Ren Zhengyu, Zhang Zhewei, Li Haichen, Fu Pumeng, Wang Ruixue, Wang Siyao, Li Yingchao
Department of Gastroenterology, First Affiliated Hospital, Xi'an Jiaotong University, Shaanxi, People's Republic of China.
Department of PET-CT Center, First Affiliated Hospital, Xi'an Jiao Tong University, Shaanxi, People's Republic of China.
J Inflamm Res. 2025 Jul 11;18:9079-9090. doi: 10.2147/JIR.S524056. eCollection 2025.
Ulcerative colitis (UC) requires new non-invasive serum biomarkers for assistance in monitoring due to the low rate of endoscopic follow-up. Previous research indicated reduced levels of serum indirect bilirubin (sIBIL), serum total bilirubin (sTBIL), and serum total bile acids (sTBAs) in UC patients. This study aims to assess their monitoring potential in UC during biologic therapy.
We conducted a retrospective single-center study including 138 UC patients and 150 controls with normal colonoscopy results. The receiver operating characteristic (ROC) curve was used to assess diagnostic value of sIBIL, sTBIL, and sTBAs. Spearman correlation analysis was performed to assess the association between these biomarkers and the severity of both endoscopic findings and clinical symptoms in UC patients. Additionally, changes in serum biomarkers were analyzed in 72 UC patients during biologic therapy, with stratified analyses based on endoscopic remission status.
Patients with UC exhibited lower concentrations of sIBIL, sTBIL, and sTBAs compared to the controls ( < 0.05), and all these biomarkers demonstrated moderate diagnostic value in identifying UC from normal controls ( < 0.05). sIBIL concentration negatively correlated with disease severity and showed a progressive increase during biologic therapy, particularly in patients achieving endoscopic remission at week 52 ( < 0.05). The sIBIL concentration in the remission group was significantly higher than that in the non-remission group after week 26 ( < 0.05). For sTBAs, concentration initially increased and then decreased, with a turning point at week 14 in the remission group ( < 0.05) and at week 26 in the non-remission group ( > 0.05). No significant differences in sTBAs concentrations were found between remission and non-remission groups at any time ( > 0.05).
sIBIL may be used as a valuable serum biomarker for the clinical diagnosis and the monitoring of response to biologics. Additionally, the change trend of sTBAs may provide reference value for monitoring UC biologic therapy. However, further studies are needed to analyze the changes in its internal composition.
由于内镜随访率较低，溃疡性结肠炎（UC）需要新的非侵入性血清生物标志物来辅助监测。先前的研究表明，UC患者血清间接胆红素（sIBIL）、血清总胆红素（sTBIL）和血清总胆汁酸（sTBAs）水平降低。本研究旨在评估它们在生物治疗期间对UC的监测潜力。
我们进行了一项回顾性单中心研究，纳入了138例UC患者和150例结肠镜检查结果正常的对照者。采用受试者操作特征（ROC）曲线评估sIBIL、sTBIL和sTBAs的诊断价值。进行Spearman相关性分析，以评估这些生物标志物与UC患者内镜检查结果和临床症状严重程度之间的关联。此外，分析了72例UC患者在生物治疗期间血清生物标志物的变化，并根据内镜缓解状态进行分层分析。
与对照组相比，UC患者的sIBIL、sTBIL和sTBAs浓度较低（<0.05），所有这些生物标志物在从正常对照中识别UC方面均显示出中等诊断价值（<0.05）。sIBIL浓度与疾病严重程度呈负相关，并且在生物治疗期间逐渐升高，特别是在第52周达到内镜缓解的患者中（<0.05）。第26周后，缓解组的sIBIL浓度显著高于非缓解组（<0.05）。对于sTBAs，浓度最初升高然后降低，缓解组在第14周出现转折点（<0.05），非缓解组在第26周出现转折点（>0.05）。在任何时间，缓解组和非缓解组之间的sTBAs浓度均未发现显著差异（>0.05）。
sIBIL可作为临床诊断和生物制剂治疗反应监测的有价值血清生物标志物。此外，sTBAs的变化趋势可能为UC生物治疗监测提供参考价值。然而，需要进一步研究分析其内部成分的变化。
