Serum trefoil factors in patients with inflammatory bowel disease.

Background: Trefoil factors (TFF1-3) play a critical role in mucosal protection and repair in the gastrointestinal tract. The aims of the present study were to examine associations between serum TFF1-3 and clinical and biochemical markers reflecting disease activity and to examine changes in TFF1-3 in patients with inflammatory bowel disease (IBD) before and during high-dose prednisolone treatment and tapering.

Methods: Serum concentrations of TFF1-3 were quantified in 48 ulcerative colitis (UC) and 50 Crohn's disease (CD) patients with little or moderate activity. Additionally, serum TFF concentrations were determined in patients with severe activity in colon IBD (4 UC and 6 CD) before and during prednisolone treatment with 7 healthy subjects as controls.

Results: Median concentrations of TFF1, TFF2, and TFF3 were significantly increased in IBD patients compared with healthy controls (p < 0.01). TFF3 concentrations correlated with clinical and biochemical parameters of disease activity in UC patients. In addition, a trend towards reduction in TFF concentrations during treatment with prednisolone and concomitant clinical and biochemical remission was observed.

Conclusions: The present data support the concept that trefoil peptides are upregulated and may play a role in IBD mucosal protection and repair. In UC patients, TFF3 levels were increased in active disease levels correlated with disease activity indices. Due to a large variation, serum TFFs are not a potential marker for disease activity.