High-sensitive C-Reactive Protein as a Marker for Inflammation in Irritable Bowel Syndrome

Abstract

Background Recent studies demonstrated low-grade inflammation in patients with Irritable Bowel Syndrome (IBS). However, these studies have been relatively small and do not enable examination of this factor in different subtypes of IBS and the possibility of confounding effects of co-morbidities that may be associated with inflammatory responses. Goals To investigate the association between high sensitive C - reactive protein (hs-CRP) and the diagnosis of IBS, IBS-subtypes, symptoms' severity and IBS-associated co-morbidities. Study This cross-sectional study uses data from a large matched case control study of IBS subjects and healthy controls (HC). hs-CRP levels were measured in all subjects. IBS diagnosis was determined by Rome III criteria, negative screening blood tests and normal colonoscopy. Subjects were evaluated for IBS severity and associated pain and psychological co-morbidities Results A total of 242 IBS patients and 244 HC were studied. Median hs-CRP levels in the IBS group were significantly higher than in HC (1.80, IQR 0.7-4.04 mg/l vs 1.20, IQR 0.5-2.97mg/l respectively, p<0.006,). Levels were highest in IBS-D patients with greater disease severity. Hs-CRP levels mildly correlated with symptoms severity (r=0.169, p=0.009); this correlation was stronger for the IBS-D patients (r=0.27, p=0.006). IBS was a significant independent predictor (p=0.025) for higher hs-CRP levels, whereas other pain and psychological co-morbidities were not. Conclusions Given these observations of cross-sectional differences in hs-CRP between IBS subtypes and severity, independent of pain and co-morbidities, more research is needed to explore a possible role of low-grade inflammation in the pathogenesis and/or clinical presentation of IBS.

Immune activation in irritable bowel syndrome: from basic to clinic

“…These studies indicated that HS-CRP is higher in IBS patients compared to healthy controls and these levels were highest in IBS-D and in those patients with greater IBS severity 72,73 . These findings also need to be confirmed in larger studies.…”

“…These findings also need to be confirmed in larger studies. Based on the latest publication 73 , the median HS-CRP levels in the IBS group and healthy controls were 1.80 and 1.20 mg/L, respectively, with large interquartile ranges questioning the clinical value of HS-CRP in differentiating IBS from healthy controls.…”

Risk of cancer in patients with irritable bowel syndrome: a nationwide population-based study

“…However, it is worth emphasizing that although one or more of these mechanisms are evident in most IBS patients, none, including inflammation hypothesis, can account for the symptoms in all cases. However, studies exploring the possible role of inflammation in the pathogenesis of IBS continue to draw the attention of many researchers in the field [30].…”

Serum biomarkers for Irritable bowel syndrome

“…Data in literature emphasize the role of inflammation, even subclinical, in the pathogenesis of IBS [26]. …”