Pilot Study of Adalimumab for Early Prevention and/or Treatment of Post-Operative Endoscopic Recurrence of Crohn's Disease

index (HBI) and serum C-reactive protein (CRP)] at baseline, before each IFX infusion, and 12 weeks after therapy, and on the degree of mucosal healing (MH) at weeks 12-20 after IFX compared to endoscopy just before initiation of IFX. Complete responders had normal HBI scores, CRP levels and complete MH; partal responders had a >50% drop in HBI scores and CRP levels and residual ulcers and/or cobblestone despite improvement over baseline; and, primary non responders showed no change or worsened HBI scores, CRP levels and endoscopy. Serum samples were obtained at baseline and at 12 weeks and were subjected to proteomic analysis, i.e. two-Dimensional Gel Electrophoresis (2DE), coupled with MatrixAssisted Laser Desorption/ Ionization Time of Flight Mass Spectrometry (MALDI-TOF-MS). Selected proteins were further evaluated by Western blotting. Results: Serum proteomic analysis was performed in 6 complete, 6 partial and 6 primary non responders to IFX. Administration of IFX markedly changed the serum protein profile of CD patients. Despite the small number of individuals tested, we obtain results suggesting that proteomic markers may help to understand response to IFX and possibly try to define new markers for response prediction. Although a confirmation study should now be done on a larger cohort of independent patients, several proteins were found to be significantly overexpressed in partial and primary non responders versus complete responders were: APOΑ1, APOA4, Alpha-1antitrypsin, beta-2-glycoprotein, clusterin, C1R, C3, C4, fibrinogen, prothrombin, transthyretin and VTDB. Conclusion: Proteomics-based approaches are useful tools for providing global disease information and identifying biomarkers in complex diseases such as CD. This is the first proteomic study on response to IFX in a Greek CD cohort. Validation studies on a much larger cohort of patients are currently in progress.