POTENTIAL OF MEASUREMENTS OF UNSATURATED VITAMIN-B(12)-BINDING CAPACITY IN SERIAL COLONOSCOPIC BIOPSY SPECIMENS FOR GLOBAL AND REGIONAL ASSESSMENTS OF DISEASE SEVERITY IN INFLAMMATORY BOWEL-DISEASE

We investigated whether measurements of unsaturated vitamin B12-bindin g capacity (UBBC), in homogenates of serial colonoscopic biopsy specim ens, could be used as objective measures of disease severity in ulcera tive colitis (UC) and Crohn's disease (CD). On a regional basis UBBC a ctivity correlated with and showed good agreement with endoscopic and histologic activity scores (r = 0.8 and 0.6, respectively, for UC, and r = 0.7 and 0.7, respectively, for CD). For global assessment aggrega te UBBC, endoscopic and histologic scores were compared with standard clinical activity scores. In UC, correlations with the van Hees index were r = 0.7, 0.8, and 0.7, respectively, and UBBC assays accurately r eflected both regional and global disease activity. In CD, correlation s with the CDAI were -0.1, 0.7, and 0.6, respectively. Thus, aggregate UBBC scores failed to reflect disease activity in CD, in which focal deep ulcers may produce high symptom scores but in which adjacent spec imens may show no accute inflammation.