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. 2019 Sep 1;8(9):351.
doi: 10.3390/antiox8090351.

Serum Free Thiols Are Superior to Fecal Calprotectin in Reflecting Endoscopic Disease Activity in Inflammatory Bowel Disease

Arno R Bourgonje  1 , Ruben Y Gabriëls  2 , Martin H de Borst  3 , Marian L C Bulthuis  4 , Klaas Nico Faber  2 , Harry van Goor  4 , Gerard Dijkstra  2
Affiliations

Serum Free Thiols Are Superior to Fecal Calprotectin in Reflecting Endoscopic Disease Activity in Inflammatory Bowel Disease

Arno R Bourgonje et al. Antioxidants (Basel). .

Abstract

Oxidative stress plays a pivotal role in the pathogenesis of inflammatory bowel diseases (IBD). Serum free thiols (R-SH) reliably reflect systemic oxidative stress, since they are readily oxidized by reactive species. Here, we aimed to establish concentrations of serum free thiols in IBD and assessed their discriminating capacity regarding endoscopic disease activity. Albumin-adjusted serum free thiol concentrations were measured in 78 IBD patients (31 Crohn's disease (CD) and 47 ulcerative colitis (UC) patients) and 50 healthy controls and analyzed for associations with disease parameters and their discriminative value regarding endoscopic disease activity (n = 54) or fecal calprotectin (n = 36) in patients for which those data were available. Mean serum free thiol concentrations were significantly lower in both CD and UC as compared to healthy controls (19.4 ± 3.1 and 17.8 ± 3.4 vs. 21.1 ± 1.9 µmol/g albumin, P < 0.001). Free thiols highly accurately discriminated between mild and moderate-to-severe disease activity, better than fecal calprotectin (FC) levels (AUC = 0.87, P < 0.001 vs. AUC = 0.76, P < 0.05, respectively) and this was maintained after cross-validation (AUC = 0.89, P < 0.001). Serum free thiols are reduced in IBD as compared to healthy controls and strongly correlate with the degree of endoscopic disease activity. Quantifying systemic redox status in IBD may be a promising, minimally invasive strategy to monitor IBD disease activity.

Keywords: biomarkers; disease activity; fecal calprotectin; free thiols; inflammatory bowel disease; oxidative stress.

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Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Albumin-adjusted serum free thiols (R-SH) (µmol/g) are highly significantly reduced in both Crohn’s disease (CD) and ulcerative colitis (UC) patients as compared to healthy controls (* P < 0.05 and *** P < 0.001, respectively).
Figure 2
Figure 2
Albumin-adjusted serum free thiols are significantly decreased in (A) IBD patients, (B) CD patients and (C) UC patients with severe endoscopic disease activity as compared to mild disease activity (** P < 0.01; * P < 0.05).
Figure 3
Figure 3
Albumin-adjusted serum free thiol (R-SH) levels (A) discriminate better between mild (1) and moderate-to-severe (2,3) endoscopic disease activity as compared to fecal calprotectin levels (B), even after adjustment for potentially confounding factors (C–D).
See this image and copyright information in PMC

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