الفهرس 
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Abstract
Inflammatory bowel disease (IBD) is characterized by a chronic inflammation of the gut, partly driven by defects in the expression and function of pattern recognition receptors, including the IFI16 protein. This protein is a target for autoantibodies and its aberrant expression was reported in colonic mucosa from active patients with ulcerative colitis.
The presence of anti-IFI16 IgG antibodies in sera has previously been reported by authors to be associated with a series of autoimmune diseases, whereas this is the first study also describing anti-IFI16 IgA distribution in parallel. The highest serum levels of IFI16 protein were found in patients with rheumatoid arthritis.
The aim of this cross sectional study was to assess the utility of IFI16 antibodies as a predictor of infliximab-induced remission in IBD patients in comparison to other modalities of treatment. To obtain this aim, we included 60 IBD patients & divided them into three groups, each group consisted of 20 patients in remission; group I: received Infliximab therapy, group II: received medical treatment apart from Infliximab and group III: didn’t receive any therapy.
We can sum up our results in the following:
• CROHN’S disease was diagnosed by endoscopy and pathology in 19 (31.7%) patients while U.C. was diagnosed in 41 (68.3%) patients. There was no significant difference between the 3 groups regarding diagnosis (p=0.926).
o Median severity score for Crohn’s among patients in the current study was 49 ranging between 5 & 492. While regarding the severity for UC; Mild form of the disease was reported in 29 (67.4%) patients, Moderate form of the disease was reported in 2 (4.7%) patients & Severe form of the disease was reported in 12 (27.9%) patients.
o Regarding the disease activity in this study, inactive disease was reported in 40(66.7%) patients & active 20 (33.3%) patients.
o Out of our study population, 8 (13.3%) patients didn’t receive any treatment, while 25 (41.7%) patients received infliximab, 8 (13.3%) patients received humera, 7 (11.7%) patients received colosalazine, 5 (8.3%) patients received steroids, 3 (5.0%) patients received pentaza, 2 (3.3%) patients received imodium, 1 (1.7%) patients received loperamide & 1 (1.7%) patients received metronidazole.
• On comparison between the 3 groups in the present study, there was no significant difference between 3 groups regarding agem sex & smoking. While there was a highly statistically significant difference between 3 groups regarding weight (p=0.009). Post hoc analysis revealed highly statistically significant difference regarding weight between group I & group III (p=0.034) & statistically significant difference regarding weight between group II & group III (p=0.003).
o In the current study, there was a highly statistically significant difference regarding tachycardia and pyrexia (p=0.0000 for both).
o According to this study, there was highly statistically significant difference between 3 groups regarding bowel movement per day, history of soft stool over 7 days, general well-being, & incidence of blood in stool & abdominal pain.
o According to our study, post hoc analysis revealed no significant statistical difference between group I & II regarding bowel movement & history of soft stool over 7 days. While there was a highly statistically significant difference on comparison between group I & group III & on comparison between group II & group III (p=0.0000 for both).
o There was no significant statistical difference in this study between the 3 groups regarding incidence of iritis/uveitis, skin manifestations & anal fissure/fistula/abscess. While incidence of abdominal mass & arthralgia/arthritis were significantly higher among patients in group III when compared with patients in the other 2 groups (p= 0.004, 0.001 respectively). Anti-diarrheal drug use was also significantly higher among patients in group III when compared with patients in the other 2 groups (p= 0.000).
o There was no significant statistical difference in this study between the 3 groups regarding platelet count, serum creatinine, Na, AST, ALT & albumin. While HCT & Hb were significantly lower among patients in group III when compared with patients in the other 2 groups (p= 0.000 for both) & TLC, ESR, CRP & K levels were significantly higher among patients in group III when compared with patients in the other 2 groups (p= 0.000 for all). Meanwhile post hoc analysis revealed no significant difference between group I & group II regarding TLC, ESR, CRP & K levels.
o Severity score for Crohn’s in this study was significantly higher in patients in group III when compared with patients in the other 2 groups (p= 0.004) & severity for UC was also significantly higher in patients in group III when compared with patients in the other 2 groups (p= 0.000).
o Regarding the treatment, we found no significant statistical difference in this study between the 3 groups regarding use of Humera, Steroids, Imodium, Loperamide & Metronidazole. While there was highly statistically significant difference between 3 groups regarding use of infliximab (100%, 5% & 20% in group I, II& III respectively; p=0.000). there was also highly statistically significant difference between 3 groups regarding receiving no medications (0%, 0% & 40% in group I, II& III respectively; p=0.000). & there was significant statistical difference between the 3 groups regarding use of Colosalazine & Pentaza (p=0.46, 0.43 respectively).
o We found in our study that there was highly statistically significant difference between 3 groups regarding anti IFI 16 IgG titre (20, 125 &175 in group I, II & II respectively, p=0.000). Post hoc analysis revealed that anti IFI 16 IgG titre was significantly lower in patients in group I (infliximab group) when compared with patients in group II & when compared with patients in group III (P=0.000 for both). Also anti IFI 16 IgG titre was significantly lower in patients in group II when compared with patients in group III (P=0.004).
• For patients in group I (infliximab group) & patients in group II, we found no significant statistical correlation between anti IFI 16 IgG titre & each of Age, sex, smoking, Weight, diagnosis, bowel movement, soft stool, laboratory parameters & severity score for Crohn’s. while for patients in group III, significant correlation was found between anti IFI 16 IgG titre & each of smoking (r= -2.133, p=0.033) & presence of anal fissure/ fistula /abscess (r= -2.149, p=0.032).
We can conclude that anti-IFI16 IgG antibodies hold the potential to serve as a biomarker of response to infliximab therapy.