Serum Amyloid A as a Surrogate Marker for Mucosal and Histologic Inflammation in Patients with Crohn’s Disease

Abstract

Inflammatory bowel disease (IBD) comprises a heterogeneous group of conditions affecting the gastrointestinal tract; Crohn’s disease (CD) and ulcerative colitis (UC) are the two main recognize dentities. Both diseases have a general commonality in their pathogenesis and are derived from dysregulated mucosal immune response to antigenic components of the normal commensal microbiota that reside within the intestine. Regarding Crohn’s disease; there is no sex-specific distribution in adult Crohn's disease. The onset of the disease usually occurs in the second to fourth decade of life with a smaller peak that has been described from 50 to 60 years. Crohn’s disease can affect any part of the GI tract from the mouth to the anus, but most commonly affects the end of the small bowel (ileum) and the beginning of the colon. Diagnosis of Crohn’s disease depends on clinical symptoms such as pediatric growth disorders, anemia, weight variations, weakness, fatigue, abdominal pain, bloody diarrhea, and arthritis and on upper gastrointestinal radiography, endoscopy, colonoscopy, and gastrointestinal tract sampling. The natural course of the disease includes periods of remission and exacerbation. Disease activity refers to the assessment of disease at a given time point, and it is important for choosing the induction therapy, assessing the need for admission to hospital, or efficacy of a drug. In Crohn’s disease various factors assess the activity of the disease (Crohn’s activity index) over a week such as, Average number of liquid or soft stools per day, Using Diphenoxylate or Loperamide for diarrhea, Average abdominal pain rating, General wellbeing each day, Arthritis or arthralgia, Iritis or uveitis. Erythemanodosum, pyoderma gangrenosum or aphthous stomatitis, Anal fissure, fistula or abscess, Fever, Abdominal mass, Hematocrit value, gender, Current weight and Baseline weight