JINLING (Judicious INdex of Luminal INflammation Grade) score, an effective indicator to assess inflammation severity in Crohn's disease.

Abstract

BACKGROUND:

With the increasing demand for individualized treatment in Crohn's disease, a score for accurate evaluation of inflammation grade will be of great significance. We have developed the JINLING score to assess inflammation severity for Crohn's disease, which incorporates an endoscopic score (SES-CD) and a 2-item patient-reported outcome (PRO2). The aim of this study was to examine the performance of JINLING score in evaluating inflammation grade and the correlation with the clinical outcomes.

METHODS:

The correlation between JINLING score and Global Histologic Disease Activity Score (GHAS), fecal calprotectin (FCP), and C-reactive protein (CRP) level was performed in an exploration phase with a retrospective data set. The data on clinical outcomes including medication effects, Crohn's disease-related surgery and biochemical results were collected from a single-center prospective validation cohort.

RESULTS:

JINLING score correlated significantly with FCP, CRP, and hemoglobin in the exploration cohort (all P < 0.05). The receiver operating characteristic (ROC) curves based on a threshold Crohn's disease activity index value of 150, GHAS of 4, and FCP of 60 μg/g to identify disease activity, all showed a higher area under the curve with JINLING score than SES-CD or PRO2 alone. In the validation cohort, patients with high inflammation grade (JINLING ≥4) had higher GHAS, CRP, and FCP than low inflammation grade patients. High JINLING score was associated with an increased risk of treatment failure (hazard ratio 2.93; 95% confidence interval 1.13-7.61, P = 0.021).

CONCLUSION:

This newly developed index served well for quantifying inflammation grade and predicting clinical outcomes. JINLING score has the potential to facilitate clinical decision-making and personalized therapy for Crohn's disease patients.

• Authors: Wenbin Gong, Kun Guo, Tao Zheng, Haohao Xie, Weijie Li, Mengxuan Li, Zhiwu Hong, Huajian Ren, Guosheng Gu, Gefei Wang, Xiuwen Wu, Jianan Ren
• Journal: European journal of gastroenterology & hepatology (Eur J Gastroenterol Hepatol) Vol. 33 Issue 8 Pg. 1049-1054 (08 01 2021) ISSN: 1473-5687 [Electronic] England
• PMID: 33136728 (Publication Type: Journal Article)
• Copyright: Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

Chemical References

• Biomarkers
• Leukocyte L1 Antigen Complex
• C-Reactive Protein

Topics

• Biomarkers
• C-Reactive Protein (analysis)
• Crohn Disease (diagnosis, drug therapy)
• Feces (chemistry)
• Humans
• Inflammation (diagnosis)
• Leukocyte L1 Antigen Complex
• Prospective Studies
• Retrospective Studies
• Severity of Illness Index