The Correlation Between Endotoxin, D-Lactate and Diamine Oxidase With Endoscopic Activity in Inflammatory Bowel Disease

Background: & Objective: The disease activity monitoring of inflammatory bowel disease (IBD) plays a crucial role for making therapeutic strategies. Endoscopy has been recognized as a gold standard for evaluating disease activity of IBD. However, this method is invasive. Currently, a noninvasive biomarker that could replace endoscope is needed in clinical practice. In this study, we examined whether the diamine oxidase (DAO), D-lactate and endotoxin (ETX) could monitor the disease activity and predict endoscopic remission in patient with IBD. Methods: : A total of 149 eligible IBD patients (82CD and67UC) who had received both endoscopic examination and intestinal barrier function detection in our hospital were enrolled in this study. Endoscopic activity was estimated by the Simple Endoscopic Score (SES-CD) for Crohn’s disease, and the ulcerative colitis endoscopic index of severity (UCEIS) for ulcerative colitis. The predictive value and optimal predictive thresholds for those biomarkers were determined by Receiver operating characteristic analysis. Results: : For UC patients, DAO, D-lactate and ETX showed better correlation with UCEIS than ESR and CRP, and exhibited satisfactory predictive value in predicting remission. Among patients with CD, DAO and ETX not only showed a better correlation than ESR and CRP with SES-CD, but also capacity to identify more severe patients. Conclusion: DAO and ETX could be used to distinguish different endoscopic activity of CD. DAO, D-lactate and ETX could predict UC endoscopic remission.