Assessment of oxidative stress parameters for evaluation of disease activity in patients with ulcerative colitis

Neutrophil infiltration of the intestinal mucosa correlates closely with disease activity in ulcerative colitis (UC). This study aimed to investigate the contribution of reactive oxygen species (ROS) to disease severity in UC. Sixty-four subjects were enrolled, including 35 patients with active UC (18 males, 17 females; mean age: 38.1±13.6 years) and 29 healthy controls (15 males, 14 females; mean age: 42.7±11.3 years). Clinical disease activity was classified according to the Truelove and Witts' index. Mucosal biopsy samples were analyzed for oxidative stress markers: malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GPO) and myeloperoxidase (MPO). Patients with UC had significantly higher mucosal levels of MPO, GPO, SOD, and MDA compared to controls (p=0.0001, 0.02, 0.001, and 0.03, respectively). When stratified by disease activity, mild, moderate, and severe UC groups exhibited progressively elevated MPO and antioxidant enzyme levels relative to controls. ROC analysis demonstrated that MDA and MPO levels had moderate discriminatory power for high disease activity (AUROC=0.74 and 0.79, respectively). All oxidative markers positively correlated with disease activity index (MDA: r=0.34, p=0.006; GPO: r=0.43, p=0.0001; MPO: r=0.59, p=0.0001; SOD: r=0.43, p=0.0001). Multivariate logistic regression identified MPO and SOD as independent predictors of disease activity. Elevated levels of ROS and associated antioxidant enzymes are significantly associated with clinical disease activity in UC. These findings support the potential therapeutic value of antioxidant-based strategies in UC management.