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

Background and 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 including 82 Crohn disease (CD) and 67 Ulcerative colitis (UC) 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 erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) and exhibited satisfactory predictive value in predicting remission. Among patients with CD, DAO and ETX not only showed a better correlation than WBC, ESR, and CRP with SES-CD but also capable 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.