title: Fecal calprotectin and α1-antitrypsin dynamics in gastrointestinal GvHD.
abstract: In a previous study, the fecal biomarkers calprotectin and α1-antitrypsin (α1-AT) at symptom onset were reported to be significantly associated with the response to steroids in gastrointestinal GvHD (GI-GvHD). The purpose of this trial was to evaluate the dynamics of the fecal biomarkers calprotectin and α1-AT throughout the course of GvHD. Patients who were refractory to steroids had initially higher biomarker levels and in the course of GvHD demonstrated a continuous increase in fecal biomarkers. In contrast, the dynamics of calprotectin and α1-AT demonstrated low and decreasing levels in cortico-sensitive GvHD. In steroid-refractory patients who received a second line of treatment, the biomarker levels at the beginning of second-line treatment did not predict the subsequent response. Nevertheless, calprotectin levels progressively decreased in subsequent responders, whereas non-responders demonstrated continuously high levels of calprotectin. α1-AT values correlated to a lesser extent with the response to second-line treatment and remained elevated in both non-responders and responders. In conclusion, calprotectin monitoring can be of use in the management of immunosuppressive treatment in GI-GvHD.
authors.affiliation: Service de Greffe de Moelle, Hôpital Saint-Louis, AP-HP, Université Paris Diderot, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: O'Meara
authors.affiliation: Service de Coprologie Fonctionnelle, Hôpitaux Universitaire Pitié Salpêtrière - Charles Foix, AP-HP, Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Kapel
authors.affiliation: Service de Greffe de Moelle, Hôpital Saint-Louis, AP-HP, Université Paris Diderot, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Xhaard
authors.affiliation: Service de Greffe de Moelle, Hôpital Saint-Louis, AP-HP, Université Paris Diderot, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Sicre de Fontbrune
authors.affiliation: Service de Coprologie Fonctionnelle, Hôpitaux Universitaire Pitié Salpêtrière - Charles Foix, AP-HP, Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Manéné
authors.affiliation: Service Greffe de Moelle, Unité Adolescents et Jeunes Adultes, Hôpital Saint-Louis, AP-HP, Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Dhedin
authors.affiliation: Inserm U728, Paris, France.
authors.forename: R P
authors.initials: RP
authors.lastname: de Latour
authors.affiliation: 1] Service de Greffe de Moelle, Hôpital Saint-Louis, AP-HP, Université Paris Diderot, Paris, France [2] Inserm U728, Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Socié
authors.affiliation: Service de Greffe de Moelle, Hôpital Saint-Louis, AP-HP, Université Paris Diderot, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Robin
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D005243:Feces; D005260:Female; D005767:Gastrointestinal Diseases / Q000188:drug therapy / Q000378:metabolism*; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000378:metabolism*; D019337:Hematologic Neoplasms / Q000378:metabolism / Q000628:therapy; D006801:Humans; D039841:Leukocyte L1 Antigen Complex / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000515:alpha 1-Antitrypsin / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D039841:Leukocyte L1 Antigen Complex; D000515:alpha 1-Antitrypsin