Official journal of the American College of Gastroenterology | ACG
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Clinical Relevance of Serum Interleukin-6 in Crohn's Disease: Single Point Measurements, Therapy Monitoring, and Prediction of Clinical Relapse
Reinisch, Walter MD1; Gasché, Christoph MD1; Tillinger, Wolfgang MD1; Wyatt, John MS1; Lichtenberger, Cornelia BS1; Willheim, Martin MD2; Dejaco, Clemens MD1; Waldhör, Thomas PhD3; Bakos, Silvia B.S1; Vogelsang, Harald MD1; Gangl, Alfred MD1; Lochs, Herbert MD4
1Univ.-Klinik für Innere Medizin IV, Abteilung Gastroenterologie und Hepatologie, Vienna, Austria
2Institut für Allgemeine und Experimentelle Pathologie, Neues AKH, Vienna, Austria
3Institut für Tumorbiologie, Abteilung Epidemiologie, Vienna, Austria
4IV. Medizinische Klinik/Charité, Berlin, Germany
Reprint requests and correspondence: Walter Reinisch, MD, Univ.-Klinik für Innere Medizin IV, Abteilung Gastroenterologie und Hepatologie, Neues AKH, Waehringer Guertel 18-20, A-1090 Vienna, Austria
Received December. 8, 1998; accepted March. 25, 1999
Abstract
OBJECTIVE:
To investigate the clinical relevance of interleukin-6 (IL-6) serum levels in patients with Crohn's disease (CD), single point IL-6 measurements in sera from consecutive CD patients and healthy donors (HD), as well as longitudinal measurements during the course of steroid therapy for active CD were performed. Patients with steroid-induced remission were followed until clinical relapse.
METHODS:
One hundred thirty-six CD patients without steroid or other immunosuppressive treatment within 2 months and surgical procedures within 3 months before study entry were investigated; 63 patients with active CD were enrolled into the follow-up program. Clinical activity was evaluated by the Crohn's disease activity index (CDAI) and serum IL-6 levels measured by enzyme-linked immunosorbent assay.
RESULTS:
IL-6 serum levels were significantly elevated in CD patients compared to HD (p < 0.001). In individual patients serum IL-6 levels correlated with corresponding CDAI scores in a subgroup referred to as primarily inflammatory patients presenting without bowel stenosis, previous intestinal resection, or concomitant inflammatory disorders (r = 0.72, p < 0.001). Primarily inflammatory patients displayed higher serum IL-6 levels (median: 6.0 pg/ml; range: 1.3–25) than CD patients with bowel stenosis (median: 2.0; range: 1.3–4.9; p < 0.01) or extensive intestinal resection (median: 1.5; range: 1.3–13.7; p < 0.001). Longitudinally measured serum IL-6 levels reflected the clinical response during steroid therapy and predicted clinical relapse after steroid-induced remission at week 9 of the treatment protocol.
CONCLUSIONS:
Serum IL-6 is a clinically relevant parameter for CD that correlates with inflammatory activity and implies a prognostic value after steroid-induced remission.