Predictive value of trefoil factor 3 for identifying activity in ulcerative colitis patients: a comparison with fecal calprotectin and C-reactive protein

Khairallah, Ahmed A.; El-Fayoumy, Mohammed S.; El-Sherbiny, Ashraf A.; El-shorbagy, Mohammed S.; El-ghamry, Fathy A.

doi:10.21608/jram.2023.206430.1209

Predictive value of trefoil factor 3 for identifying activity in ulcerative colitis patients: a comparison with fecal calprotectin and C-reactive protein

Document Type : Original Article

Authors

¹ Internal Medicine Department, National Research Centre, Cairo, Egypt.

² Internal Medicine Department, Faculty of Medicine for Boys, Cairo, Al-Azhar University, Egypt.

³ Clinical Pathology Department, Faculty of Medicine for Boys, Cairo, Al-Azhar University, Egypt.

10.21608/jram.2023.206430.1209

Abstract

Background: Trefoil factor-3 (TFF3) is primarily expressed by small intestine and colon goblet cells. Several studies have revealed that it plays a crucial function in mucosal protection and gastrointestinal tract repair.
Objective: to evaluate the significance of TFF3 as a marker of disease activity in ulcerative colitis (UC) patients.
Methods: A hospital-based case control study was done on 40 active-UC patients, 40 patients in remission state who underwent colonoscopy and 40 non-ulcerative colitis healthy individuals as control group. Serum TFF3 was measured by ELISA and compared to C-reactive protein (CRP) and fecal calprotectin (FC) values. Clinical and endoscopic assessment was scored according to Lichtiger Index and ulcerative colitis endoscopic severity index (UCEIS).
Results: Serum TFF3 was significantly correlated with Lichtiger Index (r=0.671), UCEIS (r=0.642), FC (r=0.8048) and CRP (r=0.3759). Serum TFF3 cutoﬀ point <4.25 ng/ml indicated remission with a specificity 69.2%, 69%; sensitivity 92%, 97% for endoscopic and clinical indices respectively. Also, TFF3 significantly differentiated between mild, moderate, and severe diseases. The AUC of TFF3+FC was significantly higher than that of TFF3 and FC alone for predicting UC remission.
Conclusion: Serum TFF3 is significantly correlated with clinical, endoscopic indices and FC in UC patients. Serum TFF3 is a powerful predictive biomarker of remission alone and in combination with FC in UC patients.

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