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Serum REG3alpha and C-reactive protein levels in Crohn's disease patients undergoing immunoablation and autologous hemopoetic stem cell transplantation in the ASTIC trial


Greuter, T; Lang, S; Holler, E; Hawkey, C J; Rogler, G; Biedermann, L (2015). Serum REG3alpha and C-reactive protein levels in Crohn's disease patients undergoing immunoablation and autologous hemopoetic stem cell transplantation in the ASTIC trial. Digestion, 92(2):83-89.

Abstract

BACKGROUND REG3\textgreeka has been recently shown to be a highly accurate biomarker for graft-versus-host-disease (GvHD). Given the unmet need of such biomarkers in Crohn's disease (CD) and the similarities between CD and GvHD, we aimed at investigating the role of serum REG3\textgreeka as a diagnostic and prognostic biomarker in CD patients undergoing autologous hemopoetic stem cell transplantation (HSCT) in the multicenter Autologous Stem Cell Transplantation International Crohn's Disease (ASTIC) trial and to compare it to C-reactive protein (CRP). METHODS Stored serum samples from the ASTIC trial were analyzed using a commercially available human PAP1 ELISA-kit to measure REG3\textgreeka levels. CRP was available from prior analysis in the ASTIC trial. These levels were correlated with clinical and endoscopic disease activity as well as overall clinical and endoscopic outcome 1 year after autologous HSCT. RESULTS One hundred thirty two serum samples were available for analysis. The mean concentration of REG3\textgreeka was 101.8 ng/ml (95% CI 22.6-258.3). No significant elevation of REG3\textgreeka was found among patients with active disease compared to those in remission (106.3 vs. 91.4). Patients with moderate to severe endoscopic disease activity showed substantially, although not significantly elevated REG3\textgreeka levels compared to those in remission (95.4 vs. 52.4, p = 0.052). Baseline serum REG3\textgreeka levels of patients without clinical or endoscopic remission 1 year after HSCT were not elevated compared to those in remission (63.1 vs. 66.9, and 68.4 vs. 59.2, respectively). In contrast, CRP was significantly elevated in patients with active disease compared to patients in remission (14.1 vs. 6.0 mg/dl, p = 0.032). In addition, CRP was elevated, although not significantly, in patients with severe endoscopic disease compared to those in endoscopic remission (18.7 vs. 4.1, p = 0.062). Furthermore, baseline CRP was reduced in patients with clinical and endoscopic remission after HSCT compared to those without remission, although not significantly (8.8 vs. 21.4, n.s. and 8.1 vs. 12.4, n.s.). CONCLUSION Given the divergent findings compared to GvHD, we conclude that serum REG3\textgreeka is not an accurate diagnostic and predictive biomarker in CD patients undergoing HSCT. In contrast, CRP is a valuable biomarker in order to differentiate active disease from remission. However, CRP does not seem to be of prognostic value for HSCT outcome. © 2015 S. Karger AG, Basel.

Abstract

BACKGROUND REG3\textgreeka has been recently shown to be a highly accurate biomarker for graft-versus-host-disease (GvHD). Given the unmet need of such biomarkers in Crohn's disease (CD) and the similarities between CD and GvHD, we aimed at investigating the role of serum REG3\textgreeka as a diagnostic and prognostic biomarker in CD patients undergoing autologous hemopoetic stem cell transplantation (HSCT) in the multicenter Autologous Stem Cell Transplantation International Crohn's Disease (ASTIC) trial and to compare it to C-reactive protein (CRP). METHODS Stored serum samples from the ASTIC trial were analyzed using a commercially available human PAP1 ELISA-kit to measure REG3\textgreeka levels. CRP was available from prior analysis in the ASTIC trial. These levels were correlated with clinical and endoscopic disease activity as well as overall clinical and endoscopic outcome 1 year after autologous HSCT. RESULTS One hundred thirty two serum samples were available for analysis. The mean concentration of REG3\textgreeka was 101.8 ng/ml (95% CI 22.6-258.3). No significant elevation of REG3\textgreeka was found among patients with active disease compared to those in remission (106.3 vs. 91.4). Patients with moderate to severe endoscopic disease activity showed substantially, although not significantly elevated REG3\textgreeka levels compared to those in remission (95.4 vs. 52.4, p = 0.052). Baseline serum REG3\textgreeka levels of patients without clinical or endoscopic remission 1 year after HSCT were not elevated compared to those in remission (63.1 vs. 66.9, and 68.4 vs. 59.2, respectively). In contrast, CRP was significantly elevated in patients with active disease compared to patients in remission (14.1 vs. 6.0 mg/dl, p = 0.032). In addition, CRP was elevated, although not significantly, in patients with severe endoscopic disease compared to those in endoscopic remission (18.7 vs. 4.1, p = 0.062). Furthermore, baseline CRP was reduced in patients with clinical and endoscopic remission after HSCT compared to those without remission, although not significantly (8.8 vs. 21.4, n.s. and 8.1 vs. 12.4, n.s.). CONCLUSION Given the divergent findings compared to GvHD, we conclude that serum REG3\textgreeka is not an accurate diagnostic and predictive biomarker in CD patients undergoing HSCT. In contrast, CRP is a valuable biomarker in order to differentiate active disease from remission. However, CRP does not seem to be of prognostic value for HSCT outcome. © 2015 S. Karger AG, Basel.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Gastroenterology and Hepatology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2015
Deposited On:20 Nov 2015 09:45
Last Modified:01 Oct 2016 00:01
Publisher:Karger
ISSN:0012-2823
Publisher DOI:https://doi.org/10.1159/000437300
PubMed ID:26278889

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