Fecal Amino Acid Analysis Can Discriminate De Novo Treatment-Naive Pediatric Inflammatory Bowel Disease From Controls.

Objectives: Endoscopy remains mandatory in the diagnostic work-up of inflammatory bowel disease (IBD), but is a costly and invasive procedure. Identification of novel, non-invasive, diagnostic biomarkers remains a priority. The aim of this study was to explore the potential of fecal amino acid composition as diagnostic biomarker for pediatric IBD. Methods: In this case-control study, treatment-naive, de novo pediatric IBD patients from two tertiary centers were included. Endoscopic severity of ulcerative colitis (UC) and Crohn's disease (CD) was based on global physician assessment scores, substantiated by levels of fecal calprotectin and C-reactive protein at study inclusion. Patients were instructed to collect a fecal sample prior to bowel cleansing. Healthy controls were recruited from primary schools in the same region. Dedicated amino acid analysis was performed on all samples. Results: Significant differences between 30 IBD patients (15 UC, 15 CD) and 15 age and sex matched healthy controls (HC) were found in six amino acids (histidine, tryptophan, phenylalanine, leucine, tyrosine and valine; all AUC > 0.75 and p

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