Mucosal healing (MH) has become a major target in the management of ulcerative colitis (UC). Because repeat endoscopy is expensive and invasive, we aimed to evaluate fecal calprotectin (FC) as an alternative marker to predict MH in UC. Eighty patients with UC in clinical remission were consecutively included in a prospective observational study. FC was measured using a quantitative enzyme-linked immunosorbent assay. The colonic mucosa was assessed for endoscopic and histological measures of inflammatory status. Endoscopic and histological remission were defined according to the Mayo endoscopic subscore (MES) and Geboes score (GS), respectively. Deep remission was defined as a combination of the MES and GS. FC performance and cutoff values for identifying MH and deep remission were determined using contingency tables and receiver operator characteristic (ROC) and area under the curve (AUC) analysis. The median FC concentration in patients who met the criteria for deep remission (MES ≤1 and GS < 3.1) was 65.5 μg/g, while that in patients with disease activity was 389.6 μg/g (P = .025). A FC cutoff value of 100 μg/g, determined by the ROC analysis, resulted in sensitivity and specificity of 91.7% and 57.1%, respectively, for histological remission, and 82.4% and 60.9%, respectively, for deep mucosal remission. Positive correlations were detected between FC concentrations with the histologic (CC: 0.435; P < .001) and the combined endoscopic and histologic (CC: 0.413; P < .001) scores. FC can be used confidently as a noninvasive biomarker to predict deep remission in patients with UC in clinical remission when concentrations are below 100 μg/g.

No abstract

Purpose Patients with inflammatory bowel disease (IBD) are often treated with immunosuppressants and immunobiologicals. We evaluated the humoral response after vaccination against SARS-Cov-2 in patients with IBD compared to a healthy population Methods Patients with IBD, enrolled in a tertiary outpatient unit, were followed-up with serial blood collections between September 2021 and September 2022. IgG antibody titers against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were measured before and one month after the administration of the two doses of the different vaccination regimens. The results were compared with those of a healthy control group obtained during the same period. Results Mean pre-vaccination antibody titers were 430.3 AU/mL and 90.5 AU/mL in the IBD (46 participants) and control (92 participants) groups, respectively. After two doses of vaccine, the titers significantly increased in both groups (IBD, 8038.4 AU/mL; control, 7697.5 AU/mL; p < 0.001). One month after the second dose, no significant difference was observed between the two groups (p = 0.731). In the IBD group, there was a difference between vaccination schemes, with higher titers in those who received Pfizer, younger patients (p < 0.005), and those with a previous COVID-19 infection (p < 0.012). Conclusion The use of immunosuppressants and immunobiologicals did not affect the overall humoral response to the COVID-19 vaccine in patients with IBD. However, specific vaccine regimens, age, and previous coronavirus infection significantly affected the response. This study reinforces the positive impact of booster doses and safety of SARS-CoV-2 vaccination.

No abstract