Noninvasive Blood-based Model Developed to Assess Extent and Severity of Ulcerative Colitis

Knowing the extent and severity of ulcerative colitis is essential for clinicians to determine treatment regimens and appropriate routes of administration. For example, suppositories and enemas are more effective with proctitis, and orally administered drugs, biologics and other injectable treatments are typically indicated for more severe disease.

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The Montreal classification system is used to determine the extent of ulcerative colitis. The following scoring systems are commonly used to assess the severity of the disease: Truelove and Witts score (TWS), Mayo score, Mayo endoscopic score (MES), and Degree of Ulcerative colitis Burden of Luminal Inflammation (DUBLIN) score.

Colonoscopy is currently considered the gold standard for obtaining many of the parameters necessary to determine these scores. However, the procedure is invasive, costly, time-consuming and carries some risks. These factors make it challenging to use colonoscopies in repeated follow-up care for patients with ulcerative colitis.

In an effort to reduce financial and other quality of life burdens for individuals living with ulcerative colitis, Hongliang Chen and his colleagues from the Department of Gastroenterology and Hepatology at four medical centers in northeast China sought to develop a routine blood-based tool for assessing the extent and severity of ulcerative colitis. The tool is named Jin’s model, and the researchers’ results were published earlier this month in Scientific Reports.

Chen and his colleagues included 975 adults with ulcerative colitis who were inpatients in one of four medical centers in northeast China between January 2010 and December 2019. Using routine blood samples from participants, the researchers developed two models for predicting Montreal classification and one model each for predicting Mayo score, TWS, MES, and DUBLIN score. Collectively, the models are called Jin’s model.

The prediction models were created using peripheral blood cells that contribute to the inflammation and epithelial barrier disruption present in ulcerative colitis. These include activated platelets and leukocytes.

The tool successfully predicted the extent and severity of ulcerative colitis based on commonly used scoring systems.

The authors concluded, “Jin’s model provides [ulcerative colitis] patients with a noninvasive, convenient and efficient approach to assess the extent and severity based on several prevailing classifications, especially for patients who do not tolerate or refuse colonoscopy. Jin’s model can simplify the follow-up process, save healthcare resources and reduce the financial and mental burden on patients.”