Abstract

Ulcerative colitis (UC) is characterized by chronic intestinal inflammation. Patients with UC have repeated remission and relapse. Clinical biomarkers that can predict relapse in UC patients in remission have not been identified. To facilitate the prediction of relapse of UC, we investigated the potential of novel multivariate indexes using statistical modeling of plasma free amino acid (PFAA) concentrations. We measured fasting PFAA concentrations in 369 UC patients in clinical remission, and 355 were observed prospectively for up to 1 year. Relapse rate within 1 year was 23% (82 of 355 patients). The age- and gender-adjusted hazard ratio for the lowest quartile compared with the highest quartile of plasma histidine concentration was 2.55 (95% confidence interval: 1.41–4.62; p = 0.0020 (log-rank), p for trend = 0.0005). We demonstrated that plasma amino acid profiles in UC patients in clinical remission can predict the risk of relapse within 1 year. Decreased histidine level in PFAAs was associated with increased risk of relapse. Metabolomics could be promising for the establishment of a non-invasive predictive marker in inflammatory bowel disease.

Highlights

  • Inflammatory bowel disease (IBD) is a chronic intestinal disorder comprising two major types, Crohn’s disease (CD) and ulcerative colitis (UC) [1]

  • The colon is mainly involved in UC, while the entire gastrointestinal tract is the target in CD

  • Patient inclusion criteria were as follows: (1) diagnosis of UC based on established clinical, radiographic, endoscopic and histopathological criteria; and (2) clinical remission was defined as Clinical Activity Index (CAI)

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Summary

Introduction

Inflammatory bowel disease (IBD) is a chronic intestinal disorder comprising two major types, Crohn’s disease (CD) and ulcerative colitis (UC) [1]. Patients with UC have repeated remission and relapse, and there are a limited number of clinical biomarkers that can predict relapse. Plasma Histidine for Prediction of UC Relapse any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The funder provided support in the form of salaries for authors NO, AI, MM, HS, MU, and MH, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the "author contributions" section

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