title: Pancreatitis-associated protein does not predict disease relapse in inflammatory bowel disease patients.
abstract: BACKGROUND
  The pancreatitis-associated protein (PAP) is increased in the serum of active inflammatory bowel disease (IBD) patients and its levels seem to be correlated with disease activity. Our aim was to evaluate the usefulness of serum and fecal PAP measurements to predict relapse in patients with inactive IBD.
  
  
  METHODS
  We undertook a 12-month prospective study that included 66 Crohn's disease (CD) and 74 ulcerative colitis (UC) patients. At inclusion, patients were in clinical remission, defined by a Harvey-Bradshaw (HB) Index≤4 (CD) or a partial Mayo Score (MS)<3 (UC), along with a normal serum C reactive protein (CRP) and fecal calprotectin. Patients were followed every 3 months. Blood and stool samples were collected and a clinical evaluation was performed at each visit. Serum PAP and CRP levels as well as fecal concentrations of PAP and calprotectin were assessed.
  
  
  RESULTS
  Active CD patients had an increased mean serum PAP at the diagnosis of the flare (104.1 ng/ml) and 3 months prior to activity (22.68 ng/ml) compared with patients in remission (13.26 ng/ml), p<0.05. No significant change in serum PAP levels in UC and fecal PAP levels in CD and UC were detected during disease activity. In CD, serum PAP was a poor diagnostic predictor of disease activity, with an AUC of 0.69. In patients in remission, fecal PAP was barely detectable in UC compared with CD patients.
  
  
  CONCLUSIONS
  Serum PAP is increased only in active CD patients, but this marker does not predict disease activity. Inactive UC patients have marked low levels of PAP in fecal samples compared with CD patients.
authors.affiliation: Department of Gastroenterology, Hospital Clinic of Barcelona (IDIBAPS/Centro de Investigació Bioméica en Red de Enfermedades Hepáicas y Digestivas [CIBEREHD]), Barcelona, Catalonia, Spain.
authors.forename: Tiago
authors.initials: T
authors.lastname: Nunes
authors.affiliation: Department of Gastroenterology, Hospital Clinic of Barcelona (IDIBAPS/Centro de Investigació Bioméica en Red de Enfermedades Hepáicas y Digestivas [CIBEREHD]), Barcelona, Catalonia, Spain.
authors.forename: Maria Josefina
authors.initials: MJ
authors.lastname: Etchevers
authors.affiliation: Centre de Recherche en Cancérologie de Marseille (CRCM), INSERM U1068, CNRS UMR 7258, Aix-Marseille Université and Institut Paoli-Calmettes, Parc Scientifique et Technologique de Luminy, Marseille, France.
authors.forename: Maria Jose
authors.initials: MJ
authors.lastname: Sandi
authors.affiliation: Department of Gastroenterology, Hospital Clinic of Barcelona (IDIBAPS/Centro de Investigació Bioméica en Red de Enfermedades Hepáicas y Digestivas [CIBEREHD]), Barcelona, Catalonia, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Pinó Donnay
authors.affiliation: University Lille Nord de France, F-59000, Lille, France ; Institut Pasteur de Lille, Center for Infection and Immunity of Lille, F-59019, Lille, France ; Centre National de la Recherche Scientifique, UMR8204, F-59021, Lille, France ; Institut National de la Santé et de la Recherche Médicale, U1019, Team 7, Equipe FRM, F-59019, Lille, France.
authors.forename: Teddy
authors.initials: T
authors.lastname: Grandjean
authors.affiliation: Department of Gastroenterology, Hospital Clinic of Barcelona (IDIBAPS/Centro de Investigació Bioméica en Red de Enfermedades Hepáicas y Digestivas [CIBEREHD]), Barcelona, Catalonia, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Pellisé
authors.affiliation: Department of Gastroenterology, Hospital Clinic of Barcelona (IDIBAPS/Centro de Investigació Bioméica en Red de Enfermedades Hepáicas y Digestivas [CIBEREHD]), Barcelona, Catalonia, Spain.
authors.forename: Julián
authors.initials: J
authors.lastname: Panés
authors.affiliation: Department of Gastroenterology, Hospital Clinic of Barcelona (IDIBAPS/Centro de Investigació Bioméica en Red de Enfermedades Hepáicas y Digestivas [CIBEREHD]), Barcelona, Catalonia, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Ricart
authors.affiliation: Centre de Recherche en Cancérologie de Marseille (CRCM), INSERM U1068, CNRS UMR 7258, Aix-Marseille Université and Institut Paoli-Calmettes, Parc Scientifique et Technologique de Luminy, Marseille, France.
authors.forename: Juan Lucio
authors.initials: JL
authors.lastname: Iovanna
authors.affiliation: Centre de Recherche en Cancérologie de Marseille (CRCM), INSERM U1068, CNRS UMR 7258, Aix-Marseille Université and Institut Paoli-Calmettes, Parc Scientifique et Technologique de Luminy, Marseille, France.
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Dagorn
authors.affiliation: University Lille Nord de France, F-59000, Lille, France ; Institut Pasteur de Lille, Center for Infection and Immunity of Lille, F-59019, Lille, France ; Centre National de la Recherche Scientifique, UMR8204, F-59021, Lille, France ; Institut National de la Santé et de la Recherche Médicale, U1019, Team 7, Equipe FRM, F-59019, Lille, France.
authors.forename: Mathias
authors.initials: M
authors.lastname: Chamaillard
authors.affiliation: Department of Digestive Diseases, Centro Medico Teknon, Barcelona, Catalonia, Spain.
authors.forename: Miquel
authors.initials: M
authors.lastname: Sans
mesh_terms: D000328:Adult; D000951:Antigens, Neoplasm / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D003093:Colitis, Ulcerative / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D003424:Crohn Disease / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D005243:Feces / Q000737:chemistry; D005260:Female; D006801:Humans; D037181:Lectins, C-Type / Q000097:blood*; D039841:Leukocyte L1 Antigen Complex / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D000073718:Pancreatitis-Associated Proteins; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012720:Severity of Illness Index
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D037181:Lectins, C-Type; D039841:Leukocyte L1 Antigen Complex; D000073718:Pancreatitis-Associated Proteins; C000612141:REG3A protein, human; D002097:C-Reactive Protein