Dynamics of Some Routine Immunological Parameters During Anti - TNF Therapy in Patients with Crohn’s Disease

Document Type : Research/Original Article

Authors

1 Clinical Immunology, University Hospital Lozenetz, Sofia, Bulgaria

2 Clinic of Gastroenterology, University Hospital St. Ivan Rilski, Sofia, Bulgaria

3 Department of Clinical Laboratory and Clinical Immunology, University Hospital St. Ivan Rilski, Sofia, 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 4015 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: Itwasobserved that all patients withCDhadsignificantly decreased FC levels after anti -TNFatherapy (963.97mg/kginitially
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 ASCAIgA/IgG were 17/24 tested patients, butnodifferences 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.

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