Neutrophil-elastase in chronic inflammatory bowel disease: A marker of disease activity?

BACKGROUND/AIMS: Neutrophil elastase is a proteinase which exists in granul ocytes and plays an important role in the pathogenesis of inflammatory diso rders. In inflammatory bowel disease there is a leukocyte infiltration of t he bowel mucosa. The purpose of this study was to examine whether plasma el astase represents a reliable laboratory marker for establishing the activit y of chronic inflammatory bowel disease. METHODOLOGY: We measured plasma elastase concentrations in 61 patients suff ering from either Crohn's disease or ulcerative colitis and compared these data with other clinical and laboratory findings and with elastase concentr ations in 40 healthy controls. The sensitivity and specificity of the elast ase values in chronic IBD were calculated with the use of concomitant measu rements of CRP and ESR. RESULTS: Plasma levels were found to be significantly higher in patients (4 9 mu g/l) compared with healthy controls (23 mu g/l). Patients with active disease had higher plasma levels than patients in remission. In general, th e sensitivity of elastase to detect active inflammatory bowel disease was a bout 60%; the specificity was 65%. For patients in remission, the sensitivi ty was higher than 80%. However, there was a wide range of overlapping valu es between chronic inactive patients and those with moderately active disea se. CONCLUSIONS: We conclude that plasma elastase is a useful independent marke r of disease activity in inflammatory bowel disease. Especially for identif ying patients in remission, the measurements of elastase seem to be more su itable than other parameters of inflammation, like CRP or ESR.