The Predictive Value Of Fecal Calprotectin,serum TNF-α And IL-23,12,33,18 For Severe Activity In Ulcerative Colitis

Objective: Ulcerative colitis(UC)is characterized by remission and relapses.At present,endoscopy is still the gold standard to evaluate the activity of the disease.However,there are many risks such as perforation during endoscopy,so it is difficult to perform endoscopy repeatedly in a short time.The aim of this study was to evaluate the predictive value of fecal and serum biomarkers for the disease activity in UC.Methods: UC patients underwent clinical and endoscopic evaluation using Mayo score.Patients were divided into severe,moderate and mild activity in according with their Mayo scores.Fecal calprotectin(FC),matrix-metalloproteases(MMP)-9,M2-pyruvate kinase(M2-PK)and serum tumor necrosis factor-α(TNF-α),interleukin(IL)-1β,23,12,33,18 were measured by enzyme linked immunosorbent assay(ELISA).The levels of biomarkers were compared between three groups.Receiver operating characteristics(ROC)curve analysis was conducted to assess the diagnostic performances of each biomarker and combination in predicting severe activity.Results: A total of 46 UC patients were included.The levels of FC,TNF-α,IL-23,12,33,18 were significantly higher in severe group than moderate or mild group(t=4.898,p=0.000;t=2.527,p=0.018).The levels of TNF-α were significantly higher in severe group than moderate or mild group(t=3.416,p=0.003;t=3.635,p=0.001).The levels of IL-23 were significantly higher in severe group than moderate or mild group(t=3.035,p=0.007;t=3.097,p=0.004).The levels of IL-12 were significantly higher in severe group than moderate or mild group(t=2.922,p=0.008;t=2.623,p=0.013).The levels of IL-33 were significantly higher in severe group than moderate or mild group(t=2.941,p=0.008;t=2.891,p=0.007).The levels of IL-33 were significantly higher in severe group than moderate or mild group(t=3.870,p=0.001;t=2.745,p=0.010).The area under the ROC curve(AUROC)values of FC,TNF-α,IL-23,12,33,18 were 0.811(0.640-0.924),0.859(0.713-0.949),0.846(0.697-0.941),0.792(0.634-0.904),0.833(0.682-0.932)and 0.786(0.628-0.900),respectively.Adding IL-33,IL-18,ALB to FC got the highest AUROC value of 0.960(0.891-1.000).Conclusion: FC and serum TNF-α,IL-23,12,33,18 were reliable methods for monitoring disease activity of UC patients and could predict severe activity accurately.Combining serum IL-33,IL-18 and ALB to FC could achieve the best diagnostic performance in predicting severe activity accurately.