Abstract

Abstract Background Necroptosis is a novel form of regulated necrotic cell death that is dependent on Receptor interacting protein kinase-3 (RIPK3). It leads to cell lysis and directly triggers inflammation. Several clinical and preclinical studies have implicated necroptosis in the etiopathogenesis of inflammatory bowel disease. Methods The aim of the study was to evaluate the expression of RIPK3 according to the activity and severity of ulcerative colitis (UC). Tissue expression of RIPK3 was determined immunohistochemically in intestinal biopsies from 85 patients with ulcerative colitis. Тo evaluate the severity and activity of UC were used the Montreal classification for disease severity (S), full Mayo score (MS) and Mayo endoscopic score (MES). Results A moderate direct correlation was found between disease severity and RIPK3 expression (r=0.354; p=0.001), with severe disease (S3) being characterized by overexpression of the marker (199.67). A moderate right-proportional relationship was also found in the analysis of RIPK3 expression and UC activity, measured by the full Mayo score (r=0.481; p<0.001). RIPK3 expression increased with increasing disease activity (p<0.001), and patients with severe disease activity (MS =11-12) had overexpression of the marker (211.71). A moderate correlation between RIPK3 expression and the degree of endoscopic activity was also found (r=0.363; p=0.001), with patients with severe endoscopic activity (MES=3) having high expression of the marker (198.27). Conclusion High expression of RIPK3 in UC patients was associated with severe disease activity assessed by the Montreal classification and full Mayo score and marked endoscopic activity.

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