title: Accuracies of serum and fecal S100 proteins (calprotectin and calgranulin C) to predict the response to TNF antagonists in patients with Crohn's disease.
abstract: BACKGROUND
  Calprotectin and S100A12 (calgranulin C) are markers of gut inflammation. The aim was to compare the usefulness of serum and fecal calprotectin (fCal) and S100A12 in assessing the response to anti-TNF and in predicting relapse under maintenance therapy in Crohn's diseases (CD).
  
  
  METHODS
  Thirty-two consecutive patients with CD were treated with adalimumab or infliximab. All received an induction regimen followed by maintenance therapy with infliximab 5 mg/kg every 8 weeks or adalimumab 40 mg every other week and provided at week 0 and 14 fecal and blood samples for determination serum CRP, serum and fecal calprotectin and S100A12 levels.
  
  
  RESULTS
  Clinical remission at week 14 (responders) was achieved in 21 patients and among them, 12 were still in steroid-free clinical remission at week 52. Median serum S100A12 and fCal concentrations significantly drop only in responders from week 0 to week 14 after induction, whereas serum calprotectin and fecal S100A12 levels failed to differ significantly. Fecal calprotectin levels at week 14 had the highest discriminant validity to predict clinical remission within 1 year after induction (area under the curve = 0.87) followed by fecal, serum S100A12, and serum calprotectin (area under the ROC curve = 0.70, 0.70, and 0.68, respectively). A cutoff of 82 μg/g for fCal at week 14 had a sensitivity and specificity of 93% and 75%, respectively, to predict clinical remission within 1 year of therapy.
  
  
  CONCLUSIONS
  Serum S100A12 level and fCal are reliable markers associated with response to induction therapy with anti-TNF. Fecal calprotectin was the best for predicting clinical remission in CD under maintenance therapy.
authors.affiliation: *Department of Gastroenterology, Hospices Civils de Lyon and University Claude Bernard Lyon 1, Lyon, France; †INSERM U1111 (CIRI), Lyon, France; ‡Cisbio Bioassays, Bagnols sur Cèze, France; and §Laboratory of Biochemistry, LyonSud Hospital, Pierre-Benite, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Boschetti
authors.forename: Patrick
authors.initials: P
authors.lastname: Garnero
authors.forename: Driffa
authors.initials: D
authors.lastname: Moussata
authors.forename: Charlotte
authors.initials: C
authors.lastname: Cuerq
authors.forename: Corinne
authors.initials: C
authors.lastname: Préaudat
authors.forename: Remi
authors.initials: R
authors.lastname: Duclaux-Loras
authors.forename: Anne
authors.initials: A
authors.lastname: Mialon
authors.forename: Jocelyne
authors.initials: J
authors.lastname: Drai
authors.forename: Bernard
authors.initials: B
authors.lastname: Flourié
authors.forename: Stephane
authors.initials: S
authors.lastname: Nancey
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000378:metabolism / Q000627:therapeutic use*; D015415:Biomarkers / Q000032:analysis*; D003424:Crohn Disease / Q000188:drug therapy* / Q000378:metabolism / Q000401:mortality; D004797:Enzyme-Linked Immunosorbent Assay; D005243:Feces / Q000737:chemistry*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000069285:Infliximab; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012008:Recurrence; D009418:S100 Proteins / Q000032:analysis*; D000067616:S100A12 Protein; D015996:Survival Rate; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000911:Antibodies, Monoclonal; D015415:Biomarkers; D039841:Leukocyte L1 Antigen Complex; D009418:S100 Proteins; D000067616:S100A12 Protein; C090441:S100A12 protein, human; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab