Inflammatory Bowel Disease

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Goes beyond just inflammatory processes

In developing the Monitr® Crohn’s Disease Test, Prometheus evaluated numerous factors that are related to mucosal damage and healing processes, including7:

  • Inflammatory bowel disease (IBD) biology
  • Relevant IBD signaling pathways
  • Therapeutic targets
  • Tumor biology
  • Classic wound healing
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Monitr provides healthcare professionals with more information than inflammatory biomarkers alone. This innovative, laboratory-developed test features 13 biomarkers that are associated with mucosal damage and repair processes, including7:

  • Inflammation: high-sensitivity C-reactive protein (hsCRP) and serum amyloid A 1 (SAA 1)
  • Cell adhesion: carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM 1) and vascular cell adhesion molecule 1 (VCAM 1)
  • Immune recruitment modulation: interleukin-7 (IL-7)
  • Growth factors (proliferation & repair): transforming growth factor α (TGFα)
  • Angiogenesis: angiopoietin 1 (Ang 1) and Ang 2
  • Matrix remodeling: matrix metalloproteinase 1 (MMP 1), MMP 2, MMP 3, MMP 9, and extracellular matrix metalloproteinase inducer (EMMPRIN)

Biomarkers are clinically valuable, but currently have limitations1-4

C-reactive protein (CRP) is:

  • NOT associated with high sensitivity3,*
  • NOT gut specific for inflammation5
  • NOT elevated in as many as 25% of patients with active Crohn’s disease (CD): (“CRP nonresponders”)4

Fecal calprotectin (FC) is:

  • NOT CD specific6
  • NOT preferred (poor patient compliance)7,8

Easy to order: Monitr Test Requisition Form. For assistance ordering,
contact Client Services toll-free in the US at 888-423-5227 (Monday through Friday from 6 AM to 4:30 PM PT).

*In a review and meta-analysis of 19 studies, pooled sensitivity and specificity estimates for CRP were 0.49 and 0.92, respectively.

References
  1. Peyrin-Biroulet L, Sandborn W, Sands BE, et al. Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE): determining therapeutic goals for treat-to-target. Am J Gastroenterol. 2015;110(9):1324-1338.
  2. Colombel JF, Panaccione R, Bossuyt P, et al. Effect of tight control management on Crohn’s disease (CALM): a multicentre, randomised, controlled phase 3 trial. Lancet. 2017;390(10114):2779-2789.
  3. Mosli MH, Zou G, Garg SK, et al. C-reactive protein, fecal calprotectin, and stool lactoferrin for detection of endoscopic activity in symptomatic inflammatory bowel disease patients: a systematic review and meta-analysis. Am J Gastroenterol. 2015;110(6):802-819.
  4. Jürgens M, Mahachie John JM, Cleynen I, et al. Levels of C-reactive protein are associated with response to infliximab therapy in patients with Crohn’s disease. Clin Gastroenterol Hepatol. 2011;9(5):421-427.e1.
  5. Walsham NE, Sherwood RA. Fecal calprotectin in inflammatory bowel disease. Clin Exp Gastroenterol. 2016;9:21-29.
  6. Bjarnason I. The use of fecal calprotectin in inflammatory bowel disease. Gastroenterol Hepatol (N Y). 2017;13(1):53-56.
  7. D’Haens G, Kelly O, Battat R, et al. Development and validation of a test to monitor endoscopic activity in patients with Crohn’s disease based on serum levels of proteins. Gastroenterology. 2020;158(3):515-526.e10.
  8. Shah JM, Omar E, Pai DR, Sood S. Cellular events and biomarkers of wound healing. Indian J Plast Surg. 2012;45(2):220-228.