Serum ficolin-2 correlates worse than fecal calprotectin and CRP with endoscopic Crohn's disease activity

Abstract

Background and aims: Ficolin-2 is an acute phase reactant produced by the liver and targeted to recognize N-acetyl-glucosamine which is present in bacterial and fungal cell walls. We recently showed that ficolin-2 serum levels were significantly higher in CD patients compared to healthy controls. We aimed to evaluate serum ficolin-2 concentrations in CD patients regarding their correlation with endoscopic severity and to compare them with clinical activity, fecal calprotectin, and CRP. Methods: Patients provided fecal and blood samples before undergoing ileo-colonoscopy. Disease activity was scored clinically according to the Harvey-Bradshaw Index (HBI) and endoscopically according to the simplified endoscopic score for CD (SES-CD). Ficolin-2 serum levels and fecal calprotectin levels were measured by ELISA. Results: A total of 136 CD patients were prospectively included (mean age at inclusion 41.5 ± 15.4. years, 37.5% females). Median HBI was 3 [2-6] points, median SES-CD was 5 [2-8], median fecal calprotectin was 301 [120-703] μg/g, and median serum ficolin-2 was 2.69 [2.02-3.83] μg/mL. SES-CD correlated significantly with calprotectin (R = 0.676, P < 0.001), CRP (R = 0.458, P < 0.001), HBI (R = 0.385, P < 0.001), and serum ficolin-2 levels (R = 0.171, P = 0.047). Ficolin-2 levels were higher in CD patients with mild endoscopic disease compared to patients in endoscopic remission (P = 0.015) but no difference was found between patients with mild, moderate, and severe endoscopic disease. Conclusions: Ficolin-2 serum levels correlate worse with endoscopic CD activity when compared to fecal calprotectin or CRP. © 2014 European Crohn's and Colitis Organisation.