Serological biomarkers of type I, III and IV collagen turnover are associated with the presence and future progression of stricturing and penetrating Crohnʼs disease
Summary Background Increased collagen remodelling is a key pathophysiological component underlying intestinal stricture and fistula development in Crohn's disease (CD). Aims To investigate associations between serological biomarkers of collagen turnover and disease behaviour according to the Mo...
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| Veröffentlicht in: | Alimentary pharmacology & therapeutics 2022-08, Vol.56 (4), p.675-693 |
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| creator | Bourgonje, Arno R. Alexdottir, Marta S. Otten, Antonius T. Loveikyte, Roberta Bay‐Jensen, Anne‐Christine Pehrsson, Martin Dullemen, Hendrik M. Visschedijk, Marijn C. Festen, Eleonora A. M. Weersma, Rinse K. Karsdal, Morten A. Faber, Klaas Nico Mortensen, Joachim H. Dijkstra, Gerard |
| description | Summary
Background
Increased collagen remodelling is a key pathophysiological component underlying intestinal stricture and fistula development in Crohn's disease (CD).
Aims
To investigate associations between serological biomarkers of collagen turnover and disease behaviour according to the Montreal classification in patients with CD.
Methods
Serological biomarkers of type III/IV collagen formation (PRO‐C3, PRO‐C4) and matrix metalloproteinase (MMP) or granzyme‐B (GrzB)‐mediated type I, III, IV and VI collagen degradation (C1M, C3M, C4M, C4G, C6Ma3) were measured using neo‐epitope protein fingerprint assays in 101 patients with CD (Montreal B1: n = 37; B2: n = 27; B3: n = 37) and 96 controls. Patients were followed up until their last outpatient visit to monitor stricturing/penetrating disease progression and recurrence and the occurrence of surgical interventions.
Results
C1M, C3M and C4M were significantly reduced in patients with stricturing disease (Montreal B2) and accurately differentiated them from patients with either non‐stricturing, non‐penetrating (B1) or penetrating (B3) disease (all p |
| doi_str_mv | 10.1111/apt.17063 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2673594816</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2694126594</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3883-fc59315903a7fe96ba6cf0a98ae6920e745635e9c12276f8410e2c580e93a3523</originalsourceid><addsrcrecordid>eNp1kU9uEzEUh60K1Kali14AWWLTSkzrP7HHXlZRgZEqgURhO3KcN4nLxJ7anla5EKfgBJwKJyksKuGN5efPn57fD6EzSi5pWVdmyJe0JpIfoAnlUlSMcPkKTQiTumKK8iN0nNI9IUTWhB2iIy6kpFSpCfr5FWLow9JZ0-O5C2sTf0BMOHQ4bwbAzXvcNA02foGb79iGvjdL8DiP0YdHiNhEwCalYJ3JsMBPLq9wXgEeIiTwFnYvu7Hw21pYlnJywW_9KUdny4Xzyx01gIccTd6eZzGs_O9fCS9cApPgDXrdmT7B6fN-gr59uLmbfapuP39sZte3leVK8aqzQnMqNOGm7kDLuZG2I0YrA1IzAvVUSC5AW8pYLTs1pQSYFYqA5oYLxk_Q-d5ben0YIeV27ZKF8msPYUwtkzUXeqqoLOi7F-h9KFMp3RVKTymTBSzUxZ6yMaQUoWuH6MqQNy0l7Ta8toTX7sIr7Ntn4zhfw-If-TetAlztgSfXw-b_pvb6y91e-Qd006XP</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2694126594</pqid></control><display><type>article</type><title>Serological biomarkers of type I, III and IV collagen turnover are associated with the presence and future progression of stricturing and penetrating Crohnʼs disease</title><source>Wiley Online Library Journals Frontfile Complete</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Wiley Free Content</source><creator>Bourgonje, Arno R. ; Alexdottir, Marta S. ; Otten, Antonius T. ; Loveikyte, Roberta ; Bay‐Jensen, Anne‐Christine ; Pehrsson, Martin ; Dullemen, Hendrik M. ; Visschedijk, Marijn C. ; Festen, Eleonora A. M. ; Weersma, Rinse K. ; Karsdal, Morten A. ; Faber, Klaas Nico ; Mortensen, Joachim H. ; Dijkstra, Gerard</creator><creatorcontrib>Bourgonje, Arno R. ; Alexdottir, Marta S. ; Otten, Antonius T. ; Loveikyte, Roberta ; Bay‐Jensen, Anne‐Christine ; Pehrsson, Martin ; Dullemen, Hendrik M. ; Visschedijk, Marijn C. ; Festen, Eleonora A. M. ; Weersma, Rinse K. ; Karsdal, Morten A. ; Faber, Klaas Nico ; Mortensen, Joachim H. ; Dijkstra, Gerard</creatorcontrib><description>Summary
Background
Increased collagen remodelling is a key pathophysiological component underlying intestinal stricture and fistula development in Crohn's disease (CD).
Aims
To investigate associations between serological biomarkers of collagen turnover and disease behaviour according to the Montreal classification in patients with CD.
Methods
Serological biomarkers of type III/IV collagen formation (PRO‐C3, PRO‐C4) and matrix metalloproteinase (MMP) or granzyme‐B (GrzB)‐mediated type I, III, IV and VI collagen degradation (C1M, C3M, C4M, C4G, C6Ma3) were measured using neo‐epitope protein fingerprint assays in 101 patients with CD (Montreal B1: n = 37; B2: n = 27; B3: n = 37) and 96 controls. Patients were followed up until their last outpatient visit to monitor stricturing/penetrating disease progression and recurrence and the occurrence of surgical interventions.
Results
C1M, C3M and C4M were significantly reduced in patients with stricturing disease (Montreal B2) and accurately differentiated them from patients with either non‐stricturing, non‐penetrating (B1) or penetrating (B3) disease (all p < 0.001, multivariable analysis). Similarly, the type IV collagen formation/degradation (PRO‐C4/C4M) ratio demonstrated high discriminative capacity (B1/B2: AUC = 0.90; B1/B3: AUC = 0.87, both p < 0.001, multivariable analysis). Prospectively, higher baseline levels of C1M and C4G were associated with an increased risk of penetrating disease progression (C4G: hazard ratio [HR] 1.71 [1.05–2.81], p < 0.05).
Conclusions
Elevated degradation of type I, III and IV collagen and excessive (relative) formation of type IV collagen strongly associates with stricturing CD. Type I and IV collagen fragments show predictive potential for the risk of penetrating disease progression. These biomarkers may become valuable tools for detection and prediction of stricturing and penetrating CD.
Serological biomarkers of collagen type I, type III and type IV turnover are associated with the presence and future progression of stricturing and penetrating Crohn's disease.</description><identifier>ISSN: 0269-2813</identifier><identifier>EISSN: 1365-2036</identifier><identifier>DOI: 10.1111/apt.17063</identifier><identifier>PMID: 35661188</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Biomarkers ; Cadmium ; Collagen ; Collagen (type I) ; Collagen (type III) ; Collagen (type IV) ; Crohn's disease ; Degradation ; Epitopes ; Matrix metalloproteinase ; Metalloproteinase ; Serology</subject><ispartof>Alimentary pharmacology & therapeutics, 2022-08, Vol.56 (4), p.675-693</ispartof><rights>2022 The Authors. published by John Wiley & Sons Ltd.</rights><rights>2022 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd.</rights><rights>2022. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3883-fc59315903a7fe96ba6cf0a98ae6920e745635e9c12276f8410e2c580e93a3523</citedby><cites>FETCH-LOGICAL-c3883-fc59315903a7fe96ba6cf0a98ae6920e745635e9c12276f8410e2c580e93a3523</cites><orcidid>0000-0002-3183-9007 ; 0000-0001-7277-7677 ; 0000-0003-4563-7462 ; 0000-0002-3255-6930 ; 0000-0001-7928-7371 ; 0000-0001-5026-8740 ; 0000-0001-8996-1200 ; 0000-0003-0326-7264 ; 0000-0002-4787-5563 ; 0000-0001-8168-5694 ; 0000-0001-5754-3821 ; 0000-0002-7028-4307 ; 0000-0001-7952-9297 ; 0000-0001-8893-3312</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fapt.17063$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fapt.17063$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,777,781,1412,1428,27905,27906,45555,45556,46390,46814</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35661188$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bourgonje, Arno R.</creatorcontrib><creatorcontrib>Alexdottir, Marta S.</creatorcontrib><creatorcontrib>Otten, Antonius T.</creatorcontrib><creatorcontrib>Loveikyte, Roberta</creatorcontrib><creatorcontrib>Bay‐Jensen, Anne‐Christine</creatorcontrib><creatorcontrib>Pehrsson, Martin</creatorcontrib><creatorcontrib>Dullemen, Hendrik M.</creatorcontrib><creatorcontrib>Visschedijk, Marijn C.</creatorcontrib><creatorcontrib>Festen, Eleonora A. M.</creatorcontrib><creatorcontrib>Weersma, Rinse K.</creatorcontrib><creatorcontrib>Karsdal, Morten A.</creatorcontrib><creatorcontrib>Faber, Klaas Nico</creatorcontrib><creatorcontrib>Mortensen, Joachim H.</creatorcontrib><creatorcontrib>Dijkstra, Gerard</creatorcontrib><title>Serological biomarkers of type I, III and IV collagen turnover are associated with the presence and future progression of stricturing and penetrating Crohnʼs disease</title><title>Alimentary pharmacology & therapeutics</title><addtitle>Aliment Pharmacol Ther</addtitle><description>Summary
Background
Increased collagen remodelling is a key pathophysiological component underlying intestinal stricture and fistula development in Crohn's disease (CD).
Aims
To investigate associations between serological biomarkers of collagen turnover and disease behaviour according to the Montreal classification in patients with CD.
Methods
Serological biomarkers of type III/IV collagen formation (PRO‐C3, PRO‐C4) and matrix metalloproteinase (MMP) or granzyme‐B (GrzB)‐mediated type I, III, IV and VI collagen degradation (C1M, C3M, C4M, C4G, C6Ma3) were measured using neo‐epitope protein fingerprint assays in 101 patients with CD (Montreal B1: n = 37; B2: n = 27; B3: n = 37) and 96 controls. Patients were followed up until their last outpatient visit to monitor stricturing/penetrating disease progression and recurrence and the occurrence of surgical interventions.
Results
C1M, C3M and C4M were significantly reduced in patients with stricturing disease (Montreal B2) and accurately differentiated them from patients with either non‐stricturing, non‐penetrating (B1) or penetrating (B3) disease (all p < 0.001, multivariable analysis). Similarly, the type IV collagen formation/degradation (PRO‐C4/C4M) ratio demonstrated high discriminative capacity (B1/B2: AUC = 0.90; B1/B3: AUC = 0.87, both p < 0.001, multivariable analysis). Prospectively, higher baseline levels of C1M and C4G were associated with an increased risk of penetrating disease progression (C4G: hazard ratio [HR] 1.71 [1.05–2.81], p < 0.05).
Conclusions
Elevated degradation of type I, III and IV collagen and excessive (relative) formation of type IV collagen strongly associates with stricturing CD. Type I and IV collagen fragments show predictive potential for the risk of penetrating disease progression. These biomarkers may become valuable tools for detection and prediction of stricturing and penetrating CD.
Serological biomarkers of collagen type I, type III and type IV turnover are associated with the presence and future progression of stricturing and penetrating Crohn's disease.</description><subject>Biomarkers</subject><subject>Cadmium</subject><subject>Collagen</subject><subject>Collagen (type I)</subject><subject>Collagen (type III)</subject><subject>Collagen (type IV)</subject><subject>Crohn's disease</subject><subject>Degradation</subject><subject>Epitopes</subject><subject>Matrix metalloproteinase</subject><subject>Metalloproteinase</subject><subject>Serology</subject><issn>0269-2813</issn><issn>1365-2036</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><recordid>eNp1kU9uEzEUh60K1Kali14AWWLTSkzrP7HHXlZRgZEqgURhO3KcN4nLxJ7anla5EKfgBJwKJyksKuGN5efPn57fD6EzSi5pWVdmyJe0JpIfoAnlUlSMcPkKTQiTumKK8iN0nNI9IUTWhB2iIy6kpFSpCfr5FWLow9JZ0-O5C2sTf0BMOHQ4bwbAzXvcNA02foGb79iGvjdL8DiP0YdHiNhEwCalYJ3JsMBPLq9wXgEeIiTwFnYvu7Hw21pYlnJywW_9KUdny4Xzyx01gIccTd6eZzGs_O9fCS9cApPgDXrdmT7B6fN-gr59uLmbfapuP39sZte3leVK8aqzQnMqNOGm7kDLuZG2I0YrA1IzAvVUSC5AW8pYLTs1pQSYFYqA5oYLxk_Q-d5ben0YIeV27ZKF8msPYUwtkzUXeqqoLOi7F-h9KFMp3RVKTymTBSzUxZ6yMaQUoWuH6MqQNy0l7Ta8toTX7sIr7Ntn4zhfw-If-TetAlztgSfXw-b_pvb6y91e-Qd006XP</recordid><startdate>202208</startdate><enddate>202208</enddate><creator>Bourgonje, Arno R.</creator><creator>Alexdottir, Marta S.</creator><creator>Otten, Antonius T.</creator><creator>Loveikyte, Roberta</creator><creator>Bay‐Jensen, Anne‐Christine</creator><creator>Pehrsson, Martin</creator><creator>Dullemen, Hendrik M.</creator><creator>Visschedijk, Marijn C.</creator><creator>Festen, Eleonora A. M.</creator><creator>Weersma, Rinse K.</creator><creator>Karsdal, Morten A.</creator><creator>Faber, Klaas Nico</creator><creator>Mortensen, Joachim H.</creator><creator>Dijkstra, Gerard</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>WIN</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>M7N</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3183-9007</orcidid><orcidid>https://orcid.org/0000-0001-7277-7677</orcidid><orcidid>https://orcid.org/0000-0003-4563-7462</orcidid><orcidid>https://orcid.org/0000-0002-3255-6930</orcidid><orcidid>https://orcid.org/0000-0001-7928-7371</orcidid><orcidid>https://orcid.org/0000-0001-5026-8740</orcidid><orcidid>https://orcid.org/0000-0001-8996-1200</orcidid><orcidid>https://orcid.org/0000-0003-0326-7264</orcidid><orcidid>https://orcid.org/0000-0002-4787-5563</orcidid><orcidid>https://orcid.org/0000-0001-8168-5694</orcidid><orcidid>https://orcid.org/0000-0001-5754-3821</orcidid><orcidid>https://orcid.org/0000-0002-7028-4307</orcidid><orcidid>https://orcid.org/0000-0001-7952-9297</orcidid><orcidid>https://orcid.org/0000-0001-8893-3312</orcidid></search><sort><creationdate>202208</creationdate><title>Serological biomarkers of type I, III and IV collagen turnover are associated with the presence and future progression of stricturing and penetrating Crohnʼs disease</title><author>Bourgonje, Arno R. ; Alexdottir, Marta S. ; Otten, Antonius T. ; Loveikyte, Roberta ; Bay‐Jensen, Anne‐Christine ; Pehrsson, Martin ; Dullemen, Hendrik M. ; Visschedijk, Marijn C. ; Festen, Eleonora A. M. ; Weersma, Rinse K. ; Karsdal, Morten A. ; Faber, Klaas Nico ; Mortensen, Joachim H. ; Dijkstra, Gerard</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3883-fc59315903a7fe96ba6cf0a98ae6920e745635e9c12276f8410e2c580e93a3523</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Biomarkers</topic><topic>Cadmium</topic><topic>Collagen</topic><topic>Collagen (type I)</topic><topic>Collagen (type III)</topic><topic>Collagen (type IV)</topic><topic>Crohn's disease</topic><topic>Degradation</topic><topic>Epitopes</topic><topic>Matrix metalloproteinase</topic><topic>Metalloproteinase</topic><topic>Serology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bourgonje, Arno R.</creatorcontrib><creatorcontrib>Alexdottir, Marta S.</creatorcontrib><creatorcontrib>Otten, Antonius T.</creatorcontrib><creatorcontrib>Loveikyte, Roberta</creatorcontrib><creatorcontrib>Bay‐Jensen, Anne‐Christine</creatorcontrib><creatorcontrib>Pehrsson, Martin</creatorcontrib><creatorcontrib>Dullemen, Hendrik M.</creatorcontrib><creatorcontrib>Visschedijk, Marijn C.</creatorcontrib><creatorcontrib>Festen, Eleonora A. M.</creatorcontrib><creatorcontrib>Weersma, Rinse K.</creatorcontrib><creatorcontrib>Karsdal, Morten A.</creatorcontrib><creatorcontrib>Faber, Klaas Nico</creatorcontrib><creatorcontrib>Mortensen, Joachim H.</creatorcontrib><creatorcontrib>Dijkstra, Gerard</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley Free Content</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><jtitle>Alimentary pharmacology & therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bourgonje, Arno R.</au><au>Alexdottir, Marta S.</au><au>Otten, Antonius T.</au><au>Loveikyte, Roberta</au><au>Bay‐Jensen, Anne‐Christine</au><au>Pehrsson, Martin</au><au>Dullemen, Hendrik M.</au><au>Visschedijk, Marijn C.</au><au>Festen, Eleonora A. M.</au><au>Weersma, Rinse K.</au><au>Karsdal, Morten A.</au><au>Faber, Klaas Nico</au><au>Mortensen, Joachim H.</au><au>Dijkstra, Gerard</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Serological biomarkers of type I, III and IV collagen turnover are associated with the presence and future progression of stricturing and penetrating Crohnʼs disease</atitle><jtitle>Alimentary pharmacology & therapeutics</jtitle><addtitle>Aliment Pharmacol Ther</addtitle><date>2022-08</date><risdate>2022</risdate><volume>56</volume><issue>4</issue><spage>675</spage><epage>693</epage><pages>675-693</pages><issn>0269-2813</issn><eissn>1365-2036</eissn><abstract>Summary
Background
Increased collagen remodelling is a key pathophysiological component underlying intestinal stricture and fistula development in Crohn's disease (CD).
Aims
To investigate associations between serological biomarkers of collagen turnover and disease behaviour according to the Montreal classification in patients with CD.
Methods
Serological biomarkers of type III/IV collagen formation (PRO‐C3, PRO‐C4) and matrix metalloproteinase (MMP) or granzyme‐B (GrzB)‐mediated type I, III, IV and VI collagen degradation (C1M, C3M, C4M, C4G, C6Ma3) were measured using neo‐epitope protein fingerprint assays in 101 patients with CD (Montreal B1: n = 37; B2: n = 27; B3: n = 37) and 96 controls. Patients were followed up until their last outpatient visit to monitor stricturing/penetrating disease progression and recurrence and the occurrence of surgical interventions.
Results
C1M, C3M and C4M were significantly reduced in patients with stricturing disease (Montreal B2) and accurately differentiated them from patients with either non‐stricturing, non‐penetrating (B1) or penetrating (B3) disease (all p < 0.001, multivariable analysis). Similarly, the type IV collagen formation/degradation (PRO‐C4/C4M) ratio demonstrated high discriminative capacity (B1/B2: AUC = 0.90; B1/B3: AUC = 0.87, both p < 0.001, multivariable analysis). Prospectively, higher baseline levels of C1M and C4G were associated with an increased risk of penetrating disease progression (C4G: hazard ratio [HR] 1.71 [1.05–2.81], p < 0.05).
Conclusions
Elevated degradation of type I, III and IV collagen and excessive (relative) formation of type IV collagen strongly associates with stricturing CD. Type I and IV collagen fragments show predictive potential for the risk of penetrating disease progression. These biomarkers may become valuable tools for detection and prediction of stricturing and penetrating CD.
Serological biomarkers of collagen type I, type III and type IV turnover are associated with the presence and future progression of stricturing and penetrating Crohn's disease.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>35661188</pmid><doi>10.1111/apt.17063</doi><tpages>19</tpages><orcidid>https://orcid.org/0000-0002-3183-9007</orcidid><orcidid>https://orcid.org/0000-0001-7277-7677</orcidid><orcidid>https://orcid.org/0000-0003-4563-7462</orcidid><orcidid>https://orcid.org/0000-0002-3255-6930</orcidid><orcidid>https://orcid.org/0000-0001-7928-7371</orcidid><orcidid>https://orcid.org/0000-0001-5026-8740</orcidid><orcidid>https://orcid.org/0000-0001-8996-1200</orcidid><orcidid>https://orcid.org/0000-0003-0326-7264</orcidid><orcidid>https://orcid.org/0000-0002-4787-5563</orcidid><orcidid>https://orcid.org/0000-0001-8168-5694</orcidid><orcidid>https://orcid.org/0000-0001-5754-3821</orcidid><orcidid>https://orcid.org/0000-0002-7028-4307</orcidid><orcidid>https://orcid.org/0000-0001-7952-9297</orcidid><orcidid>https://orcid.org/0000-0001-8893-3312</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Alimentary pharmacology & therapeutics, 2022-08, Vol.56 (4), p.675-693 |
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| source | Wiley Online Library Journals Frontfile Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Wiley Free Content |
| subjects | Biomarkers Cadmium Collagen Collagen (type I) Collagen (type III) Collagen (type IV) Crohn's disease Degradation Epitopes Matrix metalloproteinase Metalloproteinase Serology |
| title | Serological biomarkers of type I, III and IV collagen turnover are associated with the presence and future progression of stricturing and penetrating Crohnʼs disease |
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