[Significance of serum concentrations of pro- and anti-inflammatory cytokines in identification of patients with Crohn's disease]

Abstract

A simple, non-invasive examination separating patients with irritable bowel syndrome from those affected by Crohn's disease (CD) has not been found, so far. Immune disturbances associated with release of various cytokines play an important role in CD pathogenesis. The aim of the study was to investigate the diagnostic efficacy of serum levels of broad panel of pro- and anti-inflammatory cytokines in differentiation between patients with CD and intact bowel.

Material and methods: To the study were included 57 patients with established diagnosis of ileo-coecal CD (according to endoscopic, radiologic and histopathologic criteria) and 21 subjects with no organic bowel pathology. Serum concentrations of CRP and proinflammatory (IL-1beta, IL-6, TNF-alpha) and anti-inflammatory (IL-10, IL-1, IL-1RA, IL-6sR, TNF-alpha R2) cytokines were measured by immunoenzymatic method in both groups.

Results: Serum levels of IL-1beta, IL-6, IL-10, TNF-alpha and TNF-alpha R2 were significantly different in CD patients than in control group. Among these cytokines TNF-alpha serum level showed the highest discriminative diagnostic efficacy between both groups. The diagnostic efficacies of CRP (cut-off value was 4.25 mg/dl) and TNF-alpha (cut-off value 2.5 microg/ml) were similar, showing respectively an accuracy of 81% and 74%, sensitivity of 79% and 65% and specificity of 89% and 100%.

Conclusion: TNF-alpha showed the highest diagnostic efficacy in differentiating patients with CD from healthy subjects, however, the TNF-alpha does not exceed diagnostic value of CRP.