Faecal biomarkers of neutrophil and eosinophil origin reflect the response to biological therapy and corticosteroids in patients with IBD

Abstract

INTRODUCTION: Fecal calprotectin (FC) is a noninvasive tool for examining response to biologics in inflammatory bowel disease (IBD), but its performance in relation to other novel fecal markers of various cellular origins is unknown. METHODS: We performed a prospective multicenter cohort study and included patients with active IBD who provided a fecal sample at initiation of biological therapy. Levels of FC, myeloperoxidase (MPO), human neutrophil lipocalin (HNL), and eosinophil-derived neurotoxin (EDN) were analyzed and related to clinical remission status at 3 months. Changes in levels of markers at 3 months were calculated, and the impact of concomitant use of corticosteroids at baseline was estimated. RESULTS: In patients achieving clinical remission (n = 27), a decrease in levels of FC (P = 0.005), MPO (P < 0.001), HNL (P < 0.001), and EDN (P < 0.001) was observed, whereas no significant decrease was seen in patients not achieving remission (n = 39). There was a significant difference in the change in the level of MPO (P = 0.01) and HNL (P = 0.02) between patients achieving clinical remission and those who did not, but changes in FC and EDN could not differentiate between these groups. Patients with concomitant systemic corticosteroids at inclusion had lower levels of HNL (P = 0.01) and EDN (P < 0.001) at baseline, compared with patients without corticosteroids. DISCUSSION: Fecal MPO, HNL, and EDN are all promising biomarkers for assessing the treatment outcome of biologics in patients with IBD. Fecal levels of EDN and HNL are significantly affected by corticosteroids indicating a greater sensitivity to the effects of corticosteroids compared with levels of FC and MPO.

Aging amplifies a gut microbiota immunogenic signature linked to heightened inflammation

“…We corroborated and expanded on these findings by showing that an aging microbiota is tightly associated with signs of barrier disruption and innate inflammatory infiltration, including robust elevations in LBP and calprotectin, respectively. The cytoplasmic calprotectin is found in innate immune cells, including neutrophils and monocytes and is a gold standard biomarker used for assessing ongoing inflammatory processes in the context of inflammatory bowel diseases (Fernandes et al; Ling Lundström et al, 2023). While largely understudied in the context of aging, our findings in mice corroborates data from aged humans showing that fecal calprotectin progressively increases with age, especially within individuals over 60 years old of age (Joshi et al, 2010).…”