Sabine Jansson [1,2], Andrea Ehrström [1,2], Charlotte Ulrikka Rask [3,4], Johan Burisch [2,5,6], Michael Eriksen Benros [6,7], Jakob Seidelin [6,8], Mikkel Malham [1,2,9,10], and Vibeke Wewer[1,2,6].

Affiliates

Department of Paediatrics and Adolescent Medicine, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark [1], Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents, and Adults, Amager and Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark [2], Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Aarhus, Denmark [3], Department of Clinical Medicine, Aarhus University, Aarhus, Denmark [4], Gastro Unit, Medical Division, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark [5], Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark [6], Copenhagen Research Centre for Biological and Precision Psychiatry, Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark [7], Department of Gastroenterology and Hepatology, Copenhagen University Hospital-Gentofte and Herlev, Herlev, Denmark [8], Department of Paediatric Gastroenterology and Nutrition, Royal Hospital for Children and Young People, Edinburgh, United Kingdom [9] , Copenhagen Health Complexity Center, Department of Public Health, University of Copenhagen, Copenhagen, Denmark [10]

Abstract

Background: Cytokines play a central role in the aetiology, disease severity and treatment of adult-onset inflammatory bowel disease (IBD). However, despite the aggressive phenotype reported in paediatric-onset IBD, little is known about the cytokine levels in paediatric-onset IBD. This systematic review and meta-analysis aimed to summarize findings of cytokine levels in peripheral blood in patients with paediatric-onset IBD compared to healthy controls.

Methods: This systematic review followed the PRISMA guidelines and was registered at Prospero [CRD42024579684]. A literature search was performed on the 1st of August 2024 in PubMed, EMBASE, Web of Science and Scopus. We included studies that reported levels of cytokines in plasma or serum, in patients with paediatric-onset IBD and healthy controls. To ensure a complete overview, we did not exclude studies based on patiens’ treatment status. Pooled effect sizes of mean values were calculated using Hedges’ g for any cytokine reported by two or more studies. The Newcastle-Ottawa scale was used for quality assessment.

Results: The literature search revealed 10,110 papers (4,582 duplicates), and 5,528 articles were independently screened by two authors. Twenty articles met the inclusion criteria including a total of 920 patients with paediatric-onset IBD, 461 healthy controls. Studies reported on 57 different cytokines. Meta-analysis was performed for interleukin-6 (IL-6) (11 studies, of which 6 provided mean values) and tumour necrosis factor-α (TNF-α) (5 studies, of which 3 provided mean values). Mean values of other cytokines were not provided by two or more studies, and meta-analysis could therefore not be performed. Pooled effect sizes showed increased levels of IL-6 (standardized mean difference: 2.33, 95% confidence interval: 1.34-3.32). However, the heterogeneity between studies was high (Figure 1). Levels of TNF-α did not differ between patients and controls (standardized mean difference: 0.34 95% confidence interval: 0.00-0.68). Overall, the included studies had moderate-good quality.

Conclusion: IL-6 was increased in the peripheral blood of patients with paediatric-onset IBD. Data on other cytokines were scarce.

Poster_P6_Sabine Jansson