Faecal elastase reflects disease activity in active ulcerative colitis

Area of Science:

• Gastroenterology
• Biomarker Discovery
• Inflammatory Bowel Disease (IBD)

Background:

• Inflammatory bowel disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), requires accurate methods for assessing disease activity.
• Current biomarkers for IBD activity, such as plasma C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), have limitations.

Purpose of the Study:

• To investigate the diagnostic and prognostic value of alpha-1-proteinase inhibitor-bound elastase (EPIC) in plasma and stool samples from IBD patients.
• To evaluate the correlation of faecal EPIC levels with disease activity indices and other inflammatory markers in CD and UC.

Main Methods:

• Measurement of EPIC in plasma and stool samples from 20 CD patients, 16 UC patients, and 10 controls.
• Comparison of EPIC levels between active disease, quiescent disease, and control groups.
• Correlation analysis of faecal EPIC with disease activity indices (Crohn's disease activity index, numerical disease activity index), plasma CRP, ESR, and leucocyte counts.

Main Results:

• Median faecal EPIC levels were significantly higher in active CD and UC compared to quiescent disease and controls.
• Faecal EPIC levels were significantly higher in active ulcerative colitis and large-bowel CD (LBCD) compared to small-bowel CD (SBCD).
• Faecal EPIC correlated significantly with disease activity indices and inflammatory markers in active LBCD and active UC, potentially outperforming plasma markers in UC.

Conclusions:

• Faecal alpha-1-proteinase inhibitor-bound elastase (EPIC) is a promising biomarker for assessing disease activity in inflammatory bowel disease.
• Stool EPIC may offer a more accurate reflection of disease activity in active ulcerative colitis than plasma-based inflammatory markers.