Trefoil factor 3, neutrophil to lymphocyte ratio and platelet to lymphocyte ratio as predictor markers in ulcerative colitis activity

Abstract

Background: The Trefoil factors 3 (TFF3) include a group of three peptides that are related to mucin and are released by goblet cells located in the mucosa of the intestines serve a crucial function in the preservation of mucosal barrier integrity and exhibit an upregulation response at the specific location of mucosal injury. The objective of this study was to assess the significance of Trefoil factor 3 and hematological indicators, namely the Neutrophil to Lymphocyte ratio (NLR) and Platelet to Lymphocyte ratio (PLR), in predicting the activity of ulcerative colitis.Methods: The present research used a prospective cohort design, which included a sample of fifty patients diagnosed with ulcerative colitis (UC) in group I, and a control group (group II) consisting of twenty-five apparently healthy individuals. The patients were categorized into two distinct groups: group IA, consisting of active UC patients, and group IB, consisting of inactive UC patients. The serum levels of TFF3, NLR, PLR, and fecal calprotectin (FC) were evaluated.Results: The statistical analysis revealed a significant rise in serum TFF3 levels in group I compared to group II, as well as in group IA compared to group IB. Additionally, there was a positive correlation seen between serum TFF3 levels and inflammatory indicators such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), FC, and endoscopic activity. There was an insignificant difference between group IA and group IB as regards total leukocyte count (TLC), NLR, and PLR. TFF3, FC, NLR, PLR detect remission and activity in UC patients at cut off value of 408.6, 57.5, 2.4, 102.1, AUC 0.9, 0.7, 0.6, 0.6, with sensitivity 92.5%, 87.5%, 55%, 67.5%, specificity 80%, 80%, 40%, 50%, The positive predictive values (PPV), 94.9%, 94.6%, 78.6%, 84.4% and the negative predictive values (NPV) was 72.7%, 61.5%, 18.2%, 27.8% respectively.Conclusions: The potential use of serum TFF3 as a predictive marker for UC activity is evident since it demonstrates a positive correlation with other inflammatory indicators such as ESR, CRP, FC levels, and endoscopic activity.