Mucosal Biomarker of Innate Immune Activation Predicts Response to Vedolizumab in Crohn’s Disease

Abstract Objective Mucosal barrier dysfunction plays a crucial role in intestinal inflammation in Crohn’s disease (CD). Intestinal epithelial cell (IEC) death resulting from innate immune activation, termed pyroptosis, was recently found to be a cause of this barrier defect. The aim of this study wa...

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Bibliographic Details
Published in:Inflammatory bowel diseases 2020-10, Vol.26 (10), p.1554-1561
Main Authors: Osterman, Mark T, Gordon, Ilyssa O, Davis, Elisabeth M, Ciorba, Matthew, Glover, Sarah C, Abraham, Bincy, Khan, Freeha, Guo, Xueyan, Yee, Eric U, Allard, Felicia D, Claggett, Brian, Shen, Bo, Liu, Julia J
Format: Article
Language:English
Subjects:
Colonoscopy
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Summary:Abstract Objective Mucosal barrier dysfunction plays a crucial role in intestinal inflammation in Crohn’s disease (CD). Intestinal epithelial cell (IEC) death resulting from innate immune activation, termed pyroptosis, was recently found to be a cause of this barrier defect. The aim of this study was to determine the predictive value of pretreatment ileal biopsy pyroptosis as a biomarker for clinical response to vedolizumab in CD. Design Crohn’s disease patients ranging 18 to 80 years old from 5 IBD centers with pre-vedolizumab ileal biopsies during colonoscopy were enrolled. Biopsies were stained for activated caspases, and levels of ileal IEC pyroptosis levels were quantified. The primary outcome was clinical response 6 months after therapy, defined as a reduction of Harvey-Bradshaw Index (HBI) of ≥5 points from baseline. Secondary outcomes included clinical remission, defined as HBI
ISSN:1078-0998
1536-4844
DOI:10.1093/ibd/izz222