ABSTRACT
Introduction:Detection of activity of ulcerative colitis (UC) is vital for predicting treatment outcome. The assessment depends on clinical, serologic, and endoscopic findings. One of the noninvasive biomarkers for disease activity detection is serum Neutrophil Gelatinase-Associated Lipocalin (NGAL). Aim:To assess the relationship between NGAL and endoscopic, histopathologic and clinical activity of UC.Methods:This study wasconducted on 50 cases with definitive diagnosis of UC and 15 cases with normal colonoscopyexamination as controls.UC cases were considered active if Geobes score was ≥3.1.Complete blood count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and liver and kidney function tests were done.Serum NGAL was estimated using ELISA technique. Results:UC caseswere classified into active group (n = 36) and inactive group (n = 14). In active UC cases, median value (IQR) of serum NGAL was significantly increased(101.15 (67.53 –156.40) ng/mL) compared to inactive cases (63.35 (60.98–65.20)ng/mL) and control group (24.80 (15.50 –31.50)ng/mL).Serum NGAL was well correlated with Geobes score, Mayo score, CRP and ESR.Serum NGAL at cut-off ≥ 63 can predict activity with sensitivity88.89%, specificity 85.71%, PPV 94.12% and NPV 75%.Conclusion:Serum NGAL is valuable noninvasive marker for assessment of UC disease activity
ABSTRACT
This study aimed to find out non-invasive markers for the assessment of severity of non-alcoholic steatohepatitis [NASH] in an attempt to decrease the need for liver biopsy. It also aimed to evaluate the key role of apoptosis in the pathogenesis of the disease and the suggested role of anti-apoptotic factors in therapeutic modalities and disease prognosis. The serum levels of soluble Fas [s. Fas], s. Fas ligand, cytokeratin 18 [CK-18] fragment and Bcl-2 were measured in 80 patients and 15 non-hepatic subjects as control. The patients were divided based on histological examination of liver biopsy into three groups. Group I included 40 patients with NASH, group II had 40 patients with non-alcoholic fatty liver disease [NAFLD] non-NASH and group III had 15 non-hepatic subjects as control. Apoptosis of hepatocytes was assessed by morphological examination using a light microscope and expressed as number per square millimeter. There was a significant increase in the serum levels of s. Fas, s. Fas ligand and CK-18 fragments in the NASH group. The anti-apoptotic protein Bcl-2 showed significantly low levels in NASH patients. Apoptosis of hepatocytes was significantly higher in the NASH group. The degree of apoptosis was inversely correlated with the level of Bcl-2. A significant correlation between both s. Fas and CK-18 fragment with liver histology with regard to lobular inflammation and ballooning was found. Increased serum levels of s. Fas and CK-18 fragment in the NASH group and its correlation with the severity of disease suggested the key role of apoptosis in NASH pathogenesis which can be used for the assessment of the severity of NASH. A high level of anti-apoptotic Bcl-2 in NAFLD suggests its protective role in disease progress