PMID- 29788262
OWN - NLM
STAT- MEDLINE
DCOM- 20190911
LR  - 20190911
IS  - 1536-4844 (Electronic)
IS  - 1078-0998 (Linking)
VI  - 24
IP  - 12
DP  - 2018 Nov 29
TI  - 6-Thioguanine Nucleotide Levels Are Associated With Mucosal Healing in Patients 
      With Crohn's Disease.
PG  - 2621-2627
LID - 10.1093/ibd/izy173 [doi]
AB  - BACKGROUND: Level of 6-thioguanine nucleotides (6-TGN) has been reported to be 
      associated with clinical remission in patients with Crohn's disease (CD) 
      receiving maintenance treatment with thiopurines. Whether 6-TGN levels are 
      associated with mucosal healing (MH) has seldom been investigated. We aimed to 
      assess the correlation between 6-TGN levels and MH in patients with CD. METHODS: 
      This was a retrospective, cross-sectional, observational, multicenter study of 
      119 patients with CD treated with thiopurines in 3 inflammatory bowel disease 
      referral centers (France, Australia, and China) between June 2012 and April 2016. 
      Established CD patients who underwent ileocolonoscopy during thiopurine treatment 
      were included. MH was defined as simple endoscopic score-CD <3. Univariate and 
      multivariable regression analyses were used to evaluate variables associated with 
      MH. RESULTS: The mean concentration of 6-TGN in the MH group was higher compared 
      with that in the non-MH group (359.0 +/- 226.7 pmol/8 x 108 red blood cell count 
      [RBC] vs 277.1 +/- 170.5 pmol/8 x 108 RBC; P = 0.017). The cutoff 6-TGN 
      concentration of 397.3 pmol/8 x 108 RBC was 86.7% specific to MH, with a 
      sensitivity of 35.3% and area under curve (AUC) of 0.631 (P = 0.010). On 
      multivariable analysis, 6-TGN levels were associated with MH (odds ratio [OR], 
      3.287; 95% confidence interval [CI], 1.348-8.017; P = 0.009) whereas late 
      initiation of AZA (longer duration from disease onset) was inversely associated 
      with MH (OR, 0.972; 95% CI, 0.954-0.991; P = 0.004). CONCLUSIONS: Higher 6-TGN 
      levels are independently associated with a reduced rate of endoscopically active 
      disease and a higher rate of mucosal healing in CD patients. Prospective studies 
      of adequate sample size are required to confirm these findings.
FAU - Mao, Ren
AU  - Mao R
AD  - Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen 
      University, Guangzhou, China.
AD  - Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and 
      Surgery Institute, Cleveland Clinic, Cleveland, Ohio.
FAU - Guo, Jing
AU  - Guo J
AD  - Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen 
      University, Guangzhou, China.
AD  - Department of Gastroenterology, The Affiliated Hospital of Qingdao University, 
      Qingdao, China.
FAU - Luber, Raphael
AU  - Luber R
AD  - Department of Gastroenterology, The Alfred Hospital, Melbourne, Victoria, 
      Australia.
FAU - Chen, Bai-Li
AU  - Chen BL
AD  - Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen 
      University, Guangzhou, China.
FAU - He, Yao
AU  - He Y
AD  - Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen 
      University, Guangzhou, China.
FAU - Zeng, Zhi-Rong
AU  - Zeng ZR
AD  - Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen 
      University, Guangzhou, China.
FAU - Ben-Horin, Shomron
AU  - Ben-Horin S
AD  - Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen 
      University, Guangzhou, China.
AD  - Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Israel.
FAU - Sparrow, Miles P
AU  - Sparrow MP
AD  - Department of Gastroenterology, The Alfred Hospital, Melbourne, Victoria, 
      Australia.
FAU - Roblin, Xavier
AU  - Roblin X
AD  - Department of Gastroenterology, University Hospital of Saint Etienne, Saint 
      Etienne, France.
FAU - Chen, Min-Hu
AU  - Chen MH
AD  - Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen 
      University, Guangzhou, China.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Inflamm Bowel Dis
JT  - Inflammatory bowel diseases
JID - 9508162
RN  - 0 (Biomarkers)
RN  - 0 (Guanine Nucleotides)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Thionucleotides)
RN  - 15867-02-4 (6-thioguanylic acid)
RN  - FTK8U1GZNX (Thioguanine)
RN  - MRK240IY2L (Azathioprine)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Australia
MH  - Azathioprine/*therapeutic use
MH  - Biomarkers/blood
MH  - China
MH  - Crohn Disease/blood/*drug therapy/pathology/surgery
MH  - Cross-Sectional Studies
MH  - Drug Monitoring/methods
MH  - Endoscopy, Gastrointestinal
MH  - Female
MH  - France
MH  - Guanine Nucleotides/*blood
MH  - Humans
MH  - Immunosuppressive Agents/*therapeutic use
MH  - Linear Models
MH  - Male
MH  - Mucous Membrane/*pathology
MH  - Multivariate Analysis
MH  - ROC Curve
MH  - Retrospective Studies
MH  - Thioguanine/*therapeutic use
MH  - Thionucleotides/*blood
MH  - Young Adult
EDAT- 2018/05/23 06:00
MHDA- 2019/09/12 06:00
CRDT- 2018/05/23 06:00
PHST- 2017/11/25 00:00 [received]
PHST- 2018/05/23 06:00 [pubmed]
PHST- 2019/09/12 06:00 [medline]
PHST- 2018/05/23 06:00 [entrez]
AID - 4998847 [pii]
AID - 10.1093/ibd/izy173 [doi]
PST - ppublish
SO  - Inflamm Bowel Dis. 2018 Nov 29;24(12):2621-2627. doi: 10.1093/ibd/izy173.