title: Lamina propria and circulating interleukin-6 in newly diagnosed pediatric inflammatory bowel disease patients.
abstract: OBJECTIVE
  Understanding cytokine production patterns in early mucosal lesions of pediatric patients newly diagnosed with inflammatory bowel disease (IBD) may be critical to understanding IBD pathogenesis. Interleukin-6 (IL-6) has a central role in a multitude of immune system reactions; however, inconsistent lamina propria and serum IL-6 has been reported in IBD patients. Newly diagnosed pediatric IBD patients have not previously been evaluated for lamina propria or serum IL-6.
  
  
  METHODS
  Serum and intestinal lamina propria biopsy whole organ culture supernatants were evaluated by ELISA for IL-6 obtained from newly diagnosed IBD patients, before initiation of immunomodulatory therapies.
  
  
  RESULTS
  Levels of lamina propria IL-6 demonstrated significant correlation with graded severity of histological inflammation (p < 0.001). Log-transformed serum and organ culture IL-6 levels demonstrated significant correlation (p < 0.0001, R2 = 0.6226). Assigning a demarcation level of >400 pg/ml, serum IL-6 concentrations were a superior marker for the presence of microscopic intestinal inflammation than erythrocyte sedimentation rate (ESR), with a sensitivity of 82%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 82%. When evaluating subtypes of IBD, serum IL-6 levels were correlated more significantly with active disease in ulcerative colitis patients (p = 0.01, R2 = 0.74) than in Crohn's disease patients (p = 0.21, R2 = 0.33).
  
  
  CONCLUSIONS
  This study outlines graded production of IL-6 in intestinal lamina propria and serum of newly diagnosed pediatric IBD patients, confirming the presence of IL-6 in early IBD patients. In addition, serum IL-6 may be a good predictor of IBD in pediatric patients with suspected or newly diagnosed IBD.
authors.affiliation: Division of Gastroenterology and Nutrition, The Children's Hospital of Philadelphia, Pennsylvania 19104, USA.
authors.forename: Kurt A
authors.initials: KA
authors.lastname: Brown
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Back
authors.forename: Eduardo D
authors.initials: ED
authors.lastname: Ruchelli
authors.forename: Jonathan
authors.initials: J
authors.lastname: Markowitz
authors.forename: Maria
authors.initials: M
authors.lastname: Mascarenhas
authors.forename: Ritu
authors.initials: R
authors.lastname: Verma
authors.forename: David A
authors.initials: DA
authors.lastname: Piccoli
authors.forename: Robert N
authors.initials: RN
authors.lastname: Baldassano
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000378:metabolism* / Q000473:pathology; D015850:Interleukin-6 / Q000097:blood / Q000378:metabolism*; D007413:Intestinal Mucosa / Q000378:metabolism* / Q000473:pathology; D008297:Male; D009924:Organ Culture Techniques
chemical_list: D015850:Interleukin-6