A67 RAPID REDUCTION IN ANXIETY SCORES IN IBD PATIENTS AFTER INFLIXIMAB INFUSION IS ASSOCIATED WITH CHANGES IN KYNURENINE/TRYPTOPHAN METABOLISM
Bibliographic record
Abstract
Patients with inflammatory bowel disease (IBD) frequently suffer from psychiatric comorbidities, mainly anxiety and depression. Infliximab, an anti-TNFα antibody, is commonly used for treatment of colitis. There are anecdotal reports of IBD patients having improvement in mood only hours after infliximab infusion, well before intestinal mucosal healing could occur. To evaluate the immediate effects of infliximab infusion on intestinal and extra-intestinal symptoms and immune markers in IBD patients. IBD patients attending the McMaster University and Charlton infusion clinics were enrolled in the study. Patients were examined at baseline (day 0), 1 day, and 7 days after the infliximab infusion. We assessed anxiety and depression (HAD and STAI-Y scales), disease specific quality of life (SIDBQ), as well as disease activity scores using the Harvey Bradshaw Index (HBI) or the Mayo Score. Serum C-reactive protein (CRP), kynurenine, tryptophan, and serotonin levels were measured at each visit. We enrolled 41 IBD patients (Crohn’s disease = 35, Ulcerative Colitis = 5, indeterminate colitis = 1; median age 33 yrs, median disease duration 9 yrs). Disease activity decreased at day 1 compared to baseline (p=0.01), but this was not sustained at day 7. Anxiety scores (HADS-A) decreased significantly at day 1 (p=0.006), and remained lower at day 7 (p=0.009). An improvement in quality of life (SIBDQ) was seen only at day 7 (p=0.017). The decrease in anxiety scores strongly correlated with the improvement in quality of life (SIBDQ r=-0.81; p<0.001) at day 1 and day 7. The kynurenine/tryptophan ratio decreased significantly at day 1 (p=0.025) and remained lower at day 7 (p=0.047). However, CRP levels did not change during the study period. Infliximab infusion induces rapid changes in anxiety and disease activity. We hypothesise that this effect is central, mediated through changes in kynurenine/tryptophan metabolism, and not through improvement of gut inflammation. CIHR
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".