Abstract

SERUM SELENIUM CORRELATIONS WITH C-REACTIVE PROTEIN, SERUM CALPROTECTIN AND DISEASE ACTIVITY IN IBD PATIENTS TREATED WITH INFLIXIMAB

Manal M.Younus*, Mohammed A.Taher, Basim A. Askar, Jaffar M. Kurmanji

ABSTRACT

Crohn's disease and ulcerative colitis affect both small intestine and colon. Diagnosis require clinical, laboratory, endoscopy and imaging techniques. Nowadays infliximab as an anti TNF alpha is successfully used in the treatment of both CD and UC. Additionally, there is an increasing interest in using complementary and alternative medicines (CAM) in IBD such as micronutrients including selenium. Many biomarkers have been studied extensively specially c-reactive protein and fecal calprotectin and correlations were suggested with disease activity and endoscopy activity but there is a lack of information regarding the correlations between serum selenium and disease activity, CRP and serum calprotectin in IBD patients receiving infliximab which is why it was studied in this study. Patients and methods: The study was designed as an interventional prospective study conducted in the Gastroenterology and Hepatology specialized hospital, a tertiary center in Medical City Directorate in Baghdad, Iraq. A total of 46 IBD patients treated with infliximab were enrolled and they were systematically randomized into 2 groups; one received infliximab with no selenium supplementation and the other group received infliximab plus selenium supplementation and followed up for 3 consecutive visits every 8 weeks for 24 weeks after the baseline visit. At baseline and study end patients provided blood samples for selenium, CRP and calprotectin and clinical activity for crohn's disease was measured by CDAI and mayo scores for ulcerative colitis. Results: Selenium supplemented patients showed a significant decrease in CRP and serum calprotectin levels (p – value 0.001 and 0.008) while selenium level showed a significant increase (p – value 0.001) and disease activity was not affected by the addition of selenium supplementation. Both CRP and serum calprotectin correlated significantly with serum selenium (Spearman’s r - 0.531 and - 0.387, P 0.001 and 0.002). No correlation was found between serum selenium and CDAI and mayo scores. Conclusions: selenium supplementation significantly decreased CRP and serum calprotectin and serum selenium correlate negatively with c-reactive protein and serum calprotectin in IBD patients treated with infliximab.

Keywords: (CD) Crohn's disease, (IBD) inflammatory bowel disease, (IFX) infliximab, (TNF) tumor necrosis factor,(UC) ulcerative colitis, (Se) selenium, (CRP) C-reactive protein, TNBS, (hsCRP).