Tu1118 Non-Invasive Determination of Disease Activity in Ulcerative Colitis by Serum Luminex Profiling

BACKGROUND Introducing a non-invasive method for determining disease activity is important in patients with ulcerative colitis (UC). So in this study, we aimed to assess the association between disease activity index and microalbuminuria in patients with UC. METHODS In the present cross-sectional study, 84 patients with UC were selected. The disease activity was calculated by the partial Mayo clinic score. Microalbuminuria was assessed using the immunoturbidimetric method in a first-voided sample in the morning in two consecutive days and the mean of these two measurements was reported as urinary microalbumin level. Serum C reactive protein (CRP), erythrocyte sedimentation rate (ESR), and fecal calprotectin were measured respectively using conventional turbidimetric immunoassay, Westergren method, and ELISA methods. RESULTS The mean age of the participants was 40.01 ± 12.85 years, 60.8% of them were female and 53.5% had microalbuminuria. The frequency of microalbuminuria was significantly higher in patients with active compared with inactive inflammatory bowel disease (IBD). There were significant differences between the patients with active and inactive disease regarding CRP, ESR, and calprotectin (p < 0.001). Moreover, there was a strong correlation between microalbuminuria and CRP (r = 0.89, p < 0.001), ESR (r = 0.92, p < 0.001), and calprotectin (r = 0.91, p < 0.001). CONCLUSION Microalbuminuria could be used as a non-invasive marker of disease activity in patients with UC.

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P198 Practical deep learning tool for the scoring of ulcerative colitis disease activity in central reading

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab076.324 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S263-S264

Author(s):

M Byrne ◽

J East ◽

M Iacucci ◽

S Travis ◽

R Kalapala ◽

...

Keyword(s):

Ulcerative Colitis ◽

Clinical Trials ◽

Disease Activity ◽

Video Quality ◽

Opinion Leaders ◽

Subject Matter Experts ◽

Web Based ◽

Software Interface ◽

Index Of Severity

Abstract Background Central Reading Org.& the pharma industry employ subject matter experts(SMEs)to score videos from sites participating in clinical trials for Ulcerative Colitis(UC).As we are developing Artificial Intelligence(AI)models for scoring purposes,we need to build a new software interface that can incorporate these AI models to aid SMEs,making their determination of the scores for each segment of the video & for the video as a whole.We propose a system that reduces the time for SMEs to review & score videos,improving the accuracy of scoring,with the help of our AI models. Methods We built a web-based interface supported by our AI models which can read,write multiple databases & data stores to read & display videos to be scored by a central reader, as well as the associated metadata required to improve the process.User interface shows a timeline with markers for the segments of the colon,with sections that are blurry,poorly prepped,or unscorable highlighted in different colours.While we could also highlight sections of the video with the precise score assigned to it by the AI,this would bias the central reader’s opinion.We hide the precise score generated by our AI models & instead display 3 colours for low,medium or high disease activity.When a video is loaded to be read by the user,the playback marker is set to the first high disease activity section based on known medical indexes such as the Mayo Endoscopic Subscore(MES) & UCEIS(Ulcerative Colitis Endoscopic Index of Severity),usually consists of a few seconds of video & that video is played back continuously in a loop until the reader selects the appropriate score for that section.When the reader saves the section,the software immediately moves the video cursor to the highest scored section of the video.That way the central reader can review only the relevant portions of the video to confirm the score assigned to each segment.If the central reader’s scores do not align well with the AI scores then the software continues to show more sections of the video to the user,including sections it may have labeled as unscorable,that may be scorable. Results The review of the system by 3 key opinion leaders,user experience was positive.Not only does the system allow the reader’s attention to be more efficiently used,but the interface allows both AI & central reader scores to be saved,allowing for the latter to be used iteratively to re-train & improve the underlying AI model(s).Our tool was also used by a gastroenterologist specialist in order to perform video quality assessment & colon sections scoring. Conclusion We developed an AI tool that can be used to improve the efficiency & accuracy of the central reading process in clinical trials for UC.Further work is ongoing to improve the interface.

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Serum Beta 2-Microglobulin as a Biomarker of Activity in Ulcerative Colitis

QJM ◽

10.1093/qjmed/hcaa052.031 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

E H Nashaat ◽

M M Mohamed ◽

T M Aziz ◽

M W Nakhla

Keyword(s):

Ulcerative Colitis ◽

Disease Activity ◽

Disease Severity ◽

Inactive Disease ◽

Control Group ◽

Active Ulcerative Colitis ◽

Presenting Symptoms ◽

Non Invasive ◽

Beta 2 ◽

Beta 2 Microglobulin

Abstract Background ulcerative colitis (UC) is a chronic, idiopathic, inflammatory bowel disease that causes inflammation and ulcers in the innermost layers of the large intestine (colon) and rectum. Assessment of intestinal inflammation in UC is crucial and still remains a difficult challenge for the clinician. Although endoscopic modalities with biopsy sampling seem to be the most reliable method for estimating disease severity, they are invasive and costly. Apart from endoscopic interventions, disease severity can be assessed using both laboratory studies and non-invasive imaging tests. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cells (WBCs), acid glycoprotein, platelet count and albumin are in common use but have only modest accuracy in reflecting UC disease activity. Therefore, adjunctive use of additional serum markers that will be more sensitive and specific for determination of disease activity and achieving diagnostic accuracy is strongly needed in daily clinical practice. Aim of the Work to investigate the diagnostic utility of beta 2 microglobulin (B2-M) levels and analyze this correlation with the activity of ulcerative colitis disease. Patients and Methods a case control study that was conducted at the Gastroenterology Clinic, Internal Medicine Department, Ain Shams University during the period of January to July 2018. 60 patients were recruited for the study. They were divided as follows; Group “A”: 40 patients newly diagnosed as ulcerative colitis based on colonoscopy and biopsy, subdivided as follows; 20 patients with active ulcerative colitis and 20 patients with inactive ulcerative colitis. Group “B”: 20 healthy individuals free from any systemic diseases serving as a control group. Results in this study, the serum levels of serum B2-microglobulins were highest in patients with active ulcerative colitis compared to those with inactive ulcerative colitis and the control groups. Also B2-microglobulins values become higher with higher number of presenting symptoms and endoscopic activity, which becomes higher in severe disease. Conclusion our results revealed that serum B2-microglobulin was simple and non-invasive marker that could be helpful for differentiating active UC from inactive disease. Moreover, it was more helpful when used together with serum laboratory inflammatory indices (ESR and CRP).

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P253 The prevalence of type 6 herpes with polyps in patients with inflammatory bowel disease

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.382 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S276-S276

Author(s):

G Babayeva-Sadigova ◽

Z Babayev ◽

U Mahmudov ◽

G Asadova ◽

F Quliyev ◽

...

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Crohn’S Disease ◽

Disease Activity ◽

Pyruvate Kinase ◽

Bowel Disease ◽

Herpes Viruses ◽

Intestinal Polyps ◽

Inflammatory Bowel

Abstract Background The prevalence of opportunistic infections in individuals with inflammatory bowel disease (IBD) remains relevant. Viral infections are a common cause of systemic inflammation of the digestive tract. Clinically expressed herpes infections are a serious problem, especially for individuals with prolonged immunosuppression. The aim of this study was t o assess the frequency of detection of herpes-6 type with polyps in patients with IBD. Methods 189 patients with IBD, 102 with ulcerative colitis and 87 with Crohn’s disease were examined. Of the number of patients: 98women, 91man. The age of the patients is from 16 to 63 years (mean age 41.4 ± 4.8), out of 189 patients intestinal polyps were identified in 61 patients with a colonoscopy. In addition to standard clinical and endoscopic examinations, disease activity was assessed by indicators of highly sensitive C-reactive protein, homocysteine, vitamin D in blood serum, albumin in urine, calprotectin, lactoferrin and pyruvate kinase in faeces. All patients underwent a serological blood test by ELISA for specific antibodies to herpesvirus type 1–6 IgG/IgM antibodies, as well as avidity, determination of DNA to herpes viruses of types 1–6 species by PCR in blood and mucosal biopsy. Results Among patients with IBD (n = 189), active herpes viruses in the blood were found in 65 patients (34.4%); of them, 39 patients (20.6% (n = 189) and 60%(n = 65),respectively) were diagnosed with monoherpesvirus infections, and 26 (13.7%(n = 189) and 40%(n = 65), respectively) of myxedvirus infections. PCR of the biopsy material was positive in isolation for type 6 herpes virus in 22 cases (11.6% (n = 189) and 33.8% (n = 65)) and in 34 cases (17.9% (n = 189) and 52.3% (n = 65)) a myxedvirus lesion was detected in the tissue (HV6 + EPB, HV6 + CMV), these indicators were detected in patients with intestinal polyps. Although clinical and endoscopic and laboratory indicators of disease activity were significantly higher in patients with mixed tissue lesions (p˂0.05), the level of faecal pyruvate kinase was higher in patients with polyps, indicating a negative effect of herpes type 6 on the course of inflammatory bowel diseases. At the same time, no significant differences were found between patients with ulcerative colitis and Crohn’s disease. Conclusion The frequency of occurrence of herpes type 6 on PCR biopsy in patients with polyps with IBD is more than 91.8% (36.5% in isolation and 55.7% of mixed lesions) and is accompanied by higher rates of faecal pyruvate kinase, which is already an indicator of emerging malignancy. The authors propose the determination of polyps in patients with IBD HV6 by PCR biopsy of intestinal tissue.

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