A non-invasive comparison between NASH and Crohn's disease

Abstract Background Medications limiting the adhesion of ‘adherent and invasive E. coli’ (AIEC) represent potential strategies to treat Crohn’s disease (CD). However, the ileal AIEC identification is a time-consuming procedure, and the number of AIEC strains which colonise ileal CD mucosa remains unknown. There is an unmet need for non-invasive biomarkers to identify patients colonised by AIEC. We aimed to evaluate non-invasive biomarker of ileal AIEC colonisation in patients with CD. Methods This prospective and multi-centre study included CD patients requiring ileocoloscopy. Saliva, serum, stools and ileal biopsies were collected. Abundance and global invasive ability of ileal or faecal E. coli were performed. Isolated E. coli were characterised as AIEC or non-AIEC on I407 epithelial cells and THP1 macrophages. The ERIC-PCR profiles of ileal E. coli were performed. Ileal E. coli/CEACAM6 interaction was analysed by a yeast aggregation test and T84 assays (CEACAM6 protein expression, adhesion inhibition test with D-mannose). Quantification of serum anti-E. coli and ileal or salivary CEACAM6 was realised by ELISA. Results Overall, 102 CD patients were enrolled in this study and 25.8% of them exhibited ileal AIEC colonisation (AIEC+). The abundance and global invasive ability of ileal mucosa-associated E. coli were higher in AIEC+ CD patients compared with CD patients without AIEC (AIEC−) (p = 0.0065 and p = 0.0007, respectively). There was no difference between faecal abundance and invasive ability of E. coli between AIEC+ and AIEC− patients. The ERIC-PCR profiles of ileal E. coli showed that CD AIEC+ were for 78% of them colonised by not more than 2 clonal AIEC strains. In addition, AIEC were able to interact with CEACAM6 by binding D-mannose residues and to induce CEACAM6 expression in T84 cells (p = 0.0009 and p = 0.0185, vs. non-AIEC; respectively). This was also supported by adhesion inhibition test. Serum anti-E. coli level was higher for CD AIEC+ (vs. CD AIEC-). Ileal CEACAM6 level were positively correlated with abundance of ileal associated E. coli in AIEC+ patients (r = 0.4000; p = 0.0362) and with salivary CEACAM6 level (r = 0.4690; p < 0.0001). The non-invasive biomarker ‘serum anti-E.coli/salivary CEACAM6’ index was higher for CD AIEC+ (p = 0.0174; vs. CD AIEC-). A cut-off value < 1.34 × 10−6 eliminated the presence of ileal AIEC with a high negative predictive value (90% CI95% [69%–95%]). Conclusion Our study reported that identification of faecal AIEC cannot replace identification of AIEC from ileal biopsies, most of AIEC infection are mono or bi-clonal (≤ 2 strains) and that non-invasive biomarker such as ‘serum anti-E.coli/salivary CEACAM6’ index could be helpful to screen CD patients for AIEC infection.

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Serum adipokines as non-invasive biomarkers in Crohn’s disease

Scientific Reports ◽

10.1038/s41598-020-74999-6 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Lorena Ortega Moreno ◽

Ancor Sanz-Garcia ◽

Marina J. Fernández de la Fuente ◽

Ricardo Arroyo Solera ◽

Samuel Fernández-Tomé ◽

...

Keyword(s):

Logistic Regression ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Area Under The Curve ◽

Healthy Controls ◽

High Concentration ◽

Serum Samples ◽

Receiver Operating Characteristic Curves ◽

Non Invasive ◽

Healthy Control

Abstract Adipose tissue secretes molecules that can promote activity in Crohn’s disease. We aimed to evaluate the role of serum adipokines as possible biomarkers in Crohn’s disease. Serum samples were obtained from 40 patients with endoscopically active or quiescent Crohn’s disease and 36 healthy controls. Serum leptin, ghrelin, resistin and adiponectin levels were analysed by Multiplex in a Luminex 200 system technology. Receiver Operating Characteristic curves were performed to evaluate the adipokines discriminatory capacity. A logistic regression adjusted by possible confounders (i.e. gender, age, BMI) was performed for those adipokines that showed an area under the curve > 0.7. No differences were found in age, gender or BMI among groups. Distribution for serum resistin was different among the three groups of study, and only this adipokine showed an area under the curve of 0.75 comparing actives patients and healthy control groups. Resistin median concentration was selected as a cut-off for a logistic regression analysis; odds ratio along its 95% confidence interval adjusted by gender, age, and BMI yielded a value of 5.46 (1.34–22.14) comparing actives patients and healthy controls. High concentration of serum resistin is probably associated to activity, being this association independent of gender, age or BMI.

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P057 WIRELESS ELECTRODE PATCHES SHOW INTRAPATIENT REPRODUCIBILITY IN A LONGITUDINAL STUDY OF PATIENTS WITH CROHN’S DISEASE IN REMISSION

Inflammatory Bowel Diseases ◽

10.1093/ibd/zaa010.037 ◽

2020 ◽

Vol 26 (Supplement_1) ◽

pp. S16-S16

Author(s):

Steve Axelrod ◽

Lindsay Axelrod ◽

Anand Navalgund ◽

Estelle Spear ◽

Akshar Patel ◽

...

Keyword(s):

Small Intestine ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Motor Activity ◽

Myoelectric Activity ◽

Drug Induced ◽

Ipod Touch ◽

Frequency Spectra ◽

Non Invasive ◽

Specific Frequency

Abstract Background Crohn’s disease (CD) patients would benefit from a non-invasive indicator of gut function to better predict changes in disease state, such as the onset of flare. A study of CD patients using non-invasive wireless electrode patches (G-Tech Medical, Mountain View, CA) that read myoelectric signals from the gut over 3 days is underway at Stanford University’s IBD center. The study will include 40 patients presenting in flare and 30 in remission to be tested at t=0, 1, 3 and 6 months. In addition, one-time tests will be performed on 20 healthy controls. Aims Herein, we report on the first 6 CD patients tested at t=0 and 1 month while in remission. Methods Each patient wore 3 abdominal patches (each 2.7” diameter) for 3 consecutive days while pursuing regular daily activities and meals (Figure 1). Each patch recorded 4 channels of myoelectric activity from the stomach, small intestine and colon, and transmitted the raw data to an iPod Touch, which relayed the data to a secure cloud server. Data were later downloaded and processed to remove artifacts, create frequency spectra, and search them for peaks representing rhythmic motor activity. We find that, nominally, stomach activity appears at 3 cycles/minute (cpm), small intestine at 6–12 cpm, and colon at 12–25 cpm. Results Figure 2 shows peak spectra for the 6 patients at t=0 and 1 month. Individual peaks represent motor activity at a specific frequency associated with the stomach, small intestine, or colon. Each patient has a unique overall pattern, or GutPrint, reflecting the frequencies and levels of activity of their GI motility. The GutPrint for each individual reproduces well at the second test and is easily recognizable for each subject. Although the peak amplitudes may vary, virtually all of the peaks that appear at specific frequencies at t=0 are also present at 1 month representing a quantifiable signature that reflects each patient’s unique motility. Conclusion The G-Tech patch system provides a practical and noninvasive, physiologic means of measuring motor activity of the gut over multiple days. Its intra-patient reproducibility allows for the possibility of measuring changes to gut performance over time, whether naturally- or drug-induced, showing promise in CD monitoring.

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Intra-abdominal and pelvic abscess in Crohn's disease: results of non-invasive and surgical management

British Journal of Surgery ◽

10.1046/j.1365-2168.1998.00575.x ◽

1998 ◽

Vol 85 (3) ◽

pp. 367-371 ◽

Cited By ~ 70

Author(s):

Jawhari ◽

Kamm ◽

Ong ◽

Forbes ◽

Bartram ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Surgical Management ◽

Pelvic Abscess ◽

Non Invasive

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Monitoring and detection of disease recurrence after resection for Crohn’s disease: the role of non-invasive fecal biomarkers

Expert Review of Gastroenterology & Hepatology ◽

10.1080/17474124.2017.1356226 ◽

2017 ◽

Vol 11 (10) ◽

pp. 899-909 ◽

Cited By ~ 5

Author(s):

Takayuki Yamamoto ◽

Takahiro Shimoyama

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Disease Recurrence ◽

Non Invasive ◽

Fecal Biomarkers

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T1222 Small Animal PET-CT as a Non-Invasive Method to Evaluate Terminal Ileal Inflammation in a Murine Model of Crohn's Disease

Gastroenterology ◽

10.1016/s0016-5085(10)62377-3 ◽

2010 ◽

Vol 138 (5) ◽

pp. S-514-S-515 ◽

Cited By ~ 1

Author(s):

Pieter Hindryckx ◽

Steven Staelens ◽

Steven Deleye ◽

Harald Peeters ◽

Debby Laukens ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Murine Model ◽

Small Animal ◽

Small Animal Pet ◽

Animal Pet ◽

Non Invasive ◽

Pet Ct ◽

Invasive Method

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P138 Platelet-to-lymphocyte ratio index: a reliable tool for non-invasive assessment of endoscopic activity in small bowel Crohn’s Disease

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab076.265 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S225-S225

Author(s):

V Macedo Silva ◽

M Freitas ◽

S Xavier ◽

T Cúrdia Gonçalves ◽

P Boal Carvalho ◽

...

Keyword(s):

Crohn’S Disease ◽

Small Bowel ◽

Crohn's Disease ◽

Fecal Calprotectin ◽

Mucosal Healing ◽

C Reactive Protein ◽

Platelet To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Reactive Protein ◽

Non Invasive

Abstract Background The platelet-to-lymphocyte ratio (PLR) index has been a recent focus of investigation as a reliable marker of inflammation. This score was recently shown to have a good accuracy upon predicting endoscopic remission in patients with colonic Crohn’s Disease (CD). We aimed to assess the discriminative power of PLR index in patients with isolated small bowel CD. Methods Single center study of consecutive patients with isolated small bowel CD (L1 ± L4 disease according to Montreal classification) who underwent small bowel capsule endoscopy (SBCE) for assessment of endoscopic activity between January 2019 and December 2020. Only complete SBCEs were considered. CD endoscopic activity was classified according to the Lewis score (LS) value. Complete blood count, C-reactive protein and fecal calprotectin values were collected within 1 month of SBCE. Results Final sample included 49 patients, 35 (71.4%) of them females, with a mean age of 35.1±11.8 years. SBCE reported mucosal healing (LS<135) in 30.6% of the patients; mild activity (135≤LS<790) in 42.9% and moderate-to-severe activity (LS≥790) in 26.5% of the patients. PLR index positive correlation with LS was significant and moderate (k=0.597; p<0.001). This correlation was stronger than the one seen between fecal calprotectin (k=0.525; p=0.001) or C-reactive protein (k=0.321; p=0.029) and the LS score. In particular, PLR index presented an excellent accuracy for predicting patients with a moderate-to-severe endoscopic activity (AUC=0.908; 95%CI=0.816–0.999; p<0.001), with an optimal cut-off of PLR above 157 (sensitivity 92.3%; specificity 82.9%). The accuracy for prediction of mucosal healing was good (AUC=0.743; 95%CI=0.600–0.887; p=0.007), with an optimal cut-off of PLR below 126 (sensitivity 66.7%; specificity 80.0%). Conclusion PLR index demonstrated an excellent acuity for predicting patients with moderate to severe disease in small bowel CD. Moreover, it also demonstrated good acuity for predicting mucosal healing on this set of patients. These results come from a significant correlation of PLR index with endoscopic activity in small bowel CD. Our findings establish this index as a promising and easy-to-apply tool for non-invasive and regular follow-up of patients with small bowel CD.

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