Accuracies of fecal calprotectin, lactoferrin, M2-pyruvate kinase, neopterin and zonulin to predict the response to infliximab in ulcerative colitis.
BACKGROUND
Fecal markers might predict the response to anti-TNFα in ulcerative colitis (UC).


OBJECTIVE
To compare the performance of fecal calprotectin (fCal), lactoferrin (fLact), M2-PK (fM2-PK), neopterin (fNeo), and zonulin (fZon) to predict the response to therapy in active UC patients.


METHODS
Disease activity from 31 consecutive patients with an active UC, treated with infliximab (IFX) was assessed by the Mayo score at baseline and at week 14 and by the partial Mayo score at W52 and stool samples collected for fecal marker measurements at W0, W2, and W14.


RESULTS
At W14, 19 patients (61%) were responders to IFX induction. The median levels of fCal, fLact and fM2-PK drop dramatically from baseline to W14 in clinical responders. At W2, fM2-PK, fLact and fCal levels predicted accurately the response to IFX induction. At W14, fLact, fCal, and fM2-PK were individually reliable markers to predict sustained response at W52. The performances of fNeo and fZon were weaker in this setting.


CONCLUSIONS
The performance of fM2-PK at W2 to predict response to induction therapy with IFX was superior to that of fLact and fCal, whereas monitoring fLact was the best tool to predict adequately the course of the disease at one year under maintenance IFX in UC.
Department of Gastroenterology, Centre Hospitalier Universitaire L'Archet, Nice, France.
Anne-Claire
AC
Frin
Department of Gastroenterology, Centre Hospitalier Universitaire L'Archet, Nice, France.
Jérôme
J
Filippi
Department of Gastroenterology, Hospices Civils de Lyon, Lyon-Sud Hospital, Pierre-Bénite, France & INSERM U1111, International Center for Research in Infectiology, Lyon, France.
Gilles
G
Boschetti
Department of Gastroenterology, Hospices Civils de Lyon, Lyon-Sud Hospital, Pierre-Bénite, France & INSERM U1111, International Center for Research in Infectiology, Lyon, France.
Bernard
B
Flourie
Laboratory of Biochemistry, Hospices Civils de Lyon, Lyon-Sud Hospital, Pierre-Bénite, France.
Jocelyne
J
Drai
Laboratory of Biochemistry, Centre Hospitalier Universitaire Pasteur, Nice, France.
Patricia
P
Ferrari
Department of Gastroenterology, Centre Hospitalier Universitaire L'Archet, Nice, France.
Xavier
X
Hebuterne
Department of Gastroenterology, Hospices Civils de Lyon, Lyon-Sud Hospital, Pierre-Bénite, France & INSERM U1111, International Center for Research in Infectiology, Lyon, France. Electronic address: stephane.nancey@chu-lyon.fr.
Stéphane
S
Nancey
D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis*; D002772:Cholera Toxin / Q000032:analysis; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D005243:Feces / Q000737:chemistry; D005260:Female; D005602:France; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006242:Haptoglobins; D006801:Humans; D000069285:Infliximab / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D007781:Lactoferrin / Q000032:analysis; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis; D008297:Male; D008875:Middle Aged; D019798:Neopterin / Q000032:analysis; D011446:Prospective Studies; D011498:Protein Precursors; D011770:Pyruvate Kinase / Q000032:analysis; D012372:ROC Curve; D012074:Remission Induction; D055815:Young Adult
D015415:Biomarkers; D005765:Gastrointestinal Agents; D006242:Haptoglobins; D039841:Leukocyte L1 Antigen Complex; D011498:Protein Precursors; C408043:zonulin; D019798:Neopterin; D002772:Cholera Toxin; D000069285:Infliximab; D011770:Pyruvate Kinase; D007781:Lactoferrin
Fecal markers; Response to infliximab; Ulcerative colitis