254 In the Pro-inflammatory panel, concentrations of IFN-γ and IL-6 were significantly elevated in CD patients with ‘increased’ fecal calprotectin levels as compared to patients with ‘normal’ fecal calprotectin levels (IFN-γ: 23.00 pg/mL (IQR: 10.13-38.72) vs. 7.80 pg/mL (IQR: 4.09-19.72) (P < 0.05); IL-6: 1.29 pg/mL (0.93-1.88) vs. 0.78 pg/mL (0.39-1.15) (P < 0.01). In addition, in the Vascular injury panel, we found significantly higher concentrations of SAA and CRP in patients with increased fecal calprotectin levels as compared to the group with normal fecal calprotectin levels (SAA: 9.02x106 pg/mL (IQR: 4.64x106-2.87x107) vs. 4.78x106 pg/mL (2.84x106-8.87x106) (P < 0.05); CRP: 6.79x106 pg/mL (IQR: 3.61x106-2.64x107) vs. 1.25x106 pg/mL (IQR: 6.03x105-4.67x106) (P < 0.01)). In the Cytokine panel, Chemokine panel and Angiogenesis panel, no significant differences in serum biomarker concentrations were observed between both groups. Interestingly, we also observed elevated concentrations of IL-17A and TNF-β in patients with increased fecal calprotectin levels, but these were borderline non-significant (P = 0.058 and P = 0.051, respectively). Distributions of the significantly correlating serum biomarkers between groups are shown in Figure 1 (IFN-γ and CRP, P < 0.01) and Figure 2 (IL-6, IL-17A, TNF-β and SAA, P < 0.05). A highly significant positive correlation was observed between the pro-inflammatory cytokines IFN-γ (ρ = 0.523, P < 0.01, Figure 1A) and CRP (ρ = 0.511, P < 0.01, Figure 1B) and fecal calprotectin levels. Significant, but less strong correlations were demonstrated between IL-6 (ρ = 0.403, P < 0.05, Figure 2A), IL-17A (ρ = 0.352, P < 0.05, Figure 2B), TNF-β (ρ = 0.396, P < 0.05, Figure 2C) and SAA (ρ = 0.323, P < 0.05, Figure 2D), and fecal calprotectin levels. No significant correlations were observed between the fecal calprotectin level and the other 31 investigated cytokines, chemokines and markers for angiogenesis and vascular injury. Figure 1 | Distribution of serum biomarker levels in patients with normal (blue, < 200 mg/kg) and increased (red, > 200 mg/kg) fecal calprotectin levels, shown in boxplots. (A) Serum CRP levels (pg/mL). (B) Serum IFN-γ levels (pg/mL). *P < 0.05; **P < 0.01. Chapter 7
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