Abstract
The aim of the study was to determine the comparative usefulness of inflammatory markers, in evaluating disease activity in patients with inflammatory bowel disease. Disease activity was assessed by the Mayo Clinic score for ulcerative colitis, and Harvey-Bradshaw score for Crohn's disease. Five hundred normal blood donors who had no underlying inflammatory condition served as controls. The erythrocyte sedimentation rate, platelet and white blood cell count, C reactive protein, and the leucocyte adhesiveness/aggregation test (LAAT) were determined in each patient. One hundred and twenty four patients with inflammatory bowel disease were tested while in remission and 128 in relapse. Their mean (SD) per cent of aggregated white blood cells in the peripheral blood was 8 (5) and 17 (10) respectively compared with controls 6 (4) (p < 0.0001). Moreover, the LAAT could effectively discriminate between various grades of disease activity, the values in patients with active disease being 13 (6)% in mild, 17 (10)% in moderate, and 26 (10)% in severe disease (p < 0.0001). Other acute phase reactants including the erythrocyte sedimentation rate, the white blood cell count, the platelet count, neutrophil count, as well as, the C reactive protein concentration did not differentiate as well between the various groups. Using logistic regression analysis to differentiate between inflammatory bowel disease patients in remission or relapse, the LAAT was the single best indicator. The addition of any other test did not contribute to the discrimination. Among the different laboratory variables tested only the LAAT significantly discriminated between the five different subgroups of controls, remission and mild, moderate or severe disease activity.
Full text
PDF



Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Andre C., Descos L., Landais P., Fermanian J. Assessment of appropriate laboratory measurements to supplement the Crohn's disease activity index. Gut. 1981 Jul;22(7):571–574. doi: 10.1136/gut.22.7.571. [DOI] [PMC free article] [PubMed] [Google Scholar]
- André C., Descos L., Vignal J., Gillon J. C-reactive protein as a predictor of relapse in asymptomatic patients with Crohn's disease. Scott Med J. 1983 Jan;28(1):26–29. doi: 10.1177/003693308302800106. [DOI] [PubMed] [Google Scholar]
- Aspey B. S., Jessimer C., Pereira S., Harrison M. J. Do leukocytes have a role in the cerebral no-reflow phenomenon? J Neurol Neurosurg Psychiatry. 1989 Apr;52(4):526–528. doi: 10.1136/jnnp.52.4.526. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Berliner S., Abramovitz M., Kariv N., Weinberger A., Yaron M., Lavie G., Pinkhas J., Aronson M. The leukergy test in rheumatic diseases. New implications for an old test. Arthritis Rheum. 1985 Aug;28(8):899–903. doi: 10.1002/art.1780280809. [DOI] [PubMed] [Google Scholar]
- Berliner S., Caspi D., Neuman Y., Ostfeld I., Hod M., Yaron M., Pinkhas J., Aronson M. Aggregation of white cells and C-reactive protein: relation between these two indices in acute phase reaction. J Clin Pathol. 1987 Jan;40(1):103–106. doi: 10.1136/jcp.40.1.103. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Berliner S., Fishelson Z., Bruhis S., Kaufman H., Pinhas J., Aronson M. The phenomenon of leukergy: induction and detection of leukocyte aggregation in whole human blood. J Lab Clin Med. 1987 May;109(5):575–582. [PubMed] [Google Scholar]
- Berliner S., Fried M., Caspi D., Weinberger A., Yaron M., Pinkhas J., Aronson M. Evaluation of disease activity in rheumatic patients by leucocyte adhesiveness/aggregation. Ann Rheum Dis. 1988 Jun;47(6):458–462. doi: 10.1136/ard.47.6.458. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Best W. R., Becktel J. M., Singleton J. W., Kern F., Jr Development of a Crohn's disease activity index. National Cooperative Crohn's Disease Study. Gastroenterology. 1976 Mar;70(3):439–444. [PubMed] [Google Scholar]
- Carlos T. M., Harlan J. M. Membrane proteins involved in phagocyte adherence to endothelium. Immunol Rev. 1990 Apr;114:5–28. doi: 10.1111/j.1600-065x.1990.tb00559.x. [DOI] [PubMed] [Google Scholar]
- Chambers R. E., Stross P., Barry R. E., Whicher J. T. Serum amyloid A protein compared with C-reactive protein, alpha 1-antichymotrypsin and alpha 1-acid glycoprotein as a monitor of inflammatory bowel disease. Eur J Clin Invest. 1987 Oct;17(5):460–467. doi: 10.1111/j.1365-2362.1987.tb01143.x. [DOI] [PubMed] [Google Scholar]
- Clark W. M., Madden K. P., Rothlein R., Zivin J. A. Reduction of central nervous system ischemic injury in rabbits using leukocyte adhesion antibody treatment. Stroke. 1991 Jul;22(7):877–883. doi: 10.1161/01.str.22.7.877. [DOI] [PubMed] [Google Scholar]
- Cooke W. T., Prior P. Determining disease activity in inflammatory bowel disease. J Clin Gastroenterol. 1984 Feb;6(1):17–25. [PubMed] [Google Scholar]
- Dearing W. H., McGuckin W. F., Elveback L. R. Serum alpha 1-acid glycoprotein in chronic ulcerative colitis. Gastroenterology. 1969 Feb;56(2):295–303. [PubMed] [Google Scholar]
- Dinerman J. L., Mehta J. L. Endothelial, platelet and leukocyte interactions in ischemic heart disease: insights into potential mechanisms and their clinical relevance. J Am Coll Cardiol. 1990 Jul;16(1):207–222. doi: 10.1016/0735-1097(90)90481-4. [DOI] [PubMed] [Google Scholar]
- Fadilah R., Berliner S., Kidron D., Ben-Bassat M., Frumkin R., Jaffe A., Pinkhas J., Aronson M. The state of leukocyte adhesiveness/aggregation in the peripheral blood of patients with respiratory tract infections. Respiration. 1990;57(2):109–113. doi: 10.1159/000195830. [DOI] [PubMed] [Google Scholar]
- Fagan E. A., Dyck R. F., Maton P. N., Hodgson H. J., Chadwick V. S., Petrie A., Pepys M. B. Serum levels of C-reactive protein in Crohn's disease and ulcerative colitis. Eur J Clin Invest. 1982 Aug;12(4):351–359. doi: 10.1111/j.1365-2362.1982.tb02244.x. [DOI] [PubMed] [Google Scholar]
- Fiasse R., Lurhuma A. Z., Cambiaso C. L., Masson P. L., Dive C. Circulating immune complexes and disease activity in Crohn's disease. Gut. 1978 Jul;19(7):611–617. doi: 10.1136/gut.19.7.611. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fried M., Ben-Hur N., Berliner S., Medalia O., Aronson M., Kidron D., Ben-Bassat M. The state of leucocyte adhesiveness/aggregation (LAA) in the peripheral blood of burned mice: an early and sensitive inflammatory indicator and a marker of pulmonary leukostasis. Burns. 1991 Dec;17(6):458–461. doi: 10.1016/0305-4179(91)90071-n. [DOI] [PubMed] [Google Scholar]
- Galante A., Carta S., Domenici B., Pietroiusti A. Proposal of a new method to avoid misinterpretations in the evaluation of the leukergy test. Scand J Clin Lab Invest. 1992 Sep;52(5):431–433. doi: 10.3109/00365519209088379. [DOI] [PubMed] [Google Scholar]
- Goldman G., Kahn P. J., Aharonson M., Kariv N., Stadler J., Wiznitzer T. Leukergy in inflammatory bowel disease. Dis Colon Rectum. 1988 Nov;31(11):854–856. doi: 10.1007/BF02554848. [DOI] [PubMed] [Google Scholar]
- Harlan J. M. Leukocyte-endothelial interactions. Blood. 1985 Mar;65(3):513–525. [PubMed] [Google Scholar]
- Harvey R. F., Bradshaw J. M. A simple index of Crohn's-disease activity. Lancet. 1980 Mar 8;1(8167):514–514. doi: 10.1016/s0140-6736(80)92767-1. [DOI] [PubMed] [Google Scholar]
- Helman C. A., Novis B. H., Bank S., Wormold L., Jacobs P. Serum lysozyme in Crohn's disease and ulcerative colitis. S Afr Med J. 1977 Dec 17;52(26):1042–1044. [PubMed] [Google Scholar]
- Jensen K. B., Jarnum S., Koudahl G., Kristensen M. Serum orosomucoid in ulcerative colitis: its relation to clinical activity, protein loss, and turnover of albumin and IgG. Scand J Gastroenterol. 1976;11(2):177–183. [PubMed] [Google Scholar]
- Kjeldsen J., Schaffalitzky de Muckadell O. B. Assessment of disease severity and activity in inflammatory bowel disease. Scand J Gastroenterol. 1993 Jan;28(1):1–9. doi: 10.3109/00365529309096037. [DOI] [PubMed] [Google Scholar]
- Korelitz B. I. An indicator of Crohn's disease activity. A need unfulfilled. J Clin Gastroenterol. 1986 Jun;8(3 Pt 1):220–222. [PubMed] [Google Scholar]
- Lentnek A. L., Schreiber A. D., MacGregor R. R. The induction of augmented granulocyte adherence by inflammation. Mediation by a plasma factor. J Clin Invest. 1976 Apr;57(4):1098–1103. doi: 10.1172/JCI108354. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Molad I., Berliner S., Arber N., Kidron D., Sternberg E., Ben-Bassat M., Giler S., Pinkhas J., Aronson M. Increased leukocyte adhesiveness/aggregation and tissue leukostasis following surgical trauma. Int Surg. 1993 Jan-Mar;78(1):20–24. [PubMed] [Google Scholar]
- Myren J., Bouchier I. A., Watkinson G., Softley A., Clamp S. E., de Dombal F. T. The O.M.G.E. Multinational Inflammatory Bowel Disease Survey 1976-1982. A further report on 2,657 cases. Scand J Gastroenterol Suppl. 1984;95:1–27. [PubMed] [Google Scholar]
- Sachar D. B., Smith H., Chan S., Cohen L. B., Lichtiger S., Messer J. Erythrocytic sedimentation rate as a measure of clinical activity in inflammatory bowel disease. J Clin Gastroenterol. 1986 Dec;8(6):647–650. doi: 10.1097/00004836-198612000-00011. [DOI] [PubMed] [Google Scholar]
- Simpson P. J., Todd R. F., 3rd, Fantone J. C., Mickelson J. K., Griffin J. D., Lucchesi B. R. Reduction of experimental canine myocardial reperfusion injury by a monoclonal antibody (anti-Mo1, anti-CD11b) that inhibits leukocyte adhesion. J Clin Invest. 1988 Feb;81(2):624–629. doi: 10.1172/JCI113364. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Simpson P. J., Todd R. F., 3rd, Mickelson J. K., Fantone J. C., Gallagher K. P., Lee K. A., Tamura Y., Cronin M., Lucchesi B. R. Sustained limitation of myocardial reperfusion injury by a monoclonal antibody that alters leukocyte function. Circulation. 1990 Jan;81(1):226–237. doi: 10.1161/01.cir.81.1.226. [DOI] [PubMed] [Google Scholar]
- TRUELOVE S. C., WITTS L. J. Cortisone in ulcerative colitis; final report on a therapeutic trial. Br Med J. 1955 Oct 29;2(4947):1041–1048. doi: 10.1136/bmj.2.4947.1041. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Talstad I., Gjone E. The disease activity of ulcerative colitis and Crohn's disease. Scand J Gastroenterol. 1976;11(4):403–408. [PubMed] [Google Scholar]
- Vandenvelde C., Scheen R., Fondu P., Van Beers D. Fast PCR-based quantitative detection of B-cell malignancies. Nouv Rev Fr Hematol. 1991;33(1):25–29. [PubMed] [Google Scholar]
- van Hees P. A., van Elteren P. H., van Lier H. J., van Tongeren J. H. An index of inflammatory activity in patients with Crohn's disease. Gut. 1980 Apr;21(4):279–286. doi: 10.1136/gut.21.4.279. [DOI] [PMC free article] [PubMed] [Google Scholar]

