Systemic Inflammatory Responses in Ulcerative Colitis Patients and Clostridium difficile Infection

Area of Science:

• Gastroenterology
• Immunology
• Infectious Diseases

Background:

• Differentiating ulcerative colitis (UC) with symptomatic Clostridium difficile infection (CDI) from colonization is challenging.
• Identifying distinct inflammatory pathways in UC and CDI could reveal therapeutic targets.

Purpose of the Study:

• To compare systemic inflammatory responses in UC, UC with CDI, and CDI without UC.
• To identify biomarkers that distinguish UC from CDI.

Main Methods:

• Prospective serum collection from UC patients (with and without CDI) and CDI-only patients.
• Comparison of serum inflammatory mediators using multivariable statistics and principal component analysis (PCA).

Main Results:

• PCA showed significant separation between UC and CDI-only groups (P=0.002).
• UC patients had lower hepatocyte growth factor (HGF) and chemokine (C-C motif) ligand 2 (CCL2) levels and higher IL-23 levels compared to CDI-only patients.
• A model using IL-23, HGF, CCL2, age, gender, and hemoglobin achieved an area under the receiver operating characteristic curve (AuROC) of 0.93 for distinguishing UC from CDI.

Conclusions:

• Inflammatory profiles did not differentiate UC with CDI from UC without CDI.
• Significant differences in inflammatory profiles were observed between UC and CDI-only groups.
• Future research should explore IL-23 inhibitors and HGF stimulators as potential UC treatments.