Abstract

Background:
Crohn’s disease (CD) is a chronic inflammatory condition of the intestinal tract resulting in severe intestinal tissue damage. The concept of mucosal healing has therefore gained significant interest as a therapeutic end point in the treatment of inflammatory bowel disease (IBD). Given that the function of von Willebrand factor (VWF) is a central axis in initiation of wound healing and a marker of endothelial dysfunction, we hypothesized that changes in processing of VWF may provide additional disease characterization of CD.

Methods:
We developed neo-specific biomarkers specifically targeting the ADAMTS13-processed form of VWF (VWF-A), and formation of VWF by quantification of the pro-peptide (VWF-N). We measured these two analytes of VWF in 71 serum samples from diseased patients of which 51 were classified as CD patients and 20 as non-IBD patients. 10 age-matched healthy serum samples were included as control group.

Results:
Levels of VWF-A (p < 0.01) and VWF-N (p < 0.0001) were significantly increased in CD and non-IBD patients compared to\r\nhealthy control subjects. VWF-N level (p < 0.001) discriminated CD and non-IBD patients from control subjects with a diagnostic accuracy of 94%. No significant differences were observed in the turnover ratio of VWF-N/VWF-A between CD, non-IBD and healthy subjects.

Conclusion:
Patients with CD have increased production of VWF and ADAMTS13 proteolyzed-form of VWF compared to healthy subjects. Biomarkers of primary wound healing could serve as early predictors of disease activity and intestinal healing in patients\r\nwith CD and may be used to access personalized health status and treatment options for patients.

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