Serum Globulin Is Associated with Endoscopic Findings and Mucosal Healing in Japanese Patients with Ulcerative Colitis

Published on Feb 4, 2021in Digestive Diseases and Sciences2.751
· DOI :10.1007/S10620-021-06834-5
Kana Shiraishi1
Estimated H-index: 1
(Ehime University),
Shinya Furukawa26
Estimated H-index: 26
(Ehime University)
+ 19 AuthorsYoichi Hiasa53
Estimated H-index: 53
(Ehime University)
Sources
Abstract
Background Serum globulin is an inflammation marker. To date, no evidence regarding the association between serum globulin and disease activity in patients with ulcerative colitis has been reported. Aims We evaluated the association between serum globulin and endoscopic activity in patients with ulcerative colitis. Methods Serum globulin was divided into tertiles based on the distribution of study subjects (low globulin, ≤ 2.7 g/dl (reference); moderate globulin, 2.7-3.1 g/dl; and high globulin, > 3.1 g/dl). A single endoscopic specialist evaluated the endoscopic findings, and mucosal healing was based on Mayo endoscopic subscore. Results A total of 277 patients with ulcerative colitis were included in the study. Serum globulin was independently positively associated with diminished or absent vascular markings [moderate: adjusted odds ratio (OR) 3.70 (95% confidence interval, CI: 1.82-7.88) and high: adjusted OR 2.40 (95%CI: 1.20-4.94), p for trend = 0.005]. A similar positive association between globulin and erosion was found [high: adjusted OR 2.00 (95%CI: 1.05-3.86)]. Serum globulin was independently inversely associated with mucosal healing [moderate: adjusted OR 0.37 (95%CI: 0.18-0.73) and high: adjusted OR 0.31 (95%CI: 0.14-0.64), p for trend = 0.001] and adjusted partial mucosal healing [moderate: OR 0.51 (95%CI: 0.26-0.98), p for trend = 0.048]. The inverse association between globulin and mucosal healing was significant in the low but not the high C-reactive protein group. Conclusions In patients with ulcerative colitis, serum globulin was significantly positively associated with endoscopic activity, and was significantly inversely associated with mucosal healing, especially in the low C-reactive protein group.
References15
Newest
#1Jean-Frederic Colombel (ISMMS: Icahn School of Medicine at Mount Sinai)H-Index: 164
#2Geert R. D'Haens (UvA: University of Amsterdam)H-Index: 76
Last. Remo Panaccione (U of C: University of Calgary)H-Index: 83
view all 5 authors...
BACKGROUND AND AIMS: Management of Crohn's disease and ulcerative colitis has typically relied upon treatment intensification driven by symptoms alone. However, a 'treat-to-target' management approach may help to address underlying inflammation, minimise disease activity at early stages of inflammatory bowel disease, limit progression, and improve long-term outcomes. METHODS: A systematic literature review was conducted to identify data relevant to a treat-to-target approach in inflammatory bowe...
48 CitationsSource
#1Seung Hoon Lee (Catholic University of Korea)H-Index: 15
#2Jeong eun Kwon (Catholic University of Korea)H-Index: 1
Last. Mi-La Cho (Catholic University of Korea)H-Index: 56
view all 3 authors...
Inflammatory bowel disease (IBD) is a chronic inflammatory state of the gastrointestinal tract and can be classified into 2 main clinical phenomena: Crohn's disease (CD) and ulcerative colitis (UC). The pathogenesis of IBD, including CD and UC, involves the presence of pathogenic factors such as abnormal gut microbiota, immune response dysregulation, environmental changes, and gene variants. Although many investigations have tried to identify novel pathogenic factors associated with IBD that are...
134 CitationsSource
#1Shailja C. Shah (ISMMS: Icahn School of Medicine at Mount Sinai)H-Index: 17
#2Jean-Frederic Colombel (ISMMS: Icahn School of Medicine at Mount Sinai)H-Index: 164
Last. Neeraj Narula (MUMC: McMaster University Medical Centre)H-Index: 23
view all 4 authors...
Background & Aims The paradigm for treatment for ulcerative colitis (UC) is shifting from resolving symptoms toward objective measures such as mucosal healing (MH). However, it is unclear whether MH is associated with improved long-term outcomes. We performed a systematic review and meta-analysis to identify and analyze studies comparing long-term outcomes of patients with MH with those without MH. Methods We performed a systematic search of 3 large databases to identify prospective studies of p...
130 CitationsSource
#1William J. Sandborn (UCSD: University of California, San Diego)H-Index: 182
#2Julián PanésH-Index: 94
Last. Chinyu Su (Pfizer)H-Index: 16
view all 6 authors...
Background & Aims Accurate biomarkers of disease activity and therapeutic response can be valuable for clinical trials. We performed a post hoc analysis of data from a phase 2 trial to assess the relationship between the concentration of fecal calprotectin (FCP) and clinical and endoscopic outcomes of patients with moderate to severe ulcerative colitis receiving tofacitinib. Methods In a double-blind, placebo-controlled, phase 2 trial, 194 patients were assigned randomly to groups given tofaciti...
66 CitationsSource
#1Jürgen Scheller (HHU: University of Düsseldorf)H-Index: 64
#2Christoph Garbers (CAU: University of Kiel)H-Index: 32
Last. Stefan Rose-John (CAU: University of Kiel)H-Index: 129
view all 3 authors...
Cytokines receptors exist in membrane bound and soluble form. A soluble form of the human IL-6R is generated by limited proteolysis and alternative splicing. The complex of IL-6 and soluble IL-6R stimulates target cells not stimulated by IL-6 alone, since they do not express the membrane bound IL-6R. We have named this process trans-signaling. Soluble gp130 is the natural inhibitor of IL-6/soluble IL-6R complex responses. Recombinant soluble gp130 protein is a molecular tool to discriminate betw...
195 CitationsSource
#1Jean-Frederic Colombel (university of lille)H-Index: 164
#2Paul Rutgeerts (Katholieke Universiteit Leuven)H-Index: 167
Last. William J. Sandborn (UCSD: University of California, San Diego)H-Index: 182
view all 15 authors...
Background & Aims In the Active Ulcerative Colitis Trial (ACT)-1 and ACT-2, patients with ulcerative colitis treated with infliximab were more likely than those given placebo to have a clinical response, undergo remission, and have mucosal healing. We investigated the association between early improvement (based on endoscopy) and subsequent clinical outcome. Methods Patients underwent endoscopic evaluations at weeks 0, 8, 30, and 54 (ACT-1 only), and were categorized into 4 subgroups by week 8 (...
631 CitationsSource
#1Laurent Peyrin-Biroulet (Nancy-Université)H-Index: 103
#2Marc Ferrante (Katholieke Universiteit Leuven)H-Index: 59
Last. Andreas Sturm (Charité)H-Index: 45
view all 13 authors...
Abstract Over the past years, mucosal healing has emerged as a major therapeutic goal in clinical trials in inflammatory bowel diseases. Accumulating evidence indicates that mucosal healing may change the natural course of the disease by decreasing the need for surgery and reducing hospitalization rates in both ulcerative colitis and Crohn's disease. Mucosal healing may also prevent the development of long-term disease complications, such as bowel damage in Crohn's disease and colorectal cancer ...
244 CitationsSource
#1Gary R. Lichtenstein (HUP: Hospital of the University of Pennsylvania)H-Index: 82
#2Paul Rutgeerts (Katholieke Universiteit Leuven)H-Index: 167
Treatment of patients with ulcerative colitis (UC) has traditionally focused on improving symptoms, with the main objective of inducing and maintaining symptomatic remission. However, new evidence suggests that concentrating exclusively on clinical outcome measures may not be adequate to achieve long-term treatment success. Indeed, physicians should also be assessing the reduction of endoscopic activity, with the intention of achieving complete mucosal healing (defined as the absence of all muco...
176 CitationsSource
#1Kathrine Frey Frøslie (Rikshospitalet–Radiumhospitalet)H-Index: 19
#2Jørgen JahnsenH-Index: 49
Last. Morten H. Vatn (University of Oslo)H-Index: 77
view all 4 authors...
Background & Aims: Mucosal healing (MH) in inflammatory bowel disease may be an important sign of efficacy of treatment and a prognostic marker of long-term disease. The aim of the study was to examine both the possible predictors of mucosal healing and the impact of healing on subsequent course of disease. Methods: In 740 incident patients diagnosed with ulcerative colitis (UC) or Crohn's disease (CD) between 1990 and 1994 (before biologic therapy was available), demographics and symptoms were ...
885 CitationsSource
#1Ford Alexander C (St James's University Hospital)H-Index: 2
#2Moayyedi Paul (MUMC: McMaster University Medical Centre)H-Index: 1
Last. 吴东H-Index: 1
view all 5 authors...
2,881 Citations
Cited By1
Newest
OBJECTIVE Serum albumin is used as a marker of acute inflammation. Several studies have addressed the association between serum albumin and clinical outcome in patients with ulcerative colitis (UC). While mucosal healing (MH) has been indicated as the therapeutic goal for UC, the association between serum albumin and MH remains unclear. We evaluated this issue in patients with UC overall and explored whether duration of UC affected this association. DESIGN This cross-sectional study recruited co...
Source