title: TNF-alpha gene expression in colorectal mucosa as a predictor of remission after induction therapy with infliximab in ulcerative colitis.
abstract: BACKGROUND
  It has been documented that treatment with infliximab (IFX) induces remission in 1/3 of patients with moderate to severe ulcerative colitis (UC). Predictors of response could improve selection of patients with a higher probability of favorable outcome.
  
  
  OBJECTIVE
  To determine predictor factors for the clinical outcome of IFX induction therapy in UC.
  
  
  METHODS
  UC patients with moderate to severe disease who received 5mg/kg IFX at weeks 0, 2 and 6weeks were included. Ulcerative colitis disease activity index (UCDAI) score including endoscopic sub-scores were assessed before and after treatment. Several predictors, including TNF-alpha mRNA expression, were tested in a regression model.
  
  
  RESULTS
  Fifty-nine patients completed the study. Age, gender, steroid therapy, immunosuppressive, pancolitis, endoscopic sub-score, disease duration, C-reactive protein, interleukin-(IL)-4, IL-10 or interferon-gamma (IFN-gamma) did not predict mucosal or clinical remission. There was an inverse and independent association between pre-treatment TNF-alpha expression levels and clinical and endoscopic remission of IFX treatment (logistic regression, p=0.01 and p=0.003, odds ratio 2.5 and 4.8, respectively).
  
  
  CONCLUSIONS
  The clinical outcome of an induction therapy with IFX in UC is inversely associated with the pre-treatment gene expression levels of TNF-alpha in colorectal mucosa.
authors.affiliation: Laboratory of Gastroenterology, Institute of Clinical Medicine, University of Tromsø, Breivika, N-9037 Tromsø, Norway.
authors.forename: Trine
authors.initials: T
authors.lastname: Olsen
authors.forename: Rasmus
authors.initials: R
authors.lastname: Goll
authors.forename: Guanglin
authors.initials: G
authors.lastname: Cui
authors.forename: Ingrid
authors.initials: I
authors.lastname: Christiansen
authors.forename: Jon
authors.initials: J
authors.lastname: Florholmen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000235:genetics* / Q000473:pathology / Q000503:physiopathology; D003106:Colon / Q000033:anatomy & histology; D005260:Female; D005786:Gene Expression Regulation; D006801:Humans; D000069285:Infliximab; D007413:Intestinal Mucosa / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012007:Rectum / Q000033:anatomy & histology; D012074:Remission Induction; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000235:genetics / Q000378:metabolism; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab