Granulocyte and monocyte adsorptive apheresis (GMA) is widely used as a remission induction therapy for active ulcerative colitis (UC) patients. However, there are no available biomarkers for predicting the clinical outcome of GMA. We investigated the utility of Fecal calprotectin (FC) as a biomarker for predicting the clinical outcome during GMA therapy in active UC patients. In this multicenter prospective observation study, all patients received 10 sessions of GMA, twice a week, for 5 consecutive weeks. FC was measured at entry, one week, two weeks, and at the end of GMA. Colonoscopy was performed at entry and after GMA. The clinical activity was assessed based on the partial Mayo score when FC was measured. Clinical remission (CR) was defined as a partial Mayo score of ≤ 2 and endoscopic remission (ER) was defined as Mayo endoscopic subscore of either 0 or 1. We analyzed the relationships between the clinical outcome (CR and ER) and the change in FC concentration. Twenty-six patients were included in this study. The overall CR and ER rates were 50.0% and 19.2%, respectively. After GMA, the median FC concentration in patients with ER was significantly lower than that in patients without ER (469 mg/kg vs. 3107 mg/kg, p = 0.03). When the cut-off value of FC concentration was set at 1150 mg/kg for assessing ER after GMA, the sensitivity and specificity were 0.8 and 0.81, respectively. The FC concentration had significantly decreased by one week. An ROC analysis demonstrated that the reduction rate of FC (ΔFC) at 1 week was the most accurate predictor of CR at the end of GMA (AUC = 0.852, P = 0.002). When the cut-off value of ΔFC was set at ≤ 40% at 1 week for predicting CR at the end of GMA, the sensitivity and specificity were 76.9% and 84.6%, respectively. We evaluated the utility of FC as a biomarker for assessing ER after GMA and predicting CR in the early phase during GMA in patients with active UC. Our findings will benefit patients with active UC by allowing them to avoid unnecessary invasive procedures and will help establish new strategies for GMA.

中文翻译：

---

粪便钙卫蛋白是预测溃疡性结肠炎患者粒细胞和单核细胞吸附分离术临床结果的有用生物标志物：一项前瞻性观察研究


粒细胞和单核细胞吸附分离术（GMA）被广泛用作活动性溃疡性结肠炎（UC）患者的缓解诱导疗法。然而，没有可用的生物标志物来预测 GMA 的临床结果。我们研究了粪便钙卫蛋白 (FC) 作为生物标志物在预测活动性 UC 患者 GMA 治疗期间临床结果的效用。在这项多中心前瞻性观察研究中，所有患者均接受 10 次 GMA，每周两次，连续 5 周。 FC 在 GMA 开始时、一周、两周和结束时进行测量。在进入时和 GMA 后进行结肠镜检查。测量 FC 时根据部分 Mayo 评分评估临床活性。临床缓解（CR）定义为部分 Mayo 评分≤ 2，内镜缓解（ER）定义为 Mayo 内镜分项评分为 0 或 1。我们分析了临床结果（CR 和 ER）与内镜检查变化之间的关系。 FC 浓度。本研究纳入了 26 名患者。总体 CR 和 ER 率分别为 50.0% 和 19.2%。 GMA 后，有 ER 患者的中位 FC 浓度显着低于无 ER 患者（469 mg/kg vs. 3107 mg/kg，p = 0.03）。当GMA后评估ER的FC浓度截止值设定为1150 mg/kg时，敏感性和特异性分别为0.8和0.81。一周后FC浓度显着下降。 ROC 分析表明，1 周时的 FC 降低率 (ΔFC) 是 GMA 结束时 CR 的最准确预测指标（AUC = 0.852，P = 0.002）。当将 1 周时 ΔFC 的临界值设定为 ≤ 40% 来预测 GMA 结束时的 CR 时，敏感性和特异性分别为 76.9% 和 84.6%。 我们评估了 FC 作为生物标志物在 GMA 后评估 ER 以及在 GMA 期间预测活动性 UC 患者早期 CR 的效用。我们的研究结果将使活动性 UC 患者受益，让他们避免不必要的侵入性手术，并将有助于制定新的 GMA 策略。