Mo1833 – Capsule Endoscopy Impact on Therapeutic Decisions in Patients with Crohn’s Disease: A Real-World Experience

Background: Vimentin is a type III intermediate filament protein that stabilises cell architecture, but might be more active involved in intestinal inflammation during Crohn's disease (CD) and ulcerative colitis (UC).In lamina propria vimentin is found fibroblast and myofibroblasts, but are also produced by activated macrophages in inflammatory diseases.Protein fragments from vimentin turnover can be measured by competitive enzyme-linked immunosorbent assay (ELISA) targeting MMP-2 and -8 degraded and citrullinated-vimentin (VICM) and thereby maybe act as a serological biomarker of intestinal inflammation.The aim of this study is to evaluate how VICM correlates to clinical and endoscopic disease activity in CD and UC.Methods: We included 63 CD patients, 107 UC patients and 20 healthy controls in a prospective biomarker evaluation study.35% (n=24) of CD patients and 49% (n=52) of UC patients had active disease.We recorded Harvey-Bradshaw Index (HBI) or Simple Clinical Colitis Activity Index (SCCAI), and measured VICM, C-reactive protein (CRP) and faecal calprotectin (FC).17 CD and 63 UC patients underwent sigmoidoscopy or colonoscopy and were scored with Simple Endoscopic Score for Crohn's disease (SES-CD) or Endoscopic Mayo Score.Results: VICM was significantly elevated in CD and UC patients compared to healthy controls (p=0.0001).VICM correlated positively to SES-CD, SCCAI and Endoscopic Mayo Score (Fig. 1B, Fig. 2A andB), and had a tendency to correlate to HBI (Fig. 1A).VICM had a stronger correlation to the endoscopic scores than CRP (Fig. 1B, 1D, 2B, 2D), but not as strong a correlation as FC (Fig. 1A,1E,2A,2E).Conclusion: VICM is significantly elevated in IBD patients in remission and IBD patients with active disease compared to healthy controls.Furthermore, VICM correlates significantly to endoscopic disease activity in CD and to clinical and endoscopic activity in UC.VICM has a higher correlation to the endoscopic scores compared to CRP.As VICM is produced locally in the inflamed gut and CRP is a systemic inflammation marker produced in the liver.Thus VICM might act as a serological biomarker of inflammation in the intestinal wall in IBD.