Trajectory of fecal lactoferrin for predicting prognosis in ulcerative colitis

Objectives:To investigate the characteristics and prognostic value of fecal lactoferrin trajectories in ulcerative colitis(UC).Methods:This study used data from the UNIFI trial(ClinicalTrials.gov,NCT02407236)and included patients who received ustekinumab during induction for trajectory modeling(n=637).Patients who received ustekinumab during maintenance therapy were used for 1-year outcome analyses(n=403).The levels of fecal lactoferrin,fecal calprotectin,and serum C-reactive protein were measured at weeks O,2,4,and 8.The trajectories of these biomarkers were developed using a latent class growth mixed model.Results:The trajectories of fecal lactoferrin,fecal calprotectin,and serum C-reactive protein were distinct,but all were associated with prior exposure to anti-tumor necrosis factor agents and vedolizumab.Furthermore,the fecal lactoferrin trajectory was the most valuable predictor of endoscopic,clinical,and histological remission.Compared to the high/moderate-rapid decrease trajectory group,the moderate-slow decrease,high-slow decrease,and high-stable groups had adjusted odds ratios(95%confidence interval)of o.38(0.18,0.78;P=0.010),0.47(0.23,0.93;P=0.032),and 0.33(0.17,0.63;P=0.001),respectively,of 1-year endoscopic remission.Patients with high/moderate-rapid decrease trajectories also had the highest likelihood of achieving clinical and histological remission.Finally,we developed a patient-stratification scheme based on fecal lactoferrin trajectories and concentrations.Patients with good,moderate,and poor prognoses in the scheme had a distinct probability of achieving 1-year endoscopic remission(52.7%,30.9%,and 12.8%,respectively).Conclusions:The trajectory of fecal lactoferrin is a valuable prognostic factor for 1-year remission in UC.

Insights into the molecular mechanisms and therapeutic implications of interleukin-6 for inflammatory bowel disease

Inflammatory bowel disease(IBD)is a debilitating chronic inflammatory disorder that primarily affects the digestive system,which mainly encompasses Crohn’s disease(CD)and ulcerative colitis(UC).Currently,the exact pathogenesis of IBD has not reached a unified conclusion,and most theories attribute it to the result of a combination of genetic,environmental,immunological,and microbial factors.Despite the availability of various treatment options such as biological agents,the management of IBD remains a significant challenge owing to the complicated and heterogeneous nature of this disease.