Oxidative Stress-Related Biomarkers in Inflammatory Bowel Disease: Dual Tools for Remission Assessment and Prediction of Treatment Outcome

Oxidative stress is increasingly recognized as a significant contributor to the pathogenesis of inflammatory bowel disease (IBD). However, the clinical utility of oxidative stress-related biomarkers for assessing and predicting disease activity remains unclear. This prospective observational study aimed to evaluate the diagnostic and predictive performance of oxidative stress-related biomarkers in distinguishing between active IBD and remission across clinical, biochemical, and endoscopic criteria. A total of 76 patients with IBD were followed across three visits: baseline (biological treatment initiation), post-induction (6–12 weeks), and final follow-up (24–36 weeks). Associations with clinical, biochemical, and endoscopic remission status at the final follow-up were evaluated using correlation matrices, receiver operating characteristic curve analysis, principal component analysis, and logistic regression. Ceruloplasmin, plasma free thiols, gamma-glutamyl transferase, and albumin showed significant diagnostic values for distinguishing active disease from remission, using C-reactive protein (CRP)-based criteria. Serum uric acid, advanced oxidation protein products, gamma-glutamyl transferase, total antioxidant capacity, and ceruloplasmin predicted clinical or CRP-based remission when measured at baseline or post-induction, with predictive value varying by biomarker and the time point. Overall, our findings reinforce the role of oxidative stress in the pathogenesis of IBD and highlight the potential of oxidative stress-related biomarkers to be used as tools for monitoring disease activity and predicting IBD treatment outcomes.