title: Diagnostic importance of faecal markers in long-term monitoring of anti-TNF-α therapy in primary responders with Crohn's disease.
abstract: BACKGROUND
  Monitoring the response to biological treatment in Crohn's disease (CD) is a very important element of the therapeutic optimisation.
  
  
  OBJECTIVE
  To evaluate the usefulness of measuring calprotectin, lactoferrin, and myeloperoxidase in stool as markers of long-term clinical and endoscopic response to anti-tumour necrosis factor α (anti-TNF) treatment in CD.
  
  
  METHODS
  The studied group consisted of 35 CD patients treated with anti-TNF-α antibodies. Clinical activity was evaluated using Crohn's Disease Activity Index (CDAI), and the exacerbation of endoscopic changes was evaluated using a Simple Endoscopic Score for Crohn's Disease (SES-CD). The concentration of calprotectin, lactoferrin, and myeloperoxidase was measured using the ELISA method. All measurements were performed three times - before, after 3 months, and after a year of therapy.
  
  
  RESULTS
  During anti-TNF treatment the concentrations of all measured faecal markers decreased significantly in relation to baseline values. We observed a significant correlation at all time-points: before the therapy, after 3 months, and 12 months after starting the therapy, between the concentration of calprotectin and SES-CD, calprotectin and CDAI, as well as between lactoferrin and SES-CD, and lactoferrin and CDAI. Myeloperoxidase correlated with both SES-CD and CDAI only after 1 year of treatment.
  
  
  CONCLUSIONS
  Faecal calprotectin and lactoferrin are valuable markers of clinical and endoscopic activity of CD in patients treated with anti-TNF antibodies. They are useful in monitoring the response to treatment. The usefulness of myeloperoxidase in this respect remains controversial.
authors.affiliation: Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Liliana
authors.initials: L
authors.lastname: Łykowska-Szuber
authors.affiliation: Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Klimczak
authors.affiliation: Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Eder
authors.affiliation: Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Iwona
authors.initials: I
authors.lastname: Krela-Kaźmierczak
authors.affiliation: Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Kamila
authors.initials: K
authors.lastname: Stawczyk-Eder
authors.affiliation: Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Michalak
authors.affiliation: Department of General Surgery, Gastroenterological and Endocrinological Surgery, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Adam
authors.initials: A
authors.lastname: Studniarek
authors.affiliation: Department of General Surgery, Gastroenterological and Endocrinological Surgery, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Kościński
authors.affiliation: Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Szymczak
authors.affiliation: Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Linke
keywords: Crohn’s disease; anti-TNF antibodies; faecal markers