Serum amyloid A is a better predictive biomarker of mucosal healing than C-reactive protein in ulcerative colitis in clinical remission

BMC Gastroenterol. 2020 Apr 3;20(1):85. doi: 10.1186/s12876-020-01229-8.

Abstract

Background: Many studies have revealed that mucosal healing improves the long-term prognosis of ulcerative colitis. Frequent colonoscopy is difficult because of its invasiveness and cost. Therefore, in diagnosing and treating ulcerative colitis, noninvasive, low-cost methods for predicting mucosal healing using useful biomarkers are required in the clinical setting. This study aimed to evaluate whether serum amyloid A is a better serum biomarker than C-reactive protein in predicting mucosal healing in ulcerative colitis patients in clinical remission.

Methods: Ulcerative colitis patients whose C-reactive protein and serum amyloid A were measured within 1 month before and after colonoscopy were included in this retrospective study, and the relationship between the C-reactive protein and serum amyloid A values and the mucosal condition was analyzed. Mucosal condition was assessed using the Mayo Endoscopic Score, with score 0 or 1 indicating mucosal healing.

Results: A total of 199 colonoscopic examinations were conducted in 108 ulcerative colitis patients who underwent C-reactive protein and serum amyloid A blood tests. In clinical remission patients, serum amyloid A showed a strong correlation with mucosal inflammation compared to C-reactive protein and had excellent sensitivity and specificity rates with significant statistical significance.

Conclusions: Serum amyloid A is a more useful marker compared to C-reactive protein in predicting mucosal inflammation in ulcerative colitis patients in clinical remission.

Keywords: C-reactive protein; Mucosal healing; Serum amyloid a; Ulcerative colitis.

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Biological Products / therapeutic use
  • Biomarkers / metabolism
  • C-Reactive Protein / metabolism*
  • Child
  • Colitis, Ulcerative / drug therapy
  • Colitis, Ulcerative / metabolism*
  • Colitis, Ulcerative / pathology
  • Colonoscopy*
  • Female
  • Humans
  • Immunologic Factors / therapeutic use
  • Intestinal Mucosa / pathology*
  • Male
  • Mesalamine / therapeutic use
  • Middle Aged
  • Remission Induction
  • Serum Amyloid A Protein / metabolism*
  • Severity of Illness Index
  • Young Adult

Substances

  • Adrenal Cortex Hormones
  • Anti-Inflammatory Agents, Non-Steroidal
  • Biological Products
  • Biomarkers
  • Immunologic Factors
  • Serum Amyloid A Protein
  • Mesalamine
  • C-Reactive Protein