Buldukoglu Osman Cagin, Ocal Serkan, Akca Serdar, Atar Galip Egemen, Kaya Besir, Isik Muhammet Devran, Koca Ozlem, Harmandar Ferda Akbay, Cekin Yesim, Cekin Ayhan Hilmi
Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey.
Department of Medical Microbiology, Antalya Training and Research Hospital, Antalya, Turkey.
BMC Gastroenterol. 2025 May 30;25(1):418. doi: 10.1186/s12876-025-04009-4.
Ulcerative colitis (UC) is a chronic inflammatory disease with a worldwide prevalance of around 5 million patients. Assessment of disease activity is crucial in management of UC patients. Gasdermin D (GSDMD) is a protein which belongs to the gasdermin protein family and plays a role in inflammatory cell death, pyroptosis. GSDMD activation has been shown to be related to inflammatory states in a variety of disorders, including inflammatory bowel diseases. With this study, we aimed to reveal a potential new inflammatory serum marker for assessing disease activity and severity in UC patients in a non-invasive manner.
This prospective study was carried out at Antalya Training and Research Hospital, Turkey, between September 2022 and March 2024. 93 UC patients were enrolled in the study. Patient and disease characteristics, laboratory workout data, and severity indexes comprising Truelove and Witts’ severity index (TWSI) and Mayo endoscopic subscore (MES) were analyzed with serum GSDMD levels.
GSDMD, CRP (C-reactive protein), and body-mass index were statistically significant independent predictors of increasing disease severity according to TWSI. GSDMD and CRP were statistically significant independent predictors of higher MES scores. GSDMD demonstrated excellent discriminative performance in distinguishing patients with moderate-to-severe MES from those with normal or mild MES, with an area under the curve value of 0.976. A cut-off value of 6.0 ng/mL for GSDMD was identified as optimal, yielding a sensitivity of 95.0%, a specificity of 86.3%, and a Youden Index of 0.813.
The results of the study revealed that GSDMD is a robust biomarker in predicting a more severe disease state for UC in terms of TWSI and MES, putting this novel protein into highlight as a potential new biomarker in patients with UC.
溃疡性结肠炎（UC）是一种慢性炎症性疾病，全球患病率约为500万患者。疾病活动度评估对UC患者的管理至关重要。Gasdermin D（GSDMD）是一种属于gasdermin蛋白家族的蛋白质，在炎性细胞死亡（焦亡）中起作用。GSDMD激活已被证明与包括炎症性肠病在内的多种疾病的炎症状态有关。通过本研究，我们旨在揭示一种潜在的新的炎症血清标志物，以非侵入性方式评估UC患者的疾病活动度和严重程度。
本前瞻性研究于2022年9月至2024年3月在土耳其安塔利亚培训与研究医院进行。93例UC患者纳入研究。分析患者和疾病特征、实验室检查数据以及包括Truelove和Witts严重程度指数（TWSI）和梅奥内镜亚评分（MES）在内的严重程度指标与血清GSDMD水平的关系。
根据TWSI，GSDMD、C反应蛋白（CRP）和体重指数是疾病严重程度增加的统计学显著独立预测因素。GSDMD和CRP是MES评分较高的统计学显著独立预测因素。GSDMD在区分中度至重度MES患者与正常或轻度MES患者方面表现出出色的鉴别性能，曲线下面积值为0.976。确定GSDMD的最佳截断值为6.0 ng/mL，敏感性为95.0%，特异性为86.3%，约登指数为0.813。
研究结果表明，就TWSI和MES而言，GSDMD是预测UC更严重疾病状态的可靠生物标志物，使这种新型蛋白质成为UC患者潜在的新生物标志物而备受关注。
