p0893 angiopoietin-like protein 8 (angptl8) in inflammatory bowel disease and its response to anti-tnfα therapy; a prospective multi center study

Abstract Background Crohn’s disease (CD) is a chronic condition characterized by persistent inflammation of the gastrointestinal tract. Tumour necrosis factor-alpha (TNFα), a key pro-inflammatory cytokine, plays a crucial role in the disease process. Anti-TNF therapies have significantly improved CD treatment by reducing inflammation. Emerging evidence show that Angiopoietin-like protein 8 (ANGPTL8) is a novel protein and may also be involved in regulating inflammation. This study aimed to investigate the changes in ANGPTL8 level in patients with IBD compared to healthy individuals and evaluates the impact of Anti-TNF therapies on this protein. Methods This is a prospective multi-center observational study. Patients were recruited from January 2022 to June 2024. Patients were divided into 3 groups; patients with CD in clinical remission receiving infliximab for at least 24 weeks (IFX-experienced group), healthy controls (control group), and patients with CD scheduled to start infliximab (IFX-naïve group). ANGPTL8 levels were measured 24 hours before next maintenance infliximab dose in IFX-experienced group, randomly in control group, and at week 0 and week 24 in IFX-naïve group. ANGPTL8 levels were measured using enzyme-linked immunosorbent assays (ELISA). A normality test was conducted for continuous variables, accordingly variables with normal distribution a parametric t-test was applied, otherwise Mann–Whitney U test was applied to compare between treated and untreated groups for skewed variables. Results A total of 166 patients were included in this study. The number of patients with CD and IFX-experienced and IFX-naive were 82 and 13, respectively. Seventy-one were healthy controls. Mean age ranged from 27 to 33 years of age across the three groups (table 1). Eighty-four (51%) were females. ANGPTL8 levels were significantly higher in patients with CD (138.26 ± 8.47 pmol) compared to the healthy control group (102.52 ± 5.99 pmol, p = 0.001). Among the 13 IFX-naive patients receiving anti-TNFα treatment, ANGPTL8 levels decreased significantly from 145.06 ± 17.93 pmol pre-treatment (week 0) to 81.78 ± 10.61 pmol post-treatment (week 24), p = 0.007. Conclusion Our findings suggest that ANGPTL8 is elevated in CD and may be involved in the inflammatory processes. The marked reduction in ANGPTL8 levels following anti-TNFα treatment indicates its potential as a biomarker for treatment response. Further research is needed to understand the exact mechanisms through which ANGPTL8 influences CD progression and its utility in clinical practice.