title: Effects of mucosal TNF-alpha levels on treatment response in Crohn's disease patients receiving anti-TNF treatment.
abstract: OBJECTIVE
  We aimed to find out if mucosal TNF-α (m-TNF-α) levels have predictive impact on anti-TNF treatment response in Crohn's disease (CD).
  
  
  METHODS
  TNF-alpha values were determined with immunohistochemical staining of intestinal biopsies taken from 35 subjects on anti-TNF treatment for CD and 25 controls. Correlation between m-TNF-α levels and anti-TNF treatment were evaluated.
  
  
  RESULTS
  m-TNF-α levels were determined higher in CD group (28.0±8.9 vs 5.8±2.1; P<0.001). m-TNF-α levels were lower in CD patients who were hospitalized (23.0±8.7 vs. 30.3±8.1; P=0.024). Although not to a statistically significant level, favorable parameters such as clinical remission (28.5±8.0 vs. 26.4±11.8, p=0.419) and mucosal healing (29.9±8.2 vs. 23.9±9.2, p=0.097) were increased in patients with high m-TNF-α levels whereas unfavorable parameters such as relapse (26.0±9.4 vs. 29.7±8.2, P=0.107), surgery requirement (22.8±11.1 vs. 29.1±8.1, P=0.147), steroid requirement (25.9±9.0 vs. 28.6±8.9, P=0.595), and anti-TNF intensification (22.3±3.8 vs. 28.5±9.0, P=0.183) were increased in patients with low m-TNF-α levels.
  
  
  CONCLUSIONS
  High mucosal TNF-α levels before treatment have favorable effects on anti-TNF treatment response in CD. Presence of high m-TNF-α levels at the diagnosis may be encouraging in early initiation of anti-TNF treatment.
authors.forename: Ayşe
authors.initials: A
authors.lastname: Vatansever
authors.forename: Cem
authors.initials: C
authors.lastname: Çekiç
authors.forename: Neşe
authors.initials: N
authors.lastname: Ekinci
authors.forename: Elif Sarıtaş
authors.initials: ES
authors.lastname: Yüksel
authors.forename: Arzu
authors.initials: A
authors.lastname: Avcı
authors.forename: Fatih
authors.initials: F
authors.lastname: Aslan
authors.forename: Mahmut
authors.initials: M
authors.lastname: Arabul
authors.forename: Belkıs
authors.initials: B
authors.lastname: Ünsal
authors.forename: Fulya
authors.initials: F
authors.lastname: Çakalağaoğlu
mesh_terms: D000328:Adult; D003424:Crohn Disease / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007413:Intestinal Mucosa / Q000737:chemistry*; D008297:Male; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis / Q000037:antagonists & inhibitors*
chemical_list: D014409:Tumor Necrosis Factor-alpha