Prospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 7, 2017; 23(1): 135-140
Published online Jan 7, 2017. doi: 10.3748/wjg.v23.i1.135
Trefoil factor-3 is not a useful marker of mucosal healing in Crohn's disease treated with anti-TNF-α antibodies
Piotr Eder, Kamila Stawczyk-Eder, Katarzyna Korybalska, Natasza Czepulis, Joanna Luczak, Liliana Lykowska-Szuber, Iwona Krela-Kazmierczak, Krzysztof Linke, Janusz Witowski
Piotr Eder, Kamila Stawczyk-Eder, Liliana Lykowska-Szuber, Iwona Krela-Kazmierczak, Krzysztof Linke, Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznan, Poland
Katarzyna Korybalska, Natasza Czepulis, Joanna Luczak, Janusz Witowski, Department of Pathophysiology, Poznan University of Medical Sciences, 60-806 Poznan, Poland
Author contributions: Eder P and Witowski J designed the study, performed statistical analyses and wrote the manuscript; Korybalska K, Czepulis N and Luczak J performed the laboratory analyses; Stawczyk-Eder K, Lykowska-Szuber L, Krela-Kazmierczak I and Linke K managed the patients and helped to draft, review and edit the manuscript.
Supported by the Poznan University of Medical Sciences Grant, A helping hand (2014).
Institutional review board statement: The study was approved by the Bioethics Committee of the Poznan University of Medical Sciences (No. 409/2013).
Informed consent statement: Written informed consent was obtained from all the participants.
Conflict-of-interest statement: Eder P received lecture fees from Abbvie Poland and travel grants from Astellas and Abbvie Poland; Lykowska-Szuber L received travel grants from Alvogen and Abbvie Poland. Krela-Kazmierczak I received travel grants from Alvogen and Astellas. Linke K received travel grant from Abbvie Poland. Korybalska K, Stawczyk-Eder K, Czepulis N, Luczak J and Witowski J have nothing to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Piotr Eder, MD, PhD, Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Hospital, Przybyszewskiego Street 49, 60-355 Poznan, Poland. piotr.eder@op.pl
Telephone: +48-698050797 Fax: +48-618691686
Received: July 20, 2016
Peer-review started: July 22, 2016
First decision: October 20, 2016
Revised: November 2, 2016
Accepted: November 23, 2016
Article in press: November 28, 2016
Published online: January 7, 2017
Processing time: 168 Days and 20 Hours
Abstract
AIM

To evaluate whether repeated serum measurements of trefoil factor-3 (TFF-3) can reliably reflect mucosal healing (MH) in Crohn’s disease (CD) patients treated with anti-tumor necrosis factor-α (anti-TNF-α) antibodies.

METHODS

Serum TFF-3 was measured before and after anti-TNF-α induction therapy in 30 CD patients. The results were related to clinical, biochemical and endoscopic parameters. MH was defined as a ≥ 50% decrease in Simple Endoscopic Score for Crohn’s disease (SES-CD).

RESULTS

SES-CD correlated significantly with CD clinical activity and several standard biochemical parameters (albumin, leukocyte and platelet counts, C-reactive protein, erythrocyte sedimentation rate, fibrinogen). In contrast, SES-CD did not correlate with TFF-3 (P = 0.54). Moreover, TFF-3 levels did not change significantly after therapy irrespectively of whether the patients achieved MH or not. Likewise, TFF-3 did not correlate with changes in fecal calprotectin, which has been proposed as another biochemical marker of mucosal damage in CD.

CONCLUSION

Serum TFF-3 is not a convenient and reliable surrogate marker of MH during therapy with TNF-α antagonists in CD.

Keywords: Adalimumab; Crohn’s disease; Infliximab; Mucosal healing; Trefoil factors

Core tip: Mucosal healing (MH) is viewed as the holy grail of the efficacy of anti-tumor necrosis factor-α (anti-TNF-α) therapy for Crohn’s disease (CD), however performance of repeated colonoscopies is questionable for economical and safety reasons. We aimed to assess, whether serum trefoil factor-3 (TFF-3), a parameter engaged in maintaining mucosal integrity, could be useful in the assessment of MH. We found no correlation between TFF-3 and CD endoscopic activity and fecal calprotectin. Changes in TFF-3 did not reflect the degree to which MH was achieved. Thus, TFF-3 does not seem to be a reliable surrogate marker for MH in CD patients undergoing anti-TNF-α therapy.