Gut mucosal secretion of interleukin 1 beta and interleukin-8 predicts relapse in clinically inactive Crohn's disease

Trials of maintenance therapy in Crohn's disease are often underpowered, an d there is need for objective markers of relapse. We assessed the relations hip of whole gut lavage fluid cytokines to relapse in inactive Crohn's dise ase. Fifty-four patients with inactive Crohn's disease were prospectively a ssessed. Inactivity was determined as a Crohn's disease activity index of < 150 and whole gut lavage fluid immunoglobulin G <10 mug/ml. All patients un derwent whole gut lavage with analysis of IL-I beta and IL-8. Follow up was for one year. Patients with elevated whole gut lavage fluid IL-I beta (P < 0.004) and IL-8 (P < 0.02) had greater chance of relapse. Young age, short disease duration, and fistulating disease also relapsed more frequently. M ultiple regression identified IL-1 beta as an independent variable. In conc lusion, an elevated whole gut lavage fluid IL-I beta in inactive Crohn's di sease identifies patients at high risk of relapse.