Gelsolin as a Potential Biomarker for Endoscopic Activity and Mucosal Healing in Ulcerative Colitis

Abstract Background UC is a chronic, relapsing and remitting inflammatory condition of the colon. The diagnosis of UC is based on signs, symptoms, endoscopic evaluation, and histologic parameters. Accurate diagnosis and disease staging are important as these affect treatment options and prognosis. The main target in UC treatment is mucosal healing, which is related to long-term remission, reduced rates of hospitalization, and colectomy. Despite the advantages in the management of UC over the past few decades, much less has been achieved in the diagnosis and monitoring of the disease where colonoscopy remains the “gold standard” method. Therefore, a non-invasive marker correlating with mucosal healing is being sought. Aim of the Work to evaluate the role of serum gelsolin level (SGN) as a simple, easy, and available predictor for mucosal healing in patients with ulcerative colitis as compared to endoscopic scores and other widely used laboratory biomarkers. Patients and Methods The present study was conducted on 40 patients with clinical, biochemical, and endoscopic active UC and followed up during disease activity and remission. All patients were subjected to full history taking, clinical examination, routine laboratory investigations, ESR and CRP, CBC, fecal calprotectin, SGN, colonoscopy and biopsies with histopathological examination. Results The current study revealed a statistically significantly higher TLC, Platelet count, CRP, ESR and Fecal calprotectin among disease activity in relation to remission. However, serum gelsolin level, hemoglobin and albumin levels were statistically significantly lower in activity patients in comparison to remission patients. There was no statistically significant relation between SGN and gender, different laboratory parameters. There was statistically significant relation between SGN and mayo endoscopic sore as it has the highest level in MES 0. In the present study, SGN was found to be higher in patients with clinical and endoscopic remission and healing with statistically significant correlation with endoscopic mucosal scores representing mucosal healing like Mayo score and UCEIS and may be a possible useful marker for predicting endoscopic activity and mucosal healing in UC patients. It would be more helpful when used together with serum laboratory inflammatory indices (ESR, CRP and fecal calprotectin). Conclusion Serum gelsolin level can be used for prediction of mucosal healing in ulcerative colitis and endoscopic activity. A greater sample size would have resulted in more reliable subgroup analyses for UC. Larger studies are needed to be conducted to be conclude correlation between SGN and endoscopic scores and microscopic histopathological scores