In a study in Frontiers in Medicine, researchers sought to elucidate diagnostic biomarkers for disease activity and treatment response in patient with ulcerative colitis (UC). Investigators evaluated the neutrophil-to-albumin ratio (NAR) index for its viability as a predictive biomarker of disease activity and response to UC treatment (infliximab). They ultimately concluded that “NAR was significantly elevated in patients with UC and showed satisfactory performance in the assessment of disease activity and inflammatory load.”

The investigators also highlighted that NAR demonstrated a predictive ability for primary response to infliximab induction therapy, though they noted that their findings require validation in future studies.

The researchers collected electronic medical records of 146 patients with UC and 133 healthy controls from their medical center. The investigators used the enzyme-linked immunosorbent assay to assess serum cytokine and fecal calprotectin levels and used qRT-PCR to measure “mucosal expression levels of inflammatory agents.”

The authors observed that NAR was significantly increased in patients with UC compared to controls (1.95 ± 0.41 vs. 1.41 ± 0.23; p <.0001). Additionally, NAR showed a positive association with disease activity and inflammatory agent expression in UC. Notably, “pre-treatment NAR was significantly lower in infliximab responders than that in non-responders… showing a significant ability to discriminate initial responders from primary non-responders to induction therapy.” Pre-treatment NAR also was predictive of postinduction serum IFX trough level.

Investigators acknowledged limitations of their study’s design, including a small sample size, and concluded that the study “provides [evidence] to utilize NAR in the diagnosis, activity monitoring, and IFX response prediction in patients with UC.”