Abstract
Background and aim
Diagnosis of ulcerative colitis (UC) is suspected clinically and confirmed through endoscopic biopsy. It can be followed-up and assessed by noninvasive biomarkers such as fecal calprotectin. Recently, B-cell-activating factor (BAFF) has been proposed to be a regulator of B-cell and T-cell immune responses and to be associated with inflammatory processes in autoimmunity. The aim of our study was to clarify the role of fecal BAFF as a simple predictor for disease activity and severity in patients with UC.
Patients and methods
Fifty Egyptian patients with UC were divided into two groups: group I including 40 patients with active UC (newly diagnosed) and group II including 10 patients with inactive UC (previously diagnosed); disease activity was assessed according to the Mayo activity scoring index; fecal BAFF and fecal calprotectin were measured for all patients using enzyme-linked immunosorbent assay.
Results
Significantly higher levels of Fecal BAFF and fecal calprotectin were found among patients with active UC, as compared with inactive UC patients. Fecal BAFF more than or equal to 50 μg/g had 97.5% sensitivity and 100% specificity in predicting disease activity in comparison with fecal calprotectin, which had a sensitivity and specificity of 90% at a cut off value more than or equal to 47 μg/g. In predicting disease severity, fecal BAFF more than or equal to 340 μg/g had a sensitivity of 95% and specificity of 100%, while fecal calprotectin more than or equal to 170 μg/g had a sensitivity of 80% and specificity of 95%.
Conclusion
Fecal BAFF is more sensitive and specific in predicting UC activity and severity than fecal calprotectin.
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References
Cakal B, Akoz AG, Ustundag Y, Yalinkilic M, Ulker A, Ankarali H. Red cell distribution width for assessment of activity of inflammatory bowel disease. Dig Dis Sci 2009; 54:842–847.
Yüksel O, Helvaci K, Basar O, Köklü S, Caner S, Helvaci N, et al. An overlooked indicator of disease activity in ulcerative colitis: mean platelet volume. Platelets 2009; 20:277–281.
Krumbholz M, Theil D, Derfuss T, Rosenwald A, Schrader F, Monoranu CM, et al. BAFF is produced by astrocytes and up-regulated in multiple sclerosis lesions and primary central nervous system lymphoma. J Exp Med 2005; 201:195–200.
Lester SE, Proudman SM, Lee AT, Hall CA, McWilliams L, James MJ, et al. Treatment-induced stable, moderate reduction in blood cell counts correlate to disease control in early rheumatoid arthritis. Intern Med J 2009; 39:296–303.
Schroeder KW, Tremaine WJ, Ilstrup DM. Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis. A randomized study. N Engl J Med 1987; 317:1625–1629.
D’Haens G, Geboes K, Peeters M, Baert F, Ectors N, Rutgeerts P. Patchy cecal inflammation associated with distal ulcerative colitis: a prospective endoscopic study. Am J Gastroenterol 1997; 92:1275–1279.
Uzzan M, Colombel JF, Cerutti A, Treton X, Mehandru S. B-cell-activating factor (BAFF)-targeted B cell therapies in inflammatory bowel diseases. Dig Dis Sci 2016; 61:3407–3424.
Bechtold ML, Choudhary A. Bowel preparation prior to colonoscopy:a continual search for excellence. World J Gastroenterol 2013; 19:155–157.
Smith LA, Gaya DR. Utility of faecal calprotectin analysis in adult inflammatory bowel disease. World J Gastroenterol 2012; 18:6782–6789.
Striz IB. Cell-activating factor (BAFF) in inflammatory bowel disease: BAFFling no longer? Dig Dis Sci 2016; 61:2456–2458.
Schoepfer AM, Trummler M, Seeholzer P, Seibold-Schmid B, Seibold F. Discriminating IBD from IBS: comparison of the test performance of fecal markers, blood leukocytes, CRP, and IBD antibodies. Inflamm Bowel Dis 2008; 14:32–39.
Paduchova Z, Durackova Z. Fecal calprotectin as a promising marker of inflammatory diseases. Bratisl Lek Listy 2009; 10:598–602.
Zahedi MJ, Darvish Moghadam S, Hayat Bakhsh Abbasi M, Dehghani M, Shafiei Pour S, Zydabady Nejad H, et al. The incidence rate of inflammatory bowel disease in an urban area of Iran: a developing country. Middle East J Dig Dis 2014; 6:32–36.
Tall AR. C-reactive protein reassessed. N Engl J Med 2004; 350:1450–1452.
Gabay C, Kushner I. Acute-phase proteins and other systemic responses to inflammation. N Engl J Med 1999; 340:448–454.
Peyrin-Biroulet L, Standaert-Vitse A, Branche J, Chamaillard M. IBD serological panels: Facts and perspectives. Inflamm Bowel Dis 2007; 13:1561–1566.
Solem CA, Loftus EVJr, Tremaine WJ, Harmsen WS, Zinsmeister AR, Sandborn WJ. Correlation of C-reactive protein with clinical, endoscopic, etiologic, and radiographic activity in inflammatory bowel disease. Inflamm Bowel Dis 2005; 11:707–712.
Thomas RD, Westengard JC, Hay KL, Bull BS. Calibration and validation for erythrocyte sedimentation tests. Role of the International Committee on Standardization in Hematology reference procedure. Arch Pathol Lab Med 1993; 117:719–723.
Leighton JA, Shen B, Baron TH, Adler DG, Davila R, Egan JV, et al. ASGE guideline: endoscopy in the diagnosis and treatment of inflammatory bowel disease. Gastrointest Endosc 2006; 4: 558–565.
Langhorst J, Elsenbruch S, Koelzer J, Rueffer A, Michalsen A, Dobos GJ. Non-invasive markers in the assessment of intestinal inflammation in inflammatory bowel diseases: performance of fecal lactoferrin, calprotectin, and PMN-elastase, CRP, and clinical indices. Am J Gastroenterol 2008; 103:162–169.
Silberer H, Küppers B, Mickisch O, Baniewicz W, Drescher M, Traber L, et al. Fecal leukocyte proteins in inflammatory bowel disease and irritable bowel syndrome. Clin Lab 2005; 51:117–126.
Egea-Valenzuela J, Alberca-de-las-Parras F, CarballoAlvarez F. Fecal calprotectin as a biomarker of inflammatory lesions of the small bowel seen by video capsule endoscopy. Rev Esp Enferm Dig 2015; 107:211–215.
Zhang P, Liu X, Guo A, Xiong J, Fu Y, Zou K. B cell-activating factor as a new potential marker in inflammatory bowel disease. Dig Dis Sci 2016; 61:2608–2618.
Fu Y, Wang L, Xie C, Zou K, Tu L, Yan W, et al. Comparison of non-invasive biomarkers faecal BAFF, calprotectin and FOBT in discriminating IBS from IBD and evaluation of intestinal inflammation. Sci Rep 2017; 7:2669.
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Hussein, H.A., Mohamed, R.S. Fecal B-cell-activating factor as a new noninvasive marker in the evaluation of ulcerative colitis Egyptian patients: a comparative cross-sectional study. Egypt J Intern Med 31, 563–572 (2019). https://doi.org/10.4103/ejim.ejim_118_19
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DOI: https://doi.org/10.4103/ejim.ejim_118_19