  
Keyword(s):  
Vitamin D ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Intestinal Inflammation ◽  
Inactive Disease ◽  
Breakdown Product ◽  
Vitamin D Metabolites ◽  
Vitamin D Metabolism ◽  
Hydroxyvitamin D ◽  
Liquid Chromatography Tandem Mass

Background: Vitamin D deficiency is associated with active Crohn’s disease (CD). However, it remains unclear if lower 25-hydroxyvitamin D [25(OH)D] concentration is the cause, or consequence, of intestinal inflammation. Existing literature has focused on circulating 25(OH)D rather than the active metabolite 1,25(OH)2D, or its breakdown product, 24,25(OH)2D. We aimed to characterise vitamin D metabolism in a cohort of patients with active and inactive CD. Methods: Fifty-four patients with CD and not on corticosteroids or vitamin D supplements, were enrolled in a 6-month prospective cohort study. Sera were collected on enrolment and at 6 months and tested for 25(OH)D, 1,25(OH)2D, 24,25(OH)2D using liquid chromatography tandem mass spectroscopy as well as vitamin-D-binding protein. Results: There were no differences in 25(OH)D or 1,25(OH)2D levels between participants with active versus inactive disease. Levels of 24,25(OH)2D were significantly lower in those with active compared with inactive disease (mean 3.9 versus 6.0 µmol/l; p = 0.007) and therefore the ratio of 25(OH)D:24,25(OH)2D was higher (mean 17.3 versus 11.1; p = 0.001). In those patients with active disease who achieved remission, there was a mean increase in 25(OH)D of 32.3 nmol/l (i.e. to a level in the sufficient range) and 24,25(OH)2D of 2.1 µmol/l. These increases were not seen in patients with persistently active or inactive disease. Conclusion: Levels of 24,25(OH)2D, but not 25(OH)D, were lower in patients with active CD, and spontaneously increased with resolution of underlying inflammation. The utility of 24,25(OH)2D as a biomarker of disease activity and vitamin D status in CD warrants further exploration.

scholarly journals Serum MMP-9: a novel biomarker for prediction of clinical relapse in patients with quiescent Crohn’s disease, a post hoc analysis

2019 ◽  
Vol 12 ◽  
pp. 175628481988159 ◽  
Author(s):  
Doron Yablecovitch ◽  
Uri Kopylov ◽  
Adi Lahat ◽  
Michal M. Amitai ◽  
Eyal Klang ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Intestinal Inflammation ◽  
Area Under The Curve ◽  
Fecal Calprotectin ◽  
Clinical Relapse ◽  
Post Hoc Analysis ◽  
Reactive Protein ◽  
Increased Risk ◽  
Post Hoc

Background: Matrix metalloproteinase-9 (MMP-9) is a novel marker of intestinal inflammation. The aim of this study was to assess if serum MMP-9 levels predict clinical flare in patients with quiescent Crohn’s disease (CD). Methods: This study was a post hoc analysis of a prospective observational study in which quiescent CD patients were included and followed until clinical relapse or the end of a 2-year follow-up period. Serial C-reactive protein (CRP) and fecal calprotectin (FC) levels were measured, and the patients underwent repeated capsule endoscopies (CEs) every 6 months. Small bowel inflammation was quantified by Lewis score (LS) for CE. A baseline magnetic resonance enterography was also performed, and MaRIA score was calculated. Serum MMP-9 levels in baseline blood samples were quantified by ELISA. Results: Out of 58 eligible enrolled patients, 16 had a flare. Higher levels of baseline MMP-9 were found in patients who developed subsequent symptomatic flare compared with patients who did not [median 661 ng/ml, 25–75 interquartile range (IQR; 478.2–1441.3) versus 525.5 ng/ ml (339–662.7), respectively, p = 0.01]. Patients with serum MMP-9 levels of 945 ng/ ml or higher were at increased risk for relapse within 24 months [area under the curve (AUC) of 0.72 [95% confidence interval (CI): 0.56–0.88]; hazard ratio 8.1 (95% CI 3.0–21.9, p < 0.001)]. Serum MMP-9 concentrations showed weak and moderate correlation to baseline LS and FC, respectively ( r = 0.31, p = 0.02; r = 0.46, p < 0.001). No correlation was found between serum MMP-9 to CRP and MaRIA score. Conclusions: Serum MMP-9 may be a promising biomarker for prediction of clinical flare in CD patients with quiescent disease.

scholarly journals The Association of Vitamin D Status with Disease Activity in a Cohort of Crohn’s Disease Patients in Canada

Nutrients ◽  
2017 ◽  
Vol 9 (10) ◽  
pp. 1112 ◽  
Author(s):  
Dania Alrefai ◽  
Jennifer Jones ◽  
Wael El-Matary ◽  
Susan Whiting ◽  
Abdulrahman Aljebreen ◽  
...  
Keyword(s):  
Vitamin D ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Vitamin D Status
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