Büşra ÇİFTÇİ, Bayram YEŞİL
Intercontinental Journal of Internal Medicine - 2026;4(2):46-49
Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by relapsing and remitting mucosal inflammation with variable clinical severity. Accurate evaluation of disease activity is essential for treatment optimization, monitoring therapeutic response, and preventing long-term complications. Although endoscopic assessment remains the gold standard for determining mucosal inflammation, its invasive nature and limited practicality for repeated evaluation have increased interest in noninvasive inflammatory biomarkers. Recent evidence has demonstrated that several hematological and biochemical inflammatory parameters may reflect both clinical and endoscopic disease activity in UC. Acute phase reactants such as C-reactive protein (CRP) and serum albumin, along with inflammatory indices derived from the complete blood count-including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), Systemic Immune-inflammation Index (SII), and Aggregate Index of Systemic Inflammation (AISI), have shown potential utility in predicting inflammatory burden and disease severity. In addition, fecal calprotectin (FCP) has emerged as one of the most valuable noninvasive biomarkers because of its strong association with mucosal inflammation and endoscopic disease activity. The Montreal classification system also provides a standardized framework for assessing disease extent and clinical severity in UC. Growing evidence suggests that extensive colitis and severe disease activity are associated with elevated levels of inflammatory biomarkers and lower serum albumin concentrations. This review summarizes the current literature regarding the relationship between inflammatory biomarkers and disease severity in active UC and discusses the clinical utility, advantages, and limitations of these parameters in evaluating inflammatory activity and predicting endoscopic disease severity.
