Pursuing neutrophils: systematic scoping review on blood-based biomarkers as predictors of treatment outcomes in inflammatory bowel disease

Magalhães, Diogo; Peyrin–Biroulet, Laurent; Estevinho, María Manuela; Danese, Silvio; Magro, Fernando

doi:10.1177/17562848231155987

Cited by 9 publications

(2 citation statements)

References 72 publications

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“…Although there are limitations, our conclusions may provide additional value to the current rapidly changing and contentious pieces of evidence, particularly in cohorts of critically ill individuals. [52][53][54][55][56][57][58]…”

Section: Discussionmentioning

confidence: 99%

Serial neutrophils count as a stratifying tool for early follicular tonsilitis remission

Hayfa Suleiman Mefleh Obeidat,

Wajdi Nidal Jeries Smirat,

Mousa Mohammad Ali Almashagbah

et al. 2024

World J. Bio. Pharm. Health Sci.

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Background/Aim: This study examines the correlation between sequential serum neutrophil levels and the overall improvement status or reduction rate of intravenous antibiotic administration. This study seeks to identify a cost-effective and easily accessible biomarker that can accurately predict the need for hospitalisation in patients with acute tonsillitis who are receiving intravenous broad-spectrum antibiotics. The goal is to determine the patients' suitability for early discontinuation of intravenous antibiotics and discharge. Methods: This study was conducted at the King Hussein Medical Centre in Jordan, focusing on patients with severe acute tonsillitis who did not respond to oral antibiotics. Data was collected from the electronic medical record system (Hakeem) from January 2018 to May 2021. The study classified serial serum neutrophil measurements during the first week of hospital admission into four categories. The levels were compared between the non-penicillin Cohort (Group I) and penicillin Cohort (Group II) using an Independent-T Test. The outcomes of interest included a drop in neutrophil counts exceeding 50%, a decrease in the use of intravenous antibiotics in favor of oral antibiotics, and early eligibility for discharge. The study also examined serial neutrophil counts over the tested days and compared to the outcomes of positive and negative states using receiver operating curve analyses. The optimal cutoff operating point for each ROC curve was determined by selecting the highest Youden's index of each prognosticator day level. The analysis of all results was conducted using SPSS version 20 with a significance level set at p-value <0.05. Results: This study analyzed 1638 adult and elderly patients admitted to KHMC, RMS, Amman, Jordan between January 2018 and May 2021. The average age was 51.88±16.22 years, with patients dependent on intravenous penicillin being slightly older. The distribution of males and females was significant, with males making up 2.55 times the number of females. The odds ratio for positive outcomes was 4.12, with a high rate of poor outcomes in 1318 out of all eligible patients. A total of 994 (60.7%) medical patients were treated with intravenous administration, while 644 (39.3%) surgical patients were scheduled for a tonsillectomy procedure. The risk estimate for patients admitted from medical wards compared to surgical wards was an odds ratio of 0.562. The study also provided sensitivity analysis for the four tested serial neutrophil prognosticators at different day levels. Conclusion: The study supports the use of Somatic Nucleated Cell (SNC) as a reliable measure for evaluating EFR in cases of catarrhal acute tonsillitis. The maximum SNC count in Group one was 11,269 cells per cubic millimeter. Acute streptococcal infection often exhibits an ESR higher than 40, but this may be concealed by other complications. The SNC test has advantages like simplicity, quickness, and cost-effectiveness, but lacks specificity. Monitoring SNC and EFR fluctuations can initiate treatment cessation, preventing relapse and severe complications during recovery.

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Section: Discussionmentioning

confidence: 99%

Serial neutrophils count as a stratifying tool for early follicular tonsilitis remission

Hayfa Suleiman Mefleh Obeidat,

Wajdi Nidal Jeries Smirat,

Mousa Mohammad Ali Almashagbah

et al. 2024

World J. Bio. Pharm. Health Sci.

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“…Some novel biomarkers look promising, including blood-based ratios and microR-NAs [34]. The neutrophil-to-lymphocyte ratio (NLR) is a readily accessible hematological biomarker that correlates with the response of biological drugs and predicts endoscopic outcomes in both UC and CD [35,36]. On the other hand, distinct panels of miRNAs have been identified in blood and fecal samples of IBD patients, with a future potential role in disease monitoring [34].…”

Section: Serum Biomarkersmentioning

confidence: 99%

Current Approaches for Monitoring of Patients with Inflammatory Bowel Diseases: A Narrative Review

Vitello,

Maida,

Shahini

et al. 2024

JCM

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Background: Patients with inflammatory bowel diseases (IBD) require proactive monitoring both during the active phase to evaluate therapeutic response and during the remission phase to evaluate relapse or colorectal cancer surveillance. However, monitoring may vary between patients with ulcerative colitis (UC) and Crohn’s disease (CD), with distinct tools and intervals. Methods: This narrative review aims to focus on modern approaches to IBD monitoring, considering international guidelines and expert consensus. Results: The most recent European diagnostic guidelines advocate a combination of clinical, laboratory, endoscopic, and radiological parameters to evaluate the disease course of patients with IBD. Unfortunately, the conventional symptom-based therapeutic approach does not improve long-term outcomes and there is no single ideal biomarker available. Endoscopy plays a key role in evaluating response to therapy as well as monitoring disease activity. Recently, bedside intestinal ultrasound (IUS) has gained increasing interest and diffusion as it appears to offer several advantages including the monitoring of therapeutic response. Conclusion: In light of growing clinical advances, we present a schematic evidence-based monitoring algorithm that can be easily applied in clinical practice which combines all major monitoring modalities, including noninvasive tools such as IUS and video-capsule endoscopy.

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Serum Neutrophil Biomarkers to Predict Crohn's Disease Progression and Infliximab Treatment Outcomes

Magalhaes,

Santiago,

Patita

et al. 2024

UEG Journal

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Background and aimsPredicting the treatment outcomes of biological therapies is an unmet need in Crohn's Disease. In this study, we explored the potential of serum neutrophil‐related biomarkers to predict infliximab therapeutic results and disease progression in Crohn's Disease patients, over a 2‐year period, in a real‐world setting.MethodsThe study included 100 asymptomatic Crohn's Disease patients in the IFX maintenance phase from the prospective, observational, multicenter DIRECT study. Patients were categorized according to a composite outcome reflecting progression that included surgery, hospitalizations, new fistulae, abscess or stricture, and drug treatment escalation. Serum neutrophil elastase, lipocalin‐2, lactoferrin, and resistin (non‐neutrophil control) were analyzed via multiplex magnetic bead assays at multiple touchpoints. Fecal calprotectin was assessed by ELISA.ResultsOver up to 2 years of follow‐up, serum biomarkers did not differentiate between the composite outcome groups, whereas fecal calprotectin was significantly higher in patients with worse outcomes. During the infliximab maintenance phase, there was a significant, sustained reduction of neutrophil elastase (p < 0.001), lipocalin‐2 (p < 0.001), and lactoferrin (p < 0.001), but not of resistin, despite stable neutrophil levels. Correlations between NE and NGAL levels were strong (Pearson correlations 0.75–0.85); all other correlations were of small magnitude.ConclusionOur real‐world data do not support using serum neutrophil elastase, lipocalin‐2, or lactoferrin concentrations as predictors of treatment outcomes or disease evolution in infliximab ‐treated Crohn's Disease patients. On the other hand, the sustained decrease in biomarkers over time suggests that neutrophil stabilization might be an additional infliximab mechanism of action.

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Pursuing neutrophils: systematic scoping review on blood-based biomarkers as predictors of treatment outcomes in inflammatory bowel disease

Cited by 9 publications

References 72 publications

Serial neutrophils count as a stratifying tool for early follicular tonsilitis remission

Serial neutrophils count as a stratifying tool for early follicular tonsilitis remission

Current Approaches for Monitoring of Patients with Inflammatory Bowel Diseases: A Narrative Review

Serum Neutrophil Biomarkers to Predict Crohn's Disease Progression and Infliximab Treatment Outcomes

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