Clinico-endoscopic and biochemical parallels of chronic inflammatory bowel diseases with positive inflammatory markers

Abstract

Background. The prevalence of inflammatory bowel disease (IBD) is currently increasing worldwide and represents a serious problem that causes interest in the study and, especially, in the development of less invasive diagnostic measures. In the studies of years on the diagnosis of IBD, there are data indicating the possibility of using IgG4 as a diagnostic biomarker. Purpose: to investigate the peculiarities of endoscopic manifestations and activity of IBD depending on the disease severity, the levels of fecal calprotectin (FC) and IgG4. Materials and methods. One hundred patients with IBD were examined, including 75 people with ulcerative colitis (UC) and 25 with Crohn’s disease (CD). Patients were divided into groups depending on the nosology and severity of the course. All of them underwent an endoscopic examination to verify the diagnosis; the level of IgG, IgG4 in blood serum, the IgG4/IgG ratio, and the content of FC were determined. Results. A significant increase in the degree of endoscopic activity was detected along with an increase in the severity of ulcerative colitis and Crohn’s disease. It was found that the level of FC increased with increasing severity of UC and CD. In patients with UC and CD, a probable decrease in the level of IgG was revealed (p<0.05). The concentration of IgG4 in the group of patients with UC was 2.3 (p<0.05) and 2.5 times (p<0.05) higher compared to the control group and patients with CD, respectively. A correlation was found between the level of IgG4 and the index of Best, the degree of severity, the localization of the inflammatory process in the colon, and the ratio of IgG4/IgG. The relationship of the IgG4/IgG ratio with the endoscopic index of IBD activity and serum IgG4 was revealed. Conclusions. The degree of endoscopic activity of IBD increased along with the severity of the disease. A positive correlation was found between the FC level and the severity of IBD and an inverse correlation— with IgG level. The level of IgG4 depended on the endoscopic activity of IBD, which was confirmed by a correlation. A 2-fold (p<0.05) and 2.5-fold (p<0.05) increase was found in the concentration of IgG4 in the blood serum of patients with UC compared to the control group and patients with CD, respectively. The obtained data can be used for differential diagnosis of UC and CD.