Analysis of oxidative status as the predictor of disease severity in pediatric inflammatory bowel disease
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Abstract
INTRODUCTION: Inflammatory bowel diseases (IBD) are chronic, progressive conditions that affect the gastrointestinal tract. IBD pathogenesis has yet to be fully understood. However, the interaction of genetic, epigenetic, immunological, and environmental factors plays a crucial role in the disease. The complexity and unpredictability of the disease result in the absence of a singular diagnostic tool or curative treatment. The reactive oxygen species released by inflammatory cells in the GI tract result in oxidative stress, which drives and exacerbates the mucosal inflammation observed in patients with IBD. Measuring net redox status in patient samples may represent a new non-invasive predictor biomarker of disease severity and response to therapy in patients with IBD.
OBJECTIVES: This study aims to determine if there is a relationship between oxidative status and IBD disease activity.
METHODS: Patients with and without IBD at Boston Children’s Hospital were recruited and enrolled in the study from August 2022-December 2022. Consented patients provided one or more of the following bio-samples: urine, whole blood, stool, and intestinal aspirates. The oxidation-reduction potential of samples was measured using commercially available ArrowDOX and Mettler Toledo redox meters.
RESULTS: Data analysis has shown that ArrowDOX and Mettler Toledo probes reliably measure redox status in patient samples. However, we found no significant differences in the redox status of blood, urine, and stool samples collected from patients with CD and UC. When comparing redox status with known IBD biomarkers, erythrocyte sedimentation rate (ESR), and c-reactive protein (CRP), we did find a positive correlation between ESR, and CRP and redox measurements obtained from stool supernatants. There was only a weak negative correlation observed between ESR and CRP and urine redox status. Pediatric ulcerative colitis activity index (PUCAI) scores positively correlated with stool redox status in patients with UC.
CONCLUSION: Data collection over the course of the past ten months has increased the number of study participants and sample types, which has made possible a more comprehensive investigation of the relationship between redox status and IBD disease activity. Nonetheless, though we were unable to demonstrate a difference in redox measurements using these devices and protocols, the abundance of published data would suggest that accurate measurement of ambient redox could contribute to our understanding of IBD pathogenesis and response to therapy.
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Attribution-NoDerivatives 4.0 International