Serum Dipeptidyl Peptidase IV (DPP IV/CD26) in Egyptian Patients with Ulcerative Colitis

Ulcerative colitis (UC) is a form of inflammatory bowel disease (IBD (which characterized by alternating phases of active inflammation and clinical remission with complications and extra intestinal manifestations. Colonoscopy is highly sensitive and specific for detection of lesions. Biochemical markers are a non-invasive way of objectively measuring inflammation in ulcerative colitis and can play an adjunctive or primary role in the assessment of disease activity. It is likely that the combination of screening methods is more effective than the use of any method alone. Dipeptidyl Peptidase (DPP IV/CD26) has an essential role in immune regulation as a T cell activation molecule, a regulator of chemokine function and regulates signaling transduction pathways. The aim of this work was to study the utility of serum DPP IV/CD26 in diagnosis of UC and its relation to the disease activity. This study included 40 patients divided into two groups: Group I: comprised 20 patients with UC and Group II: comprised 20 patients with irritable bowel syndrome (IBS) together with 20 healthy control. The diagnosis was established on the basis of clinical history, laboratory (CBC, ESR, liver and kidney function tests, PANCA), endoscopic and histological data. There was highly significant decrease of DPP IV/CD26 levels in GI in comparison to control group, significant decrease in comparison to GII and in GII in comparison to control group. Insignificant negative correlation between grades of UC and CD26 levels was found. There were highly significant decrease of Hb level, increase of ESR in G I in comparison to GII, control group and significant increase of PLTs count in G I in comparison to control group while no significant difference in WBCs, RBCs was detected among the studied groups. Also there was significant increase of ALT in GI in comparison to GII, control group, highly significant increase of AST in GI in comparison to GII, with no significant difference in the remaining results. From these results we concluded that Dipeptidyl Peptidase (DPP IV/CD26) is involved in the pathogenesis of UC and it is a new, sensitive marker can be added to endoscopy, biopsy but not replace them in diagnosis of UC. Its activity had inverse correlation with the disease severity and it can be able to differentiate UC from IBS.