Su1259 Additional Item of Fecal Hemoglobin As a Marker for Mucosal Inflammation to Rachmilewitz's Clinical Activity Index Is Useful for the Assessment of the Activity of Ulcerative Colitis

Abstract Background In this study, we investigated the importance of netrin-1 levels in ulcerative colitis (UC) in clinical activity of the disease, and its association with other proinflammatory cytokines IL-6 and TNF-α. Methods This study is a type of case–control study. Sixty-seven patients with UC (36 of them activation, 31 of remission) and 50 healthy controls were included in the study. UC patients; ‘Truelove Witts clinical activity index by remission (n = 31), mild activation (n = 21), moderate activation (n = 6) and severe activation (n = 9) were divided into groups. Netrin, IL-6 and TNF-α measurements in plasma samples were performed using enzyme-linked immunosorbent assay kit. Results Between the patient group and the control group; there was a statistically significant difference between netrin-1, IL-6, TNF-α, neutrophil, platelet (p < 0.05 for all). The plasma netrin-1 mean of UC with severe activation group (139.21 ± 48.09 pg/ml) was statistically significantly higher than that of the mild activation (p = 0,037), remission group (p = 0,001) and control group(p = 0,011). The plasma netrin-1 mean of UC with moderate activation group was statistically significantly higher than that of the mild activation(p = 0,045) and remission group(p = 0,004). Conclusion Our results reveal that plasma netrin-1 levels have been shown to be associated with UC activation, similar to proinflammatory cytokines such as TNF-α and IL-6, in UC.

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Obestatin/Ghrelin Ratio as a New Activity Index in Ulcerative Colitis

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol04-i04/623 ◽

2019 ◽

Vol 4 (04) ◽

Author(s):

Mohammed Amin Mohammed ◽

Nesreen Moustafa Omar

Keyword(s):

Ulcerative Colitis ◽

Disease Activity ◽

Mrna Expression ◽

Activity Index ◽

Strong Relationship ◽

Serum Levels ◽

Ghrelin Level ◽

Mucosal Inflammation ◽

Predictive Values ◽

Serum Ghrelin

Background and Aim: Ulcerative colitis (UC) is an immune-mediated systemic inflammatory process that destroys the intestinal mucosa. Ghrelin, an appetite-regulatory hormone, has anti-inflammatory effects including a decrease in circulating cytokines. Some reports demonstrated a strong relationship between the serum ghrelin level and the severity of mucosal inflammation in the gastrointestinal tract. The aim is to investigate serum levels and colonic mucosal mRNA expression of ghrelin, obestatin, and obestatin/ghrelin ratio in patients with UC and to determine their potential as markers for UC disease activity. Patients and Methods: seventy-five outpatients with UC and 45 age- and sex-matched healthy volunteers were enrolled in this study after written conscious consent and approval by the Institutional Review Board of Mansoura University. UC was diagnosed by conventional clinical, radiological, endoscopic, and histopathological criteria. Serum ghrelin, obestatin levels, and their mucosal mRNA expression were measured by ELISA kits and a real-time quantitative reverse transcriptase polymerase chain reaction according to the manufacturer’s protocols. Results: Serum levels and mucosal mRNA expression of ghrelin were significantly higher in patients with active UC than patients in remission p˂0.0001). Obestatin/ghrelin ratio was significantly lower in patients with active UC (0.26±0.08) than those in remission (0.523±0.16; p˂0.0001). Obestatin/ghrelin ratio was negatively and significantly correlated with inflammation and endoscopic scores, colitis activity index, serum ghrelin level, and its mucosal mRNA expression (p˂0.05). Conclusion: obestatin/ghrelin ratio might be a reliable surrogate non-invasive marker of disease activity in UC with significantly high sensitivity, specificity, predictive values, and diagnostic accuracy.

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The Th17/Treg Immune Imbalance in Ulcerative Colitis Disease in a Chinese Han Population

Mediators of Inflammation ◽

10.1155/2016/7089137 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 11

Author(s):

Yang Gong ◽

Yifan Lin ◽

Ning Zhao ◽

Xiaojuan He ◽

Aiping Lu ◽

...

Keyword(s):

Ulcerative Colitis ◽

Healthy Subjects ◽

Activity Index ◽

Treg Cells ◽

Clinical Activity ◽

Endoscopic Evaluation ◽

Chinese Han ◽

Han Population ◽

Immune Balance ◽

Immune Imbalance

Objective. To investigate the Th17/Treg immune balance in the ulcerative colitis (UC) patients in a Chinese Han population. Methods. Ninety UC patients and 30 healthy subjects were enrolled. The serum IL-17 and TGF-β1 levels of these participants were measured with ELISA; the percentage of Th17 and Treg cells in peripheral blood was determined with flow cytometry. Results. In UC patients, the levels of IL-17 and Th17 were significantly higher compared with healthy subjects; the percentage of Th17 and IL-17 level in moderate and severe subgroup was significantly higher than in mild subgroup; a positive correlation existed between these two indexes and clinical activity index and endoscopic evaluation. TGF-β1 level and Treg cells in UC patients were lower than healthy subjects. TGF-β1 level in moderate and severe subgroup was lower than in mild subgroup. There was a negative linear correlation between Treg cells and clinical activity index, endoscopic evaluation. A positive correlation was detected between Treg cells and TGF-β1 level. Conclusions. Th17/Treg immune imbalance might play a crucial role in the development of UC. To induce the production of Treg cells and TGF-β1, inhibit the level of Th17 and IL-17, and thus recover the Th17/Treg immune balance might imply new therapeutic targets in UC management.

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P581 Baseline clinical activity index appears to predict clinical and endoscopic response in patients with ulcerative colitis undergoing intensive granulocyte and monocyte apheresis

Journal of Crohn s and Colitis ◽

10.1016/s1873-9946(13)60602-9 ◽

2013 ◽

Vol 7 ◽

pp. S243

Author(s):

A. Aisaka ◽

B. Iiduka ◽

A. Ito ◽

M. Takahashi ◽

T. Ohmori ◽

...

Keyword(s):

Ulcerative Colitis ◽

Activity Index ◽

Clinical Activity

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Effect of Aqueous Extract of Trigonella Foenum-Graecum L. Seeds On Acetic Acid- Induced Ulcerative Colitis In Rats

10.21203/rs.3.rs-490956/v1 ◽

2021 ◽

Author(s):

Aqsa Fathima ◽

Shivaprakash Gangachannaiah ◽

Ujjal Bose ◽

Shama Prasada K ◽

Rituparna Chakraborty ◽

...

Keyword(s):

Ulcerative Colitis ◽

Acetic Acid ◽

Activity Index ◽

Antioxidant Properties ◽

Herbal Product ◽

Treated Group ◽

Mucosal Inflammation ◽

Inflammatory Disorder ◽

Trigonella Foenum Graecum ◽

Trigonella Foenum Graecum L

Abstract Ulcerative colitis is an inflammatory disorder affecting colonic mucosa, characterized by intense inflammation and mucosal damage. The currently available medical treatment is not completely safe and effective in alleviating the disease manifestations and its complications. The present study aimed to evaluate the protective effect of herbal product Trigonella foenum-graecum L. (TFG) seeds in acetic acid induced Ulcerative colitis (UC) in rats. The TFG extract was administered orally at two doses of 500 and 1000 mg/kg body weight. Compared to UC group, the TFG treated group showed significantly reduced severity of the disease as indicated by decreased Disease Activity Index (DAI) and decreased intensity of mucosal inflammation as indicated by macroscopic and histological scoring. Furthermore, biochemical assessment showed increased total protein, reduced glutathione (GSH), catalase (CAT), superoxide dismutase (SOD), and decreased malonaldehyde (MDA) and pro-inflammatory cytokine TNF-α levels in TFG treated group compared to the UC group. The study demonstrates the beneficial effect of TFG in UC by its natural anti-inflammatory and antioxidant properties.

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Fecal Calprotectin and Clinical Disease Activity in Pediatric Ulcerative Colitis

ISRN Gastroenterology ◽

10.1155/2013/179024 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 15

Author(s):

Kaija-Leena Kolho ◽

Dan Turner

Keyword(s):

Ulcerative Colitis ◽

Clinical Outcome ◽

Roc Curve ◽

Clinical Remission ◽

Activity Index ◽

Fecal Calprotectin ◽

Elisa Test ◽

Clinical Activity ◽

High Level ◽

Active Disease

Objective. To explore fecal calprotectin levels in pediatric ulcerative colitis (UC) in relation with the validated clinical activity index PUCAI. Methods. This study included all 37 children (median age 14 years) with UC who had calprotectin measured (PhiCal ELISA Test) by the time of PUCAI assessment at the Children's Hospital of Helsinki in a total of 62 visits. Calprotectin values <100 μg/g of stool were considered as normal. The best cut-off value of each measure to predict 3-month clinical outcome was derived by maximizing sensitivity and specificity. Results. In clinically active disease (PUCAI ≥ 10), calprotectin was elevated in 29/32 patients (91% sensitivity). When in clinical remission, 26% (8/30) of the children had normal calprotectin but 7 (23%) had an exceedingly high level (>1000 μg/g). The best cut-off value for calprotectin for predicting poor outcome was 800 μg/g (sensitivity 73%, specificity 72%; area under the ROC curve being 0.71 (95%CI 0.57–0.85)) and for the PUCAI best cut-off values >10 (sensitivity 62%, specificity 64%; area under the ROC curve 0.714 (95%CI 0.58–0.85)). Conclusion. The clinical relevance of somewhat elevated calprotectin during clinical remission in pediatric UC is not known and, until further evidence accumulates, does not indicate therapy escalation.

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P710 The influence of probiotics to the efficacy of 5-ASA for the patients of ulcerative colitis

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.838 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S573-S574

Author(s):

R YASUDA ◽

K Uchiyama ◽

T Takagi ◽

M Kubota ◽

S Sugino ◽

...

Keyword(s):

Ulcerative Colitis ◽

Colonic Mucosa ◽

Activity Index ◽

Time Dependent ◽

Clinical Activity ◽

Release Formulation ◽

Significant Difference ◽

Ph Dependent ◽

Disease Location ◽

Index Disease

Abstract Background 5-ASA is a key drug to treat the patients with mild-to-moderate ulcerative colitis (UC). Probiotics is sometimes used to UC patients for the purpose to correct dysbiosis of intestine. In theory, the efficacy of 5-ASA, especially pH-dependent release formulation of mesalazine may be weakened by the co-treatment with probiotics because of its effect leading to acidic condition in large intestine. However, the detail analysis about UC patients treating with 5-ASA and probiotics has not been elucidated. In the present study, we demonstrated the clinical course of UC patients treated by 5-ASA with probiotics to investigate the effect of probiotics to 5-ASA treatment. Methods The subjects were 85 UC patients who were in clinical remission and taking 5-ASA at the hospital of Kyoto Prefectural University of Medicine from January to March 2014. The clinical characteristics (age, sex, clinical activity index, disease location, and type of 5-ASA) and the rate of relapse until October 2019 were compared between probiotics group and no probiotics group. Furthermore, the rates of relapse were analysed for each specific 5-ASA between probiotics user and no probiotics user. The clinical activity index (CAI) was determined using Lichtiger index. The relapse of UC is defined by the increase of CAI, additional medication for UC, and endoscopic deterioration of colonic mucosa. Results Patients were included 39 cases in probiotics group and 46 cases in no probiotics group. There was no significant difference between probiotics and no probiotics group on the average age (53.1 ± 16.8 vs. 51.3 ± 14.2 years old, p = 0.59), the rate of male gender (41.0% vs. 41.3%, p =0.97), the average CAI (2.1 ± 0.64 vs. 2.0 ± 0.73, p = 0.59), disease location (extensive/left/rectum: 20/7/12 vs. 21/10/15 cases, p = 0.31), and type of 5-ASA (salazosulfapyridine/time-dependent mesalazine/pH-dependent mesalazine: 5/18/16 vs. 6/18/22 cases, p = 0.46). Besides, there was no significant difference between probiotics group and no probiotics group (51.3% vs. 52.2%, p = 0.93) about the rate of relapse. Regarding each specific 5-ASA usage, there was no significant difference on salazosulfapyridine (40.0% vs. 33.3%, p = 1), time-dependent mesalazine (44.4% vs. 50.0%, p = 1), and pH-dependent mesalazine (62.5% vs. 59.1%, p = 0.90) between probiotics user and no probiotics user. Conclusion In the present study, the co-treatment with probiotics did not affect the relapse with UC patients regardless the type of 5-ASA, suggesting that the usage of probiotics might not disturb the efficacy of 5-ASA for UC patients.

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Therapeutic Efficacy of pH-Dependent Release Formulation of Mesalazine on Active Ulcerative Colitis Resistant to Time-Dependent Release Formulation: Analysis of Fecal Calprotectin Concentration

BioMed Research International ◽

10.1155/2014/342751 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Kousaku Kawashima ◽

Shunji Ishihara ◽

Takafumi Yuki ◽

Koji Onishi ◽

Yoshinori Kushiyama ◽

...

Keyword(s):

Ulcerative Colitis ◽

Clinical Efficacy ◽

Activity Index ◽

Fecal Calprotectin ◽

Mucosal Healing ◽

Time Dependent ◽

Clinical Activity ◽

Active Ulcerative Colitis ◽

Release Formulation ◽

Ph Dependent

Purpose. Few reports have compared the clinical efficacy of a pH-dependent release formulation of mesalazine (pH-5-ASA) with a time-dependent release formulation (time-5-ASA). We examined whether pH-5-ASA is effective for active ulcerative colitis (UC) in patients resistant to time-5-ASA.Methods. We retrospectively and prospectively analyzed the efficacy of pH-5-ASA in mildly to moderately active UC patients in whom time-5-ASA did not successfully induce or maintain remission. The clinical efficacy of pH-5-ASA was assessed by clinical activity index (CAI) before and after switching from time-5-ASA. In addition, the efficacy of pH-5-ASA on mucosal healing (MH) was evaluated in a prospective manner by measuring fecal calprotectin concentration.Results. Thirty patients were analyzed in a retrospective manner. CAI was significantly reduced at both 4 and 8 weeks after switching to pH-5-ASA. In the prospective study (n=14), administration of pH-5-ASA also significantly reduced CAI scores at 4 and 8 weeks in these patients who were resistant to time-5-ASA. In addition, fecal calprotectin concentration was significantly decreased along with improvement in CAI after switching to pH-5-ASA.Conclusions. Our results suggest that pH-5-ASA has clinical efficacy for mildly to moderately active patients with UC in whom time-5-ASA did not successfully induce or maintain remission.

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Endoscopic score vs blood cell indices for determining timing of immunomodulator withdrawal in quiescent ulcerative colitis

Scientific Reports ◽

10.1038/s41598-019-54369-7 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 1

Author(s):

Kazuhiro Takenaka ◽

Keiichi Tominaga ◽

Mimari Kanazawa ◽

Koh Fukushi ◽

Takanao Tanaka ◽

...

Keyword(s):

Ulcerative Colitis ◽

Blood Cell ◽

Activity Index ◽

Mucosal Healing ◽

Clinical Activity ◽

Monitoring Methods ◽

Mean Cell Volume ◽

Remission Maintenance ◽

Significant Difference ◽

Activity Index Score

AbstractWhile immunomodulators (IMs) are used as key drugs in remission maintenance treatment for ulcerative colitis (UC), there has been no evidence to date for determining monitoring methods and drug withdrawal. Therefore, we examined if a decrease in white blood cell count (WBC) and an elevation in mean cell volume (MCV) could be used as optimization indices and if mucosal healing (MH) could be a rationale for determining the time of IM withdrawal. Subjects were 89 UC patients who were using IMs and for whom clinical remission had been maintained. Those with a Rachmilewitz Clinical Activity Index score of 4 or lower and those with a Mayo endoscopic subscore (MES) of 0 or 1 were defined as MH. The remission maintenance rates of the following comparative groups were examined: an IM continuation group and an IM withdrawal group; an IM continuation group with a WBC of less than 3000 or a MCV of 100 or greater and an IM continuation group with a WBC of 3000 or greater and a MCV of 99 or lower; an IM continuation group of patients for whom MH had been achieved and an IM continuation group of patients for whom MH had not been achieved; and an IM withdrawal group with a MES of 0 and an IM withdrawal group with a MES of 1. A significantly higher remission maintenance rate was observed in the IM continuation group compared to the withdrawal group (p < 0.01). No significant difference was observed between the IM continuation group with a WBC of less than 3000 or a MCV of 100 or greater and the IM continuation group with a WBC of 3000 or greater and a MCV of 99 or lower (p = 0.08). Higher remission maintenance rates were observed in the IM continuation group of patients for whom MH had been achieved compared to the IM continuation group of patients for whom MH had not been achieved (p = 0.03). No significant difference was observed between the IM withdrawal group with MES 0 and the IM withdrawal group with MES 1. (p = 0.48). This retrospective study showed that remission maintenance could be firmly obtained by continuing IM administration in case of endoscopic MH; however, MH was not an indicator of IM withdrawal.

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