# Serum Oncostatin M in Ulcerative Colitis Patients and Its Relation to Disease Activity

## TL;DR

This study shows that serum oncostatin M (OSM) is a better biomarker than fecal calprotectin for assessing the severity and remission of ulcerative colitis.

## Contribution

The study demonstrates that serum OSM is more effective than fecal calprotectin in evaluating histological activity and remission in ulcerative colitis.

## Key findings

- Serum OSM levels were strongly correlated with clinical, endoscopic, and histological disease activity in ulcerative colitis.
- OSM outperformed fecal calprotectin in detecting histological remission and had higher diagnostic accuracy for active disease.
- Combining OSM and fecal calprotectin improved diagnostic accuracy for endoscopic and clinical endpoints.

## Abstract

Ulcerative colitis (UC) is a chronic, relapsing inflammatory bowel disease; non-invasive biomarkers that accurately reflect the endoscopic and histological activity of UC require validation. Therefore, our study focused on exploring the potential of serum oncostatin M (OSM) as a biomarker for evaluating UC severity. A total of UC 89 eligible participants (≥18 years) underwent extensive clinical and paraclinical evaluation. Clinical, endoscopic, and histological activity were assessed using the partial Mayo score (pMS), the Mayo endoscopic score (MES), and the Nancy Histological Index (NHI), respectively. Serum OSM levels were determined by ELISA test and measured in pg/mL; fecal calprotectin (FC) was measured in µ/g. In our study, serum OSM was significantly associated with all four outcome measures: higher OSM levels predicted higher pMS (β = 0.471, p < 0.001, R2 = 0.222), MES (β = 0.422, p < 0.001, R2 = 0.178), NHI (β = 0.422, p < 0.001, R2 = 0.256), and FC (β = 0.431, p < 0.001, R2 = 0.186). Furthermore, ROC curve analyses demonstrated that OSM had excellent diagnostic accuracy for active disease, particularly in relation to histological inflammation (AUC = 0.967). In comparison, FC showed good but slightly lower accuracy (AUC = 0.875). Notably, OSM also outperformed FC in discriminating histological remission. Pairwise ROC curve analyses using DeLong’s test further confirmed the diagnostic accuracy of OSM, FC, and combined biomarker scores (OSM+FC) across clinical, endoscopic, and histological endpoints. The combined score PRE1 (OSM + FC based on NHI) achieved perfect discrimination (AUC = 1.000, p < 0.001). Composite models PRE2 and PRE3 (OSM+FC based on MES and pMS) improved diagnostic accuracy relative to OSM, confirming the value of combining OSM with FC. Although both outperformed OSM (p < 0.05), neither achieved a superior advantage over FC. Serum OSM is strongly associated with histological activity in UC and demonstrates superior performance compared with FC in assessing histological remission.