Blood chemistry markers for evaluation of inflammatory activity in Crohn's disease during infliximab therapy

Scand J Gastroenterol. 2011 Apr;46(4):420-7. doi: 10.3109/00365521.2010.539253. Epub 2010 Nov 30.


Objective: There is a discrepancy between clinical activity and biomarkers in inflammatory bowel disease. The Harvey-Bradshaw index (HBi) is steadfast to evaluate disease activity. A set of biological markers (high sensitive C-reactive protein [hs-CRP], calprotectin, total nitrite, soluble urokinase Plasminogen Activator Receptor [suPAR], ghrelin and endothelin) are investigated to study inflammatory activity and correlation with HBi during infliximab therapy.

Material and methods: Patients with Crohn's disease (n = 22) were assessed and blood samples drawn before and 1 week after infliximab infusion (5 mg/kg) and repeated after 6 months, and compared to healthy volunteers. Hs-CRP, calprotectin, suPAR, ghrelin and endothelin were analyzed with immunoassays, and total nitrite with Griess-reaction. Results were analyzed with Wilcoxon matched-pairs test, Mann-Whitney test and Spearman correlations.

Results: After the first infusion visit, HBi and calprotectin values decreased while nitrite increased (p < 0.05). At the 6-month visit, pre-infusion index and biomarkers had returned to baseline levels. Post-infusion, again the values of HBi, hs-CRP and calprotectin decreased (p < 0.05). The suPAR levels did not change between pre- and post-infusion periods at either visit. Calprotectin, nitrite and suPAR differed from healthy controls throughout the study (p < 0.05). Endothelin decreased with each treatment but was, like ghrelin, not different from controls. We found HBi to correlate with hs-CRP (Spearman r = 0.32, p < 0.05), but calprotectin did not, neither did nitrate nor suPAR.

Conclusions: Although infliximab ameliorates Crohn's disease symptoms, inflammatory markers are not persistently normalized, indicating a chronic inflammatory condition that may require continued infliximab therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anti-Inflammatory Agents / therapeutic use
  • Antibodies, Monoclonal / therapeutic use
  • Biomarkers / blood
  • C-Reactive Protein / metabolism*
  • Crohn Disease / blood*
  • Crohn Disease / drug therapy
  • Crohn Disease / pathology*
  • Endothelins / blood*
  • Female
  • Ghrelin / blood*
  • Humans
  • Infliximab
  • Leukocyte L1 Antigen Complex / blood*
  • Male
  • Middle Aged
  • Nitrites / blood*
  • Predictive Value of Tests
  • Receptors, Urokinase Plasminogen Activator / blood*
  • Severity of Illness Index
  • Young Adult


  • Anti-Inflammatory Agents
  • Antibodies, Monoclonal
  • Biomarkers
  • Endothelins
  • Ghrelin
  • Leukocyte L1 Antigen Complex
  • Nitrites
  • Receptors, Urokinase Plasminogen Activator
  • C-Reactive Protein
  • Infliximab