This indicates a need for simply reachable, efficacious and cost-effective biomarkers for proper management of UC. However, both of them are costly and not commonly utilized in clinical practice. Other markers as fecal calprotectin and lactoferrin are more specific and sensitive. UC activity have been assessed in different studies using laboratory markers as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), with sensitivities and specificities ranging between 50 and 60%. However, previous studies offer contradictory findings about effective noninvasive markers for the detection of mucosal activity in UC. Away from endoscopy, disease severity can be assessed using laboratory investigations and non-invasive radiology. Of particular concern is that multiple endoscopic biopsies during clinical remission may increase the risk of UC activity recurrence in the long term. Endoscopy may show active mucosal inflammation in absence of clinical manifestations and in the same manner clinical remission is not linked to mucosal cure. īoth mucosal and clinical evaluation are independently essential in ulcerative colitis. Despite success in practice, endoscopic and histopathological examination are invasive, costly and have some complications in use. However, it is a difficult challenge and a major area of interest. A primary concern of UC is assessment of intestinal inflammation and evaluation of healing with long-term prognosis. Ulcerative colitis (UC) is a chronic relapsing form of inflammatory bowel disease (IBD) characterized by continuous mucosal inflammation in the innermost layers of the colon and rectum. NLRs and LMRs are simple non-invasive affordable independent markers of disease activity in UC. Besides, NLR was significantly higher in patients with pancolitis and positively correlated with endoscopically severe disease. NLR, LMR, and CRP were found to be significant independent markers for discriminating disease activity (p = 0.000). The cut-off value of LMR for determining the disease activity was ≤ 2.88 with a sensitivity of 90% and a specificity of 90%. The mean LMRs of active UC was significantly lower compared with inactive UC patients and controls (2.25 ± 0.51, 3.58 ± 0.76, 3.64 ± 0.49 respectively p < 0.0001). Significant elevation of NLR was observed in active UC group compared to inactive UC and controls (2.63 ± 0.43, 1.64 ± 0.25, 1.44 ± 0.19 respectively p 1.91, with a sensitivity and a specificity of 90% and 90% respectively. White blood cell count, NLR, LMR, C-reactive protein, and Erythrocyte sedimentation rate were measured and recorded. Another 40 group-matched healthy participants were enrolled. Group 1 (active UC) and group 2 (inactive UC). Study conducted on 80 UC patients who were classified into two groups of 40 each according to Mayo score and colonoscopic findings. For this purpose, we evaluated differential leucocytic ratio, mainly neutrophil–lymphocyte ratio (NLR) and lymphocyte-monocyte ratio (LMR) as simple available indicators of disease activity in patients with ulcerative colitis. Apart from endoscopic interventions, readily attainable cost-effective biomarkers for ulcerative colitis (UC) assessment are required.
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