Author/Authors :
velikova, tsvetelina veselinova university hospital lozenetz, bulgaria , spassova, zoya angelova university hospital st. ivan rilski - clinic of gastroenterology, bulgaria , milatchkov, lyuben mitkov university hospital st. ivan rilski - clinic of gastroenterology, bulgaria , panova, dobriana georgieva university hospital st. ivan rilski - clinic of gastroenterology, bulgaria , ivanova - todorova, ekaterina ivanova university hospital st. ivan rilski - department of clinical laboratory and clinical immunology, bulgaria , tumangelova - yuzeir, kalina dinkova university hospital st. ivan rilski - department of clinical laboratory and clinical immunology, bulgaria , kurteva, ekaterina krasimirova university hospital st. ivan rilski - department of clinical laboratory and clinical immunology, bulgaria , kyurkchiev, dobroslav stanimirov university hospital st. ivan rilski - department of clinical laboratory and clinical immunology, bulgaria , deredjan, siragan arshavir university hospital st. ivan rilski - clinic of gastroenterology, bulgaria , nikolov, rosen kirilov university hospital st. ivan rilski - clinic of gastroenterology, bulgaria , altankova, iskra petrova university hospital lozenetz, bulgaria , vladimirova, lyudmila mateva university hospital st. ivan rilski - clinic of gastroenterology, bulgaria
Abstract :
background: fecal and immunological biomarkers can be used to diagnose and manage patients with crohn’s disease (cd). anti - tumor necrosis factor (tnf) should be evaluated in addition to biomarkers to determine the response to therapy. objectives: the current study aimed at following up fecal calprotectin (fc), perinuclear anti - neutrophil cytoplasmic antibodies (panca), anti - saccharomyces cerevisiae antibodies (asca), and anti - nuclear antibodies (ana) in patients with cd on anti-tnf therapy. methods: a total of 57 patients with cd and the mean age of 40 ± 15 years (ranged: 20 - 75) were monitored after initiation of anti - tnfa treatment. stool samples were tested for fc (alegria automated the enzyme - linked immunosorbent assay (elisa) system), and serum samples for anca, ana (indirect immunofluorescence - iif), and asca (elisa) in the beginning and after six months on immunosuppressive therapy plus anti - tnfa agents. results: it was observed that all patients with cd had significantly decreased fc levels after anti - tnfa therapy (963.97 mg/kg initially vs. 268.42 mg/kg after treatment; p = 0.043). moreover, in 75% of patients, fc levels dropped below the cutoff value of 50 mg/kg. positive for asca iga/igg were 17/24 tested patients, but no differences were observed regarding the application of anti - tnfa therapy. however, the titers of panca decreased in four patients after anti - tnfa treatment. conclusions: initial and follow - up measurements of some immunological markers such as fc and panca could be of benefit for patients with cd in anti - tnf therapy, whereas others such as ana and asca were not useful to monitor the therapy.
