Tumor Necrosis Factor-α, Fecal Calprotectin, and Disease Activity in Inflammatory Bowel Disease Patients

Abstract

INTRODUCTION: Inflammatory bowel disease (IBD) has increased incidence and the lack of effective long-term therapeutic options has resulted in mortality from intestinal complications and also significant costs to the country’s health-care system. Evaluation of disease activity in IBD patients is beneficial for establishing clinical judgments, especially in giving therapy and knowing the response of the given therapy. Tumor necrosis factor (TNF)-α, fecal calprotectin (FC), Lichtiger index, and Crohn’s Disease Endoscopic Index of Severity (CDEIS) are useful tools for evaluating disease activity. This study wants to know the relationship between biomarkers with disease activity. METHODS: A cross-sectional retrospective study was conducted on IBD patients. The diagnosis of IBD was based on findings from the gastrointestinal tract during colonoscopy and biopsy that showed features of IBD. TNF-α _was taken from the patient’s serum, while FC was from the patient’s stool sample. Lichtiger index was taken from anamneses, while CDEIS from endoscopy. The data will be analyzed using SPSS 22.0. RESULTS: A total of 35 patients with IBD met the inclusion criteria. This study found a 0.7-fold risk in IBD patients to have moderate-severe activity if they had TNF-α _levels of ≥ 1.14 pg/mL, although it was not significant (p = 0.581; OR:0.68; 95%CI 0.18-2.66). A significant relationship was found in the value of FC with disease activity in IBD patients, with a six-fold risk of having IBD with moderate-to-severe activity if FC levels ≥254 μg/g (p=0,011, OR:6,24, 95%CI 1,44-27,06). CONCLUSION: Fecal calprotectin levels have significant relationship with disease activity in IBD patients, both clinically and endoscopically. Fecal calprotectin is a decent marker for assessing disease activity in IBD patients.