Abstract:

Objective To investigate the roles of serum soluble programmed death receptor-1（sPD-1） and soluble tumor necrosis factor-like weak apoptosis inducer（sTWEAK） levels in the monitoring of disease condition and prognosis assessment of patients with ulcerative colitis. Methods A total of 90 patients with ulcerative colitis and 57 healthy subjects（control group） from Qinhuangdao Integrated Traditional Chinese and Western Medicine Hospital of Hebei Port Group Co.，Ltd. were enrolled. The patients with ulcerative colitis were classified into remission group（31 cases），mild group（18 cases），moderate group（28 cases） and severe group（13 cases） according to modified Mayo scores. They were also classified into recurrence group（40 cases） and non-recurrence group（50 cases） according to whether the disease relapsed after 1-year follow up. The clinical data were collected，and the levels of sPD-1，sTWEAK，C-reactive protein（CRP） and tumor necrosis factor-alpha（TNF-α） were determined. Logistic regression analysis was used to evaluate the influencing factors of poor prognosis in patients with ulcerative colitis. Pearson correlation analysis was used to evaluate the correlation between sPD-1，sTWEAK and CRP，TNF-α. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of single determinations of CRP，TNF-α，sPD-1，sTWEAK and the combined determination of sPD-1 and sTWEAK in judging the poor prognosis of patients with ulcerative colitis. Results The levels of sPD-1 and sTWEAK in mild group，moderate group and severe group were successively increased（P<0.05），and they were higher than those in remission group and healthy control group（P<0.05）. There was no statistical significance in sPD-1 and sTWEAK levels between healthy control group and remission group（P>0.05）. The levels of sPD-1，sTWEAK，CRP and TNF-α in recurrence group were higher than those in non-recurrence group（P<0.05）. Serum sPD-1，sTWEAK and CRP，TNF-α were positively correlated（P<0.05）. The areas under curves（AUC） of single determinations of CRP，TNF-α，sPD-1 and sTWEAK for judging the poor prognosis of patients with ulcerative colitis was 0.707，0.664，0.789 and 0.752，respectively，and the AUC of the combined determination of sPD-1 and sTWEAK for judging poor prognosis was 0.866. The increasing of CRP，TNF-α，sPD-1 and sTWEAK levels were risk factors for the recurrence of ulcerative colitis（P<0.05）. Conclusions The expression levels of sPD-1 and sTWEAK in patients with ulcerative colitis are increased and are related to the poor prognosis of patients. They may be used as indicators for monitoring the disease condition and prognosis assessment of patients with ulcerative colitis.

Key words: Soluble programmed death receptor-1, Soluble tumor necrosis factor-like weak apoptosis inducer, Ulcerative colitis, Recurrence