Neutrophil activation parameter is a promising new biomarker of disease activity in ulcerative colitis.

OBJECTIVES

Invasive endoscopy and fecal calprotectin remain the standard for monitoring of ulcerative colitis (UC) However, these procedures are resource- and time-consuming, and patients are reluctant to participate. As neutrophil granulocytes are mediators of inflammation in UC, we evaluated the biomarker capacity of two novel markers of neutrophil activation. We investigated the association between these markers and clinical disease scores and their ability to distinguish between patients with UC and healthy individuals.

MATERIALS AND

METHODS

In a prospective study setting, blood samples were collected from 68 consecutive patients with a suspected flare of UC and from 71 healthy controls. Neutrophil Reactivity Intensity (Neut-RI) and Neutrophil Granularity Intensity (Neut-GI) were analyzed using the automated hematology analyzer Sysmex XN-9000. ROC curve analysis assessed the ability to discriminate between controls and UC patients. In patients, the Mayo score, Simple Clinical Colitis Activity Index (SCCAI) score, fecal calprotectin and C-reactive protein (CRP) were recorded. Spearman's correlation coefficients between clinical data and the novel markers were calculated.

RESULTS

Neut-RI and Neut-GI levels were significantly higher among patients than controls (p < 0.001). Neut-RI discriminated between patients and controls (AUC 0.756, 95% CI 0.676; 0.837) and correlated significantly with Mayo score and SCCAI (Spearman's Rho 0.40/0.27). No such correlations were found for fecal calprotectin or CRP. Furthermore, Neut-RI discriminated patients with proctitis from patients with more widespread disease (p < 0.05).

CONCLUSIONS

Neut-RI significantly correlated with disease activity in UC patients and proved superiority to fecal calprotectin. Neut-RI could be a promising low-cost, non-invasive biomarker for disease activity in UC.