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Clinical relevance of inflammatory markers in the evaluation of severity of ulcerative colitis: A retrospective study

  • Tao He , Lian-Qiang Song , Xiao-Yu Weng , Peng Pan , Hui Ding , Mei-Qin Liu , Shi-Lin Qiu EMAIL logo and Shan-Ming Sun EMAIL logo
Published/Copyright: May 5, 2025
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From the journal Open Life Sciences Volume 20 Issue 1

Abstract

This study aimed to investigate the clinical relevance of inflammatory markers in the severity assessment of ulcerative colitis (UC). The inflammatory markers included the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and calcium ion (Ca2+) levels. A retrospective analysis was on 110 patients with UC and 52 patients with irritable bowel syndrome (IBS), admitted to Weifang People’s Hospital between June 2019 and February 2021. UC severity was classified using the modified Mayo score and the Montreal classification system. The study assessed the predictive accuracy and correlation of these inflammatory markers with UC severity and extent. Levels of NLR, PLR, CRP, ESR, and Ca2+ were significantly elevated in individuals with UC compared to those with IBS. Among patients with UC, significant differences in these markers were observed across varying severity levels as defined by the modified Mayo score. However, aside from ESR, no significant differences were noted in NLR, PLR, CRP, or Ca2+ levels across groups defined by lesion extent. Receiver operating characteristic curve analysis indicated that NLR exhibited the highest predictive accuracy for UC, with a cut-off value of 2.603 yielding a sensitivity of 0.545, specificity of 0.288, and an area under the curve (AUC) of 0.896. The combined use of NLR, PLR, CRP, ESR, and Ca2+ demonstrated superior predictive performance, achieving an AUC of 0.972, sensitivity of 0.927, and specificity of 0.923 at a cut-off value of 0.455. NLR, PLR, CRP, ESR, and Ca2+ exhibit predictive value for UC, with NLR demonstrating the highest individual predictive performance. The combined use of these markers enhances predictive accuracy, highlighting their potential application in clinical practice for the evaluation of severity UC. Due to ethical considerations at our institution, the IBS group was used as a substitute for healthy controls. The IBS group was included solely for the calibration and testing of inflammatory biomarkers, as well as for subsequent analysis of their role in assessing UC severity.

Keywords: disease assessment; neutrophil/lymphocyte ratio; platelet/lymphocyte ratio; ulcerative colitis

1 Introduction

Ulcerative colitis (UC) is a chronic, nonspecific inflammatory bowel disease (IBD) characterized by persistent or recurrent episodes of diarrhea, bloody stools, purulent mucus, abdominal pain, urgency, and varying degrees of systemic symptoms [1]. Despite extensive research, the underlying pathogenesis of UC remains unclear. The disease has become a significant global health concern, with its incidence rising rapidly in China [2,3].

Colonoscopy and mucosal biopsy are considered the gold standards for diagnosing UC and evaluating its severity. However, these methods are invasive, costly, and associated with potential complications such as bleeding and perforation, which often result in low patient compliance. This underscores the need for simpler, safer, and more cost-effective serological markers to assess UC severity. Despite their availability, currently used serological markers for the severity assessment of UC have demonstrated suboptimal accuracy [4].

In recent years, the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have gained recognition as novel inflammatory markers, with studies highlighting their relevance to infections, tumors, and autoimmune diseases [5–8]. Additionally, hypocalcemia is a common complication in UC, with evidence suggesting a correlation between calcium ion (Ca2+) levels and disease severity [9].

The present study aims to evaluate the predictive value of NLR, PLR, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and Ca2+ levels, both individually and in combination, for UC. Furthermore, this study seeks to assess their utility in determining disease severity, providing insights to support clinical monitoring and the evaluation of treatment outcomes in UC.

2 Data and methods

2.1 General data

This study included 110 individuals diagnosed with UC and 52 individuals diagnosed with irritable bowel syndrome (IBS) who were hospitalized at Weifang People’s Hospital between June 2019 and February 2021. Patients with IBS served as the control group, as IBS is widely regarded as a functional gastrointestinal disorder, and current evidence suggests no statistically significant differences in serological markers between patients with IBS and healthy individuals [10].

The UC group comprised 48 males and 62 females, with a mean age of 45.7 ± 16.9 years, while the control group included 20 males and 32 females, with a mean age of 38.2 ± 12.6 years. A comparison of demographic data between the two groups indicated no statistically significant differences (p > 0.05), ensuring their comparability. The study protocol was approved by the Medical Ethics Committee of Weifang People’s Hospital (approval number: wfj-20220806).

  1. Informed consent: Informed consent has been obtained from all individuals included in this study.

  2. Ethical approval: The research related to human use has been complied with all the relevant national regulations, institutional policies and in accordance with the tenets of the Helsinki Declaration, and has been approved by the Ethics Committee of Weifang people’s Hospital (Approval number is KYLL20240327-1).

2.2 Inclusion and exclusion criteria

Inclusion criteria: UC diagnosis was confirmed based on the “Consensus Opinions on the Diagnosis and Treatment of Inflammatory Bowel Disease” issued by the Inflammatory Bowel Disease Group of the Chinese Society of Gastroenterology, Chinese Medical Association, 2023 [1]. IBS diagnosis was established using the Rome IV criteria [11].

Exclusion criteria: (1) individuals younger than 16 years or older than 85 years; (2) individuals with concurrent conditions, including diabetes, coronary artery atherosclerotic heart disease, rheumatic diseases, acute or chronic infectious diseases, malignancies, or renal dysfunction; (3) individuals with incomplete clinical data; and (4) pregnant or lactating women.

2.3 Research methods

The following clinical and laboratory data were collected for each participant: name, age, gender, stool characteristics, results of the first colonoscopy performed after admission, CRP, ESR, complete blood count, and electrolytes. The NLR and PLR were calculated using the equations: NLR = neutrophil count/lymphocyte count; PLR = platelet count/lymphocyte count. Comparisons of the five serological indicators (NLR, PLR, CRP, ESR, and Ca2+) were conducted between patients with UC and IBS, across different extents of UC lesions, and among varying severities of UC. Variations in NLR, PLR, CRP, ESR, and Ca2+ levels were analyzed in relation to the extent of UC lesions, and their correlation with the modified Mayo score was assessed.

The predictive utility of NLR, PLR, CRP, ESR, and Ca2+, both individually and in combination, was evaluated using receiver operating characteristic (ROC) curve analysis.

The severity of UC was determined using the modified Mayo score [12], which consists of four components: bowel movement frequency, rectal bleeding, endoscopic findings, and global assessment by the physician. Each component was scored on a scale of 0–3, with a total score categorized as follows: ≤2 with no individual component >1: symptom remission; 3–5: mild disease; 6–10: moderate disease; and 11–12: severe disease.

The extent of UC was classified based on the Montreal classification including pan-colitis [13]:

(1) Proctitis (E1): disease confined to the rectum; (2) left-sided colitis (E2): disease extending from the rectum to the splenic flexure; (3) extensive colitis (E3): disease extending proximal to the splenic flexure.

Endoscopic disease activity, assessed using white-light endoscopy, was graded according to the Mayo Endoscopic Score (MES) [14]: 0: inactive disease; 1: mild disease; 2: moderate disease; 3: severe disease.

2.4 Sample collection and laboratory analysis

Fasting blood samples were collected from the median cubital vein on the second day following admission. The following analyses were conducted: complete blood count: performed using EDTA-K2 anticoagulant tubes with an automated hematology analyzer; CRP and calcium ion (Ca2+) levels: measured from serum samples collected in gel separator tubes using a biochemical analyzer; and ESR: assessed using blood samples collected in sodium citrate tubes with an automated ESR analyzer.

2.5 Fecal calprotectin (FC) assessment

Stool samples were collected within 3 days of undergoing sigmoidoscopy. Samples were processed using the ‘Faecal Sample Preparation Kit’ (Roche Diagnostics). FC levels were measured using two methods: “Quantum Blue” assay (Buhlmann, Switzerland) and the EliA fluoroimmunoassay (Phadia, ThermoFisher, Sweden).

2.6 Statistical methods

Data analysis was performed using SPSS 25.0 software. For continuous variables following a normal distribution, results were expressed as mean ± standard deviation (Mean ± SD), and comparisons between groups were conducted using the independent samples t-test. For variables that did not follow a normal distribution, data were presented as the median and interquartile range, and differences between groups were assessed using the Mann–Whitney U test or the Kruskal–Wallis rank-sum test.

Logistic regression analysis was utilized to identify predictive factors for UC. Among the inflammatory markers, NLR, PLR, CRP, ESR, and Ca2+ were deemed for inclusion in the regression model based on their statistical significance in univariate analysis.

The predictive reliability of the markers was evaluated using ROC curves. Specificity and sensitivity values were calculated for each indicator, and the area under the curve (AUC) was used as a measure of predictive performance. The AUC ranges from 0.5 to 1, with higher values indicating greater predictive reliability. An AUC of 0.5 reflects no predictive ability, while values closer to 1 indicate strong predictive performance. A p-value of less than 0.05 was considered statistically significant for all analyses.

3 Results

3.1 Participant demographics and clinical data

A total of 110 patients with UC and 52 patients with IBS who met the inclusion criteria were included in this study. Among the UC group, 48 patients were male (43.6%, 48/110) and 62 were female (56.4%, 62/110), with an age range of 21–69 years and a mean age of 45.7 ± 16.9 years. The average disease duration for patients with UC was 6 years, ranging from 2 to 15 years. In the IBS group, 20 patients were male (38.5%, 20/52) and 32 were female (61.5%, 32/52), with an age range of 24–65 years and a mean age of 38.2 ± 12.6 years. Statistical analysis showed no significant differences in sex, age, or other demographic characteristics between the UC and IBS groups (p > 0.05). Further details are provided in Table 1.

Table 1

Basic data

Group Cases Gender (male/female) Age (years, X ¯ ± S) Duration of illness (years, IQR)
UC group 110 48/62 45.7 ± 16.9 6 (2, 15)
IBS group 52 20/32 38.2 ± 12.6 —

Abbreviations: IBS, irritable bowel syndrome; UC, ulcerative colitis.

3.2 Comparison of NLR, PLR, CRP, ESR, and Ca2+ between the UC and IBS groups

Patients in the UC group exhibited significantly higher levels of NLR, PLR, CRP, and ESR compared to the IBS group. In contrast, the UC group demonstrated significantly lower levels of Ca2+. These differences were statistically significant (p < 0.05) and are summarized in Table 2.

Table 2

Comparing NLR, PLR, CRP, ESR, and Ca2+ levels between the UC and IBS groups

Group UC group IBS group Z value p value
NLR 3.84 (3.07–4.50) 1.94 (1.72–2.88) −8.126 <0.001
PLR 161.99 (134.05–201.82) 138.28 (103.87–153.33) −4.768 <0.001
CRP 18.00 (12.14–23.94) 8.33 (6.39–11.00) −7.545 <0.001
ESR 28.50 (19.75–38.50) 10.53 (5.7–19.13) −6.801 <0.001
Ca2+ 2.22 (2.09–2.37) 2.35 (2.27–2.49) −4.682 <0.001

Abbreviations: IBS, irritable bowel syndrome; UC, ulcerative colitis; NLR, neutrophils–lymphocytes ratio; PLR, platelet–lymphocytes ratio; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; Ca2+, calcium ion.

3.3 Comparison of NLR, PLR, CRP, ESR, and Ca2+ across different disease severities in the UC group

Among the 110 patients with UC, 17 cases were classified as mild, 72 as moderate, and 21 as severe. Serological markers, including NLR, PLR, CRP, and ESR, exhibited an upward trend with increasing disease severity, progressing from mild to moderate to severe UC. Conversely, Ca2+ levels showed a significant downward trend as UC severity increased. These variations in NLR, PLR, CRP, ESR, and Ca2+ levels among patients with differing disease severities were statistically significant (p < 0.05), as detailed in Table 3.

Table 3

Comparing NLR, PLR, CRP, ESR, and Ca2+ levels among patients with UC with different disease severities

Group Mild (n = 17) Moderate (n = 72) Severe (n = 21) p value
NLR 2.91 (2.57–3.63) 3.82 (3.17–4.32) 4.93 (3.97–5.85) <0.001
PLR 127.27 (100.62–146.55) 165.43 (147.16–191.54) 218.54 (154.22–270.35) <0.001
CRP 14.29 (9.60–18.32) 18.15 (13.46–23.31) 18.55 (12.19–32.62) 0.029
ESR 23.00 (12.00–32.50) 29.00 (19.50–42.00) 34.00 (24.00–42.50) 0.040
Ca2+ 2.37 (2.24–2.47) 2.20 (2.10–2.37) 2.13 (2.07–2.33) 0.005

Abbreviations: NLR, neutrophils–lymphocytes ratio; PLR, platelet–lymphocytes ratio; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; Ca2+, calcium ion.

3.4 Comparison of NLR, PLR, CRP, ESR, and Ca2+ levels across Montreal classification subgroups in the UC group

Among the 110 patients with UC, lesion extent was classified according to the Montreal classification: 26 cases were categorized as E1, 40 as E2, and 44 as E3. ESR levels demonstrated a statistically significant upward trend with increasing lesion extent from E1 to E3 (p < 0.05). Although NLR and PLR levels exhibited an increasing trend, and Ca2+ levels showed a decreasing trend with greater lesion extent, these differences were not statistically significant (p > 0.05). Similarly, CRP levels were highest in patients with E2-type lesions; however, no statistically significant correlation was observed between CRP levels and lesion extent (p > 0.05). Further details are presented in Table 4.

Table 4

Comparison of NLR, PLR, CRP, ESR, and Ca2+ levels in patients with UC having different lesion ranges

Group E1 (n = 26) E2 (n = 40) E3 (n = 44) p value
NLR 3.58 (2.89–4.39) 3.93 (3.18–4.31) 3.99 (3.13–3.99) 0.169
PLR 156.30 (133.23–181.68) 160.79 (136.51192.95) 168.65 (121.71–213.87) 0.720
CRP 17.60 (12.78–21.15) 18.98 (12.30–26.25) 17.98 (11.68–23.20) 0.592
ESR 12.00 (9.00–14.50) 29.00 (23.00–34.75) 38.50 (29.00–53.75) <0.001
Ca2+ 2.30 (2.15–2.41) 2.21 (2.11–2,37) 2.19 (2.09–2.37) 0.498

Abbreviations: NLR, neutrophils–lymphocytes ratio; PLR, platelet–lymphocytes ratio; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; Ca2+, calcium ion.

3.5 Comparison of inflammatory markers based on MES in the UC group

Among the 110 patients with UC, 11 cases were classified as MES ≤ 1, 65 as MES = 2, and 34 as MES = 3. NLR, PLR, and FC levels demonstrated an upward trend with increasing MES scores (from MES ≤ 1 to MES = 2 and MES = 3), while Ca2+ levels exhibited a corresponding downward trend. These differences were statistically significant (p < 0.05). In contrast, CRP and ESR levels showed no significant correlation with MES scores, and the differences were not statistically significant (p > 0.05). Further details are presented in Table 5.

Table 5

Logistic analysis of NLR, PLR, CRP, ESR, and Ca2+ in prediction of UC

Variable B value Standard error Wald value p value 95% CI
NLR −1.494 0.409 13.366 <0.001 0.101–0.500
PLR −0.004 0.012 0.103 0.748 0.974–1.019
CRP −0.309 0.084 13.385 <0.001 0.623–0.867
ESR −0.091 0.030 9.089 0.003 0.860–0.969
Ca2+ 3.462 2.478 1.951 0.163 0.009–2.585

Abbreviations: NLR, neutrophils–lymphocytes ratio; PLR, platelet–lymphocytes ratio; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; Ca2+, calcium ion.

3.6 Logistic regression analysis of inflammatory markers and predictive factors of UC

Logistic regression analysis was performed on serum markers that exhibited statistically significant differences between the UC and IBS groups: NLR, PLR, CRP, ESR, and Ca2+. The results indicated that NLR, CRP, and ESR are predictive factors for the UC. Detailed findings are summarized in Table 6.

Table 6

Efficacy of NLR, PLR, CRP, ESR, and Ca2+ in predicting UC independently and jointly

Index AUC Cut-off value Youden’s index Sensitivity Specificity
NLR 0.896 2.60 0.657 0.945 0.712
PLR 0.732 148.93 0.394 0.664 0.731
CRP 0.868 14.22 0.691 0.691 1.000
ESR 0.831 20.84 0.553 0.745 0.808
Ca2+ 0.728 −2.23 0.450 0.527 0.923
Jointly 0.972 −0.46 0.850 0.927 0.923

Abbreviations: NLR, neutrophils–lymphocytes ratio; PLR, platelet–lymphocytes ratio; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; Ca2+, calcium ion.

3.7 ROC analysis of inflammatory biomarkers for UC prediction

The predictive value of NLR, PLR, CRP, ESR, and Ca2+ in UC was evaluated using ROC curve analysis. Among the five biomarkers, NLR demonstrated the highest sensitivity, whereas CRP exhibited the highest specificity. NLR emerged as the most effective individual marker for UC prediction, with an optimal cut-off value of 2.603, yielding a sensitivity of 0.555, a specificity of 0.288, and an AUC of 0.896.

The combined use of all five biomarkers (NLR, PLR, CRP, ESR, and Ca2+) significantly enhanced predictive performance. At a cut-off value of 0.455, the combined model achieved a sensitivity of 0.927, a specificity of 0.923, and an AUC of 0.972, surpassing the efficacy of individual markers. Additional details are provided in Table 7 and illustrated in Figure 1.

Table 7

Evaluation of UC using inflammatory markers and their combinations

Index AUC Accuracy Sensitivity Specificity Cut-off value
NLR 0.896 0.430 0.555 0.288 2.603
PLR 0.732 0.315 0.336 0.269 148.933
CRP 0.868 0.210 0.309 1.000 14.222
ESR 0.831 0.235 0.255 0.192 20.843
Ca2+ 0.728 0.654 0.527 0.923 2.225
NLR + PLR + Ca2+ 0.914 0.846 0.864 0.808 0.397
NLR + PLR + Ca2+ + ESR + CRP 0.972 0.926 0.927 0.923 0.455

Abbreviations: NLR, neutrophils–lymphocytes ratio; PLR, platelet–lymphocytes ratio; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; Ca2+, calcium ion.

Figure 1 ROC curves for inflammatory markers in the diagnosis of UC, presented both individually and in combination (reference line).
Figure 1

ROC curves for inflammatory markers in the diagnosis of UC, presented both individually and in combination (reference line).

4 Discussion

UC is a chronic, nonspecific IBD characterized by alternating periods of relapse and remission. It follows a protracted clinical course and is associated with an increased risk of colorectal carcinogenesis. Early diagnosis and continuous monitoring of disease progression are essential for optimizing therapeutic strategies and improving prognosis.

Currently, UC diagnosis relies on a combination of clinical symptoms, hematological findings, colonoscopy, and mucosal biopsy. While colonoscopy and mucosal biopsy remain the gold standards for diagnosing UC and evaluating disease severity, these procedures are invasive, costly, and associated with patient discomfort. Such factors often result in poor compliance, adversely impacting disease management.

In recent years, novel biomarkers, such as FC and anti-neutrophil cytoplasmic antibodies, have been incorporated into clinical practice for UC assessment [15]. Despite their potential, these biomarkers are limited by low specificity, high costs, and the need for specialized testing, which constrain their widespread application. Consequently, there remains a pressing need for diagnostic tools that are highly specific, cost-effective, and practical, to facilitate UC diagnosis and guide clinical treatment effectively.

The findings of this study demonstrate that NLR, PLR, CRP, ESR, and Ca2+ levels are significantly elevated in patients with UC compared to those with IBS, supporting their utility as differential predictive markers. Statistically significant differences in NLR, PLR, CRP, ESR, and Ca2+ levels were observed across varying degrees of disease activity in patients with UC. Among these markers, ESR levels showed a significant association with lesion extent, while NLR, PLR, CRP, and Ca2+ levels did not reveal significant differences in assessing lesion extent. Logistic regression analysis identified NLR, CRP, and ESR as predictive factors for UC.

Regarding predictive efficacy, ROC curve analysis demonstrated that NLR exhibited the highest predictive performance among the five markers. A cut-off value of 2.603 for NLR yielded a sensitivity of 0.555, a specificity of 0.288, and an AUC of 0.896. These findings are consistent with those reported by Akpinar et al., who observed significantly higher NLR levels in patients with endoscopic active UC compared to those in remission [16]. Furthermore, their study demonstrated a positive correlation between NLR and the Rachmilewitz endoscopic activity index, emphasizing NLR’s potential as a predictive marker for endoscopic disease activity during colonoscopy. Similarly, a separate study conducted in Korea reported cut-off values of 2.26 for NLR and 179.8 for PLR in detecting UC, further supporting the utility of these inflammatory markers in clinical practice [17].

Similar to NLR, PLR is recognized as a novel inflammatory marker. In this study, PLR levels were significantly higher in the UC group compared to the IBS group, consistent with findings in the existing literature. Previous research has indicated that PLR is elevated during the active phase of UC compared to remission, suggesting its potential as a marker for reflecting disease activity and assessing the severity of intestinal inflammation in patients with UC [17,18].

In the current study, ROC curve analysis demonstrated that the combined use of the five indicators – NLR, PLR, CRP, ESR, and Ca2+ – yielded superior predictive performance compared to any single marker. Based on these findings, it is recommended that clinical practice incorporate the combined test of these indicators, with a cut-off value of 0.455, to effectively differentiate between UC and IBS. The IBS group was included for the calibration and testing of inflammatory biomarkers, serving as a reference group. Due to ethical considerations at our institution, the IBS group was used as a substitute for healthy controls, not for differential diagnosis with UC.

In areas of mucosal damage in patients with UC, neutrophils play a critical role as the first immune cells to infiltrate sites of inflammation. Previous research has demonstrated that neutrophils contribute to mucosal injury by producing reactive oxygen species with antimicrobial properties and releasing myeloperoxidase and elastase from their granules, which form fibrous networks to combat infection [19]. Additionally, neutrophils regulate the proliferation of invading microorganisms by secreting pro-inflammatory mediators, thereby aiding in the maintenance of tissue homeostasis [20]. However, this activity is accompanied by significant oxidative stress, which is considered as a key mechanism underlying intestinal damage in IBD.

The anti-inflammatory agent infliximab, a tumor necrosis factor inhibitor, has become a cornerstone of IBD immunotherapy, underscoring the potential of targeting oxidative stress as a therapeutic strategy [21]. In UC, inflammatory activity leads to increased apoptosis of lymphocytes in the thymus and spleen, resulting in elevated peripheral blood neutrophil levels and a reduction in lymphocyte counts during the active phase. These changes are reflected in an increased NLR, which serves as an indicator of the imbalance between these cell populations and the intensity of inflammatory activity.

Platelets play a multifaceted role in the body, contributing not only to hemostatic responses and endothelial tissue repair but also to the regulation of inflammatory processes. Upon bacterial activation, platelets release stored cytokines, inflammatory mediators, and antimicrobial peptides, and through direct interaction with immune cells or secretion of mediators, they help coordinate immune responses to inflammation and infection [22].

Although the specific role of platelets in UC remains unclear, several potential mechanisms have been proposed. First, platelets are broadly activated during inflammatory responses, and this activation exacerbates inflammation through the production of ligands via CD40–CD40L interactions [23]. Second, a possible positive feedback mechanism may exist between platelets and neutrophils, facilitated by CD40–CD40L interactions. This is supported by the observation that activated platelets are frequently localized near sites of significant neutrophil infiltration, particularly within ulcerative lesions. Third, previous research suggests that platelets may aggravate intestinal inflammation by inhibiting lymphangiogenesis, a process that is essential for resolving inflammation. This inhibition could contribute to the chronic inflammation characteristic of IBD [24].

These findings suggest that targeting the interactions between platelets and lymphatic vessels may represent a novel therapeutic approach for IBD, offering potential avenues for more effective management of chronic intestinal inflammation.

Calcium, a vital trace element, is primarily stored in bones and teeth as crystalline deposits. In its ionic form, calcium serves as a versatile intracellular messenger, playing a crucial role in numerous physiological processes. According to the 2013 “Expert Consensus on the Clinical Application of Vitamin and Mineral Supplements in the Prevention and Treatment of Inflammatory Bowel Disease,” hypocalcemia in patients with UC results from various factors. These include reduced calcium intake due to anorexia, steatorrhea, decreased intestinal mucosal absorptive surface, vitamin D deficiency, and the use of glucocorticoids. These factors collectively contribute to calcium malabsorption and inadequate dietary intake, significantly increasing the risk of osteoporosis in patients with UC [25].

Given these risks, it is imperative for clinicians to routinely monitor calcium ion levels during both the diagnostic and treatment phases to ensure comprehensive management of UC and its associated complications.

In conclusion, this study identified NLR, PLR, CRP, ESR, and Ca2+ as effective, cost-efficient, and safe biomarkers for the prediction and assessment of disease activity in patients with UC. Among these markers, the combination of all five provides the most robust predictive performance. Future research should focus on integrating additional novel serological inflammatory markers to further improve the accuracy of UC assessments.

However, this study has several limitations. First, it included only hospitalized patients in the active phase of the disease and lacked a control group of patients in remission, which may limit the generalizability of the findings. Second, colonoscopy assessments were performed by different physicians, potentially introducing variability in the interpretation of results. Additionally, the single-center, retrospective design may contribute to selection and observational bias.

To address these limitations, future studies should employ multi-center designs with larger sample sizes and long-term follow-up. Such studies should aim to explore simpler, more cost-effective, and safer serological markers for the prediction and monitoring of UC, facilitating improved patient outcomes and disease management.

# These authors contributed equally to this study.

tel: +86 0536-8192599

Acknowledgements

The authors would like to acknowledge the hard and dedicated work of all the staff that implemented the intervention and evaluation components of the study.

  1. Funding information: Authors state no funding involved.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and consented to its submission to the journal, reviewed all the results and approved the final version of the manuscript. T.H. and P.P. conceived the idea and conceptualized the study; L.Q.S. and M.Q.L. collected the data; X.Y.W. and S.L.Q. analyzed the data; L.Q.S., M.Q.L., and S.M.S. did the statistical analysis; T.H., X.Y.W., H.D., and S.M.S. drafted the manuscript, then P.P., H.D., and S.L.Q. reviewed the manuscript.

  3. Conflict of interest: Authors state no conflict of interest.

  4. Data availability statement: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Received: 2024-10-14
Revised: 2025-02-19
Accepted: 2025-03-03
Published Online: 2025-05-05

© 2025 the author(s), published by De Gruyter

This work is licensed under the Creative Commons Attribution 4.0 International License.

Articles in the same Issue

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  2. Mechanism of triptolide regulating proliferation and apoptosis of hepatoma cells by inhibiting JAK/STAT pathway
  3. Maslinic acid improves mitochondrial function and inhibits oxidative stress and autophagy in human gastric smooth muscle cells
  4. Comparative analysis of inflammatory biomarkers for the diagnosis of neonatal sepsis: IL-6, IL-8, SAA, CRP, and PCT
  5. Post-pandemic insights on COVID-19 and premature ovarian insufficiency
  6. Proteome differences of dental stem cells between permanent and deciduous teeth by data-independent acquisition proteomics
  7. Optimizing a modified cetyltrimethylammonium bromide protocol for fungal DNA extraction: Insights from multilocus gene amplification
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  12. Impact of fracture fixation surgery on cognitive function and the gut microbiota in mice with a history of stroke
  13. COLEC10: A potential tumor suppressor and prognostic biomarker in hepatocellular carcinoma through modulation of EMT and PI3K-AKT pathways
  14. High-temperature requirement serine protease A2 inhibitor UCF-101 ameliorates damaged neurons in traumatic brain-injured rats by the AMPK/NF-κB pathway
  15. SIK1 inhibits IL-1β-stimulated cartilage apoptosis and inflammation in vitro through the CRTC2/CREB1 signaling
  16. Rutin–chitooligosaccharide complex: Comprehensive evaluation of its anti-inflammatory and analgesic properties in vitro and in vivo
  17. Knockdown of Aurora kinase B alleviates high glucose-triggered trophoblast cells damage and inflammation during gestational diabetes
  18. Calcium-sensing receptors promoted Homer1 expression and osteogenic differentiation in bone marrow mesenchymal stem cells
  19. ABI3BP can inhibit the proliferation, invasion, and epithelial–mesenchymal transition of non-small-cell lung cancer cells
  20. Changes in blood glucose and metabolism in hyperuricemia mice
  21. Rapid detection of the GJB2 c.235delC mutation based on CRISPR-Cas13a combined with lateral flow dipstick
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  23. Short-chain fatty acid attenuates intestinal inflammation by regulation of gut microbial composition in antibiotic-associated diarrhea
  24. Application of metagenomic next-generation sequencing in the diagnosis of pathogens in patients with diabetes complicated by community-acquired pneumonia
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  199. Corrigendum to “Effects of Ire1 gene on virulence and pathogenicity of Candida albicans”
  200. Retraction
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https://doi.org/10.1515/biol-2025-1088
Keywords for this article
disease assessment; neutrophil/lymphocyte ratio; platelet/lymphocyte ratio; ulcerative colitis
Creative Commons
BY 4.0

Articles in the same Issue

  1. Biomedical Sciences
  2. Mechanism of triptolide regulating proliferation and apoptosis of hepatoma cells by inhibiting JAK/STAT pathway
  3. Maslinic acid improves mitochondrial function and inhibits oxidative stress and autophagy in human gastric smooth muscle cells
  4. Comparative analysis of inflammatory biomarkers for the diagnosis of neonatal sepsis: IL-6, IL-8, SAA, CRP, and PCT
  5. Post-pandemic insights on COVID-19 and premature ovarian insufficiency
  6. Proteome differences of dental stem cells between permanent and deciduous teeth by data-independent acquisition proteomics
  7. Optimizing a modified cetyltrimethylammonium bromide protocol for fungal DNA extraction: Insights from multilocus gene amplification
  8. Preliminary analysis of the role of small hepatitis B surface proteins mutations in the pathogenesis of occult hepatitis B infection via the endoplasmic reticulum stress-induced UPR-ERAD pathway
  9. Efficacy of alginate-coated gold nanoparticles against antibiotics-resistant Staphylococcus and Streptococcus pathogens of acne origins
  10. Battling COVID-19 leveraging nanobiotechnology: Gold and silver nanoparticle–B-escin conjugates as SARS-CoV-2 inhibitors
  11. Neurodegenerative diseases and neuroinflammation-induced apoptosis
  12. Impact of fracture fixation surgery on cognitive function and the gut microbiota in mice with a history of stroke
  13. COLEC10: A potential tumor suppressor and prognostic biomarker in hepatocellular carcinoma through modulation of EMT and PI3K-AKT pathways
  14. High-temperature requirement serine protease A2 inhibitor UCF-101 ameliorates damaged neurons in traumatic brain-injured rats by the AMPK/NF-κB pathway
  15. SIK1 inhibits IL-1β-stimulated cartilage apoptosis and inflammation in vitro through the CRTC2/CREB1 signaling
  16. Rutin–chitooligosaccharide complex: Comprehensive evaluation of its anti-inflammatory and analgesic properties in vitro and in vivo
  17. Knockdown of Aurora kinase B alleviates high glucose-triggered trophoblast cells damage and inflammation during gestational diabetes
  18. Calcium-sensing receptors promoted Homer1 expression and osteogenic differentiation in bone marrow mesenchymal stem cells
  19. ABI3BP can inhibit the proliferation, invasion, and epithelial–mesenchymal transition of non-small-cell lung cancer cells
  20. Changes in blood glucose and metabolism in hyperuricemia mice
  21. Rapid detection of the GJB2 c.235delC mutation based on CRISPR-Cas13a combined with lateral flow dipstick
  22. IL-11 promotes Ang II-induced autophagy inhibition and mitochondrial dysfunction in atrial fibroblasts
  23. Short-chain fatty acid attenuates intestinal inflammation by regulation of gut microbial composition in antibiotic-associated diarrhea
  24. Application of metagenomic next-generation sequencing in the diagnosis of pathogens in patients with diabetes complicated by community-acquired pneumonia
  25. NAT10 promotes radiotherapy resistance in non-small cell lung cancer by regulating KPNB1-mediated PD-L1 nuclear translocation
  26. Phytol-mixed micelles alleviate dexamethasone-induced osteoporosis in zebrafish: Activation of the MMP3–OPN–MAPK pathway-mediating bone remodeling
  27. Association between TGF-β1 and β-catenin expression in the vaginal wall of patients with pelvic organ prolapse
  28. Primary pleomorphic liposarcoma involving bilateral ovaries: Case report and literature review
  29. Effects of de novo donor-specific Class I and II antibodies on graft outcomes after liver transplantation: A pilot cohort study
  30. Sleep architecture in Alzheimer’s disease continuum: The deep sleep question
  31. Ephedra fragilis plant extract: A groundbreaking corrosion inhibitor for mild steel in acidic environments – electrochemical, EDX, DFT, and Monte Carlo studies
  32. Langerhans cell histiocytosis in an adult patient with upper jaw and pulmonary involvement: A case report
  33. Inhibition of mast cell activation by Jaranol-targeted Pirin ameliorates allergic responses in mouse allergic rhinitis
  34. Aeromonas veronii-induced septic arthritis of the hip in a child with acute lymphoblastic leukemia
  35. Clusterin activates the heat shock response via the PI3K/Akt pathway to protect cardiomyocytes from high-temperature-induced apoptosis
  36. Research progress on fecal microbiota transplantation in tumor prevention and treatment
  37. Low-pressure exposure influences the development of HAPE
  38. Stigmasterol alleviates endplate chondrocyte degeneration through inducing mitophagy by enhancing PINK1 mRNA acetylation via the ESR1/NAT10 axis
  39. AKAP12, mediated by transcription factor 21, inhibits cell proliferation, metastasis, and glycolysis in lung squamous cell carcinoma
  40. Association between PAX9 or MSX1 gene polymorphism and tooth agenesis risk: A meta-analysis
  41. A case of bloodstream infection caused by Neisseria gonorrhoeae
  42. Case of nasopharyngeal tuberculosis complicated with cervical lymph node and pulmonary tuberculosis
  43. p-Cymene inhibits pro-fibrotic and inflammatory mediators to prevent hepatic dysfunction
  44. GFPT2 promotes paclitaxel resistance in epithelial ovarian cancer cells via activating NF-κB signaling pathway
  45. Transfer RNA-derived fragment tRF-36 modulates varicose vein progression via human vascular smooth muscle cell Notch signaling
  46. RTA-408 attenuates the hepatic ischemia reperfusion injury in mice possibly by activating the Nrf2/HO-1 signaling pathway
  47. Decreased serum TIMP4 levels in patients with rheumatoid arthritis
  48. Sirt1 protects lupus nephritis by inhibiting the NLRP3 signaling pathway in human glomerular mesangial cells
  49. Sodium butyrate aids brain injury repair in neonatal rats
  50. Interaction of MTHFR polymorphism with PAX1 methylation in cervical cancer
  51. Convallatoxin inhibits proliferation and angiogenesis of glioma cells via regulating JAK/STAT3 pathway
  52. The effect of the PKR inhibitor, 2-aminopurine, on the replication of influenza A virus, and segment 8 mRNA splicing
  53. Effects of Ire1 gene on virulence and pathogenicity of Candida albicans
  54. Small cell lung cancer with small intestinal metastasis: Case report and literature review
  55. GRB14: A prognostic biomarker driving tumor progression in gastric cancer through the PI3K/AKT signaling pathway by interacting with COBLL1
  56. 15-Lipoxygenase-2 deficiency induces foam cell formation that can be restored by salidroside through the inhibition of arachidonic acid effects
  57. FTO alleviated the diabetic nephropathy progression by regulating the N6-methyladenosine levels of DACT1
  58. Clinical relevance of inflammatory markers in the evaluation of severity of ulcerative colitis: A retrospective study
  59. Zinc valproic acid complex promotes osteoblast differentiation and exhibits anti-osteoporotic potential
  60. Primary pulmonary synovial sarcoma in the bronchial cavity: A case report
  61. Metagenomic next-generation sequencing of alveolar lavage fluid improves the detection of pulmonary infection
  62. Uterine tumor resembling ovarian sex cord tumor with extensive rhabdoid differentiation: A case report
  63. Genomic analysis of a novel ST11(PR34365) Clostridioides difficile strain isolated from the human fecal of a CDI patient in Guizhou, China
  64. Effects of tiered cardiac rehabilitation on CRP, TNF-α, and physical endurance in older adults with coronary heart disease
  65. Changes in T-lymphocyte subpopulations in patients with colorectal cancer before and after acupoint catgut embedding acupuncture observation
  66. Modulating the tumor microenvironment: The role of traditional Chinese medicine in improving lung cancer treatment
  67. Alterations of metabolites related to microbiota–gut–brain axis in plasma of colon cancer, esophageal cancer, stomach cancer, and lung cancer patients
  68. Research on individualized drug sensitivity detection technology based on bio-3D printing technology for precision treatment of gastrointestinal stromal tumors
  69. CEBPB promotes ulcerative colitis-associated colorectal cancer by stimulating tumor growth and activating the NF-κB/STAT3 signaling pathway
  70. Oncolytic bacteria: A revolutionary approach to cancer therapy
  71. A de novo meningioma with rapid growth: A possible malignancy imposter?
  72. Diagnosis of secondary tuberculosis infection in an asymptomatic elderly with cancer using next-generation sequencing: Case report
  73. Hesperidin and its zinc(ii) complex enhance osteoblast differentiation and bone formation: In vitro and in vivo evaluations
  74. Research progress on the regulation of autophagy in cardiovascular diseases by chemokines
  75. Anti-arthritic, immunomodulatory, and inflammatory regulation by the benzimidazole derivative BMZ-AD: Insights from an FCA-induced rat model
  76. Immunoassay for pyruvate kinase M1/2 as an Alzheimer’s biomarker in CSF
  77. The role of HDAC11 in age-related hearing loss: Mechanisms and therapeutic implications
  78. Evaluation and application analysis of animal models of PIPNP based on data mining
  79. Therapeutic approaches for liver fibrosis/cirrhosis by targeting pyroptosis
  80. Fabrication of zinc oxide nanoparticles using Ruellia tuberosa leaf extract induces apoptosis through P53 and STAT3 signalling pathways in prostate cancer cells
  81. Haplo-hematopoietic stem cell transplantation and immunoradiotherapy for severe aplastic anemia complicated with nasopharyngeal carcinoma: A case report
  82. Modulation of the KEAP1-NRF2 pathway by Erianin: A novel approach to reduce psoriasiform inflammation and inflammatory signaling
  83. The expression of epidermal growth factor receptor 2 and its relationship with tumor-infiltrating lymphocytes and clinical pathological features in breast cancer patients
  84. Innovations in MALDI-TOF Mass Spectrometry: Bridging modern diagnostics and historical insights
  85. BAP1 complexes with YY1 and RBBP7 and its downstream targets in ccRCC cells
  86. Hypereosinophilic syndrome with elevated IgG4 and T-cell clonality: A report of two cases
  87. Electroacupuncture alleviates sciatic nerve injury in sciatica rats by regulating BDNF and NGF levels, myelin sheath degradation, and autophagy
  88. Polydatin prevents cholesterol gallstone formation by regulating cholesterol metabolism via PPAR-γ signaling
  89. RNF144A and RNF144B: Important molecules for health
  90. Analysis of the detection rate and related factors of thyroid nodules in the healthy population
  91. Artesunate inhibits hepatocellular carcinoma cell migration and invasion through OGA-mediated O-GlcNAcylation of ZEB1
  92. Endovascular management of post-pancreatectomy hemorrhage caused by a hepatic artery pseudoaneurysm: Case report and review of the literature
  93. Efficacy and safety of anti-PD-1/PD-L1 antibodies in patients with relapsed refractory diffuse large B-cell lymphoma: A meta-analysis
  94. SATB2 promotes humeral fracture healing in rats by activating the PI3K/AKT pathway
  95. Overexpression of the ferroptosis-related gene, NFS1, corresponds to gastric cancer growth and tumor immune infiltration
  96. Understanding risk factors and prognosis in diabetic foot ulcers
  97. Atractylenolide I alleviates the experimental allergic response in mice by suppressing TLR4/NF-kB/NLRP3 signalling
  98. FBXO31 inhibits the stemness characteristics of CD147 (+) melanoma stem cells
  99. Immune molecule diagnostics in colorectal cancer: CCL2 and CXCL11
  100. Inhibiting CXCR6 promotes senescence of activated hepatic stellate cells with limited proinflammatory SASP to attenuate hepatic fibrosis
  101. Cadmium toxicity, health risk and its remediation using low-cost biochar adsorbents
  102. Pulmonary cryptococcosis with headache as the first presentation: A case report
  103. Solitary pulmonary metastasis with cystic airspaces in colon cancer: A rare case report
  104. RUNX1 promotes denervation-induced muscle atrophy by activating the JUNB/NF-κB pathway and driving M1 macrophage polarization
  105. Morphometric analysis and immunobiological investigation of Indigofera oblongifolia on the infected lung with Plasmodium chabaudi
  106. The NuA4/TIP60 histone-modifying complex and Hr78 modulate the Lobe2 mutant eye phenotype
  107. Experimental study on salmon demineralized bone matrix loaded with recombinant human bone morphogenetic protein-2: In vitro and in vivo study
  108. A case of IgA nephropathy treated with a combination of telitacicept and half-dose glucocorticoids
  109. Analgesic and toxicological evaluation of cannabidiol-rich Moroccan Cannabis sativa L. (Khardala variety) extract: Evidence from an in vivo and in silico study
  110. Wound healing and signaling pathways
  111. Combination of immunotherapy and whole-brain radiotherapy on prognosis of patients with multiple brain metastases: A retrospective cohort study
  112. To explore the relationship between endometrial hyperemia and polycystic ovary syndrome
  113. Research progress on the impact of curcumin on immune responses in breast cancer
  114. Biogenic Cu/Ni nanotherapeutics from Descurainia sophia (L.) Webb ex Prantl seeds for the treatment of lung cancer
  115. Dapagliflozin attenuates atrial fibrosis via the HMGB1/RAGE pathway in atrial fibrillation rats
  116. Glycitein alleviates inflammation and apoptosis in keratinocytes via ROS-associated PI3K–Akt signalling pathway
  117. ADH5 inhibits proliferation but promotes EMT in non-small cell lung cancer cell through activating Smad2/Smad3
  118. Apoptotic efficacies of AgNPs formulated by Syzygium aromaticum leaf extract on 32D-FLT3-ITD human leukemia cell line with PI3K/AKT/mTOR signaling pathway
  119. Novel cuproptosis-related genes C1QBP and PFKP identified as prognostic and therapeutic targets in lung adenocarcinoma
  120. Bee venom promotes exosome secretion and alters miRNA cargo in T cells
  121. Treatment of pure red cell aplasia in a chronic kidney disease patient with roxadustat: A case report
  122. Comparative bioinformatics analysis of the Wnt pathway in breast cancer: Selection of novel biomarker panels associated with ER status
  123. Kynurenine facilitates renal cell carcinoma progression by suppressing M2 macrophage pyroptosis through inhibition of CASP1 cleavage
  124. RFX5 promotes the growth, motility, and inhibits apoptosis of gastric adenocarcinoma cells through the SIRT1/AMPK axis
  125. ALKBH5 exacerbates early cardiac damage after radiotherapy for breast cancer via m6A demethylation of TLR4
  126. Phytochemicals of Roman chamomile: Antioxidant, anti-aging, and whitening activities of distillation residues
  127. Circadian gene Cry1 inhibits the tumorigenicity of hepatocellular carcinoma by the BAX/BCL2-mediated apoptosis pathway
  128. The TNFR-RIPK1/RIPK3 signalling pathway mediates the effect of lanthanum on necroptosis of nerve cells
  129. Longitudinal monitoring of autoantibody dynamics in patients with early-stage non-small-cell lung cancer undergoing surgery
  130. The potential role of rutin, a flavonoid, in the management of cancer through modulation of cell signaling pathways
  131. Construction of pectinase gene engineering microbe and its application in tobacco sheets
  132. Construction of a microbial abundance prognostic scoring model based on intratumoral microbial data for predicting the prognosis of lung squamous cell carcinoma
  133. Sepsis complicated by haemophagocytic lymphohistiocytosis triggered by methicillin-resistant Staphylococcus aureus and human herpesvirus 8 in an immunocompromised elderly patient: A case report
  134. Sarcopenia in liver transplantation: A comprehensive bibliometric study of current research trends and future directions
  135. Advances in cancer immunotherapy and future directions in personalized medicine
  136. Can coronavirus disease 2019 affect male fertility or cause spontaneous abortion? A two-sample Mendelian randomization analysis
  137. Heat stroke associated with novel leukaemia inhibitory factor receptor gene variant in a Chinese infant
  138. PSME2 exacerbates ulcerative colitis by disrupting intestinal barrier function and promoting autophagy-dependent inflammation
  139. Hyperosmolar hyperglycemic state with severe hypernatremia coexisting with central diabetes insipidus: A case report and literature review
  140. Efficacy and mechanism of escin in improving the tissue microenvironment of blood vessel walls via anti-inflammatory and anticoagulant effects: Implications for clinical practice
  141. Merkel cell carcinoma: Clinicopathological analysis of three patients and literature review
  142. Genetic variants in VWF exon 26 and their implications for type 1 Von Willebrand disease in a Saudi Arabian population
  143. Lipoxin A4 improves myocardial ischemia/reperfusion injury through the Notch1-Nrf2 signaling pathway
  144. High levels of EPHB2 expression predict a poor prognosis and promote tumor progression in endometrial cancer
  145. Knockdown of SHP-2 delays renal tubular epithelial cell injury in diabetic nephropathy by inhibiting NLRP3 inflammasome-mediated pyroptosis
  146. Exploring the toxicity mechanisms and detoxification methods of Rhizoma Paridis
  147. Concomitant gastric carcinoma and primary hepatic angiosarcoma in a patient: A case report
  148. Ecology and Environmental Science
  149. Optimization and comparative study of Bacillus consortia for cellulolytic potential and cellulase enzyme activity
  150. The complete mitochondrial genome analysis of Haemaphysalis hystricis Supino, 1897 (Ixodida: Ixodidae) and its phylogenetic implications
  151. Epidemiological characteristics and risk factors analysis of multidrug-resistant tuberculosis among tuberculosis population in Huzhou City, Eastern China
  152. Indices of human impacts on landscapes: How do they reflect the proportions of natural habitats?
  153. Genetic analysis of the Siberian flying squirrel population in the northern Changbai Mountains, Northeast China: Insights into population status and conservation
  154. Diversity and environmental drivers of Suillus communities in Pinus sylvestris var. mongolica forests of Inner Mongolia
  155. Global assessment of the fate of nitrogen deposition in forest ecosystems: Insights from 15N tracer studies
  156. Fungal and bacterial pathogenic co-infections mainly lead to the assembly of microbial community in tobacco stems
  157. Influencing of coal industry related airborne particulate matter on ocular surface tear film injury and inflammatory factor expression in Sprague-Dawley rats
  158. Temperature-dependent development, predation, and life table of Sphaerophoria macrogaster (Thomson) (Diptera: Syrphidae) feeding on Myzus persicae (Sulzer) (Homoptera: Aphididae)
  159. Eleonora’s falcon trophic interactions with insects within its breeding range: A systematic review
  160. Agriculture
  161. Integrated analysis of transcriptome, sRNAome, and degradome involved in the drought-response of maize Zhengdan958
  162. Variation in flower frost tolerance among seven apple cultivars and transcriptome response patterns in two contrastingly frost-tolerant selected cultivars
  163. Heritability of durable resistance to stripe rust in bread wheat (Triticum aestivum L.)
  164. Molecular mechanism of follicular development in laying hens based on the regulation of water metabolism
  165. Animal Science
  166. Effect of sex ratio on the life history traits of an important invasive species, Spodoptera frugiperda
  167. Plant Sciences
  168. Hairpin in a haystack: In silico identification and characterization of plant-conserved microRNA in Rafflesiaceae
  169. Widely targeted metabolomics of different tissues in Rubus corchorifolius
  170. The complete chloroplast genome of Gerbera piloselloides (L.) Cass., 1820 (Carduoideae, Asteraceae) and its phylogenetic analysis
  171. Field trial to correlate mineral solubilization activity of Pseudomonas aeruginosa and biochemical content of groundnut plants
  172. Correlation analysis between semen routine parameters and sperm DNA fragmentation index in patients with semen non-liquefaction: A retrospective study
  173. Plasticity of the anatomical traits of Rhododendron L. (Ericaceae) leaves and its implications in adaptation to the plateau environment
  174. Effects of Piriformospora indica and arbuscular mycorrhizal fungus on growth and physiology of Moringa oleifera under low-temperature stress
  175. Effects of different sources of potassium fertiliser on yield, fruit quality and nutrient absorption in “Harward” kiwifruit (Actinidia deliciosa)
  176. Comparative efficiency and residue levels of spraying programs against powdery mildew in grape varieties
  177. The DREB7 transcription factor enhances salt tolerance in soybean plants under salt stress
  178. Using plant electrical signals of water hyacinth (Eichhornia crassipes) for water pollution monitoring
  179. Food Science
  180. Phytochemical analysis of Stachys iva: Discovering the optimal extract conditions and its bioactive compounds
  181. Review on role of honey in disease prevention and treatment through modulation of biological activities
  182. Computational analysis of polymorphic residues in maltose and maltotriose transporters of a wild Saccharomyces cerevisiae strain
  183. Optimization of phenolic compound extraction from Tunisian squash by-products: A sustainable approach for antioxidant and antibacterial applications
  184. Liupao tea aqueous extract alleviates dextran sulfate sodium-induced ulcerative colitis in rats by modulating the gut microbiota
  185. Toxicological qualities and detoxification trends of fruit by-products for valorization: A review
  186. Polyphenolic spectrum of cornelian cherry fruits and their health-promoting effect
  187. Optimizing the encapsulation of the refined extract of squash peels for functional food applications: A sustainable approach to reduce food waste
  188. Advancements in curcuminoid formulations: An update on bioavailability enhancement strategies curcuminoid bioavailability and formulations
  189. Impact of saline sprouting on antioxidant properties and bioactive compounds in chia seeds
  190. The dilemma of food genetics and improvement
  191. Bioengineering and Biotechnology
  192. Impact of hyaluronic acid-modified hafnium metalorganic frameworks containing rhynchophylline on Alzheimer’s disease
  193. Emerging patterns in nanoparticle-based therapeutic approaches for rheumatoid arthritis: A comprehensive bibliometric and visual analysis spanning two decades
  194. Application of CRISPR/Cas gene editing for infectious disease control in poultry
  195. Preparation of hafnium nitride-coated titanium implants by magnetron sputtering technology and evaluation of their antibacterial properties and biocompatibility
  196. Preparation and characterization of lemongrass oil nanoemulsion: Antimicrobial, antibiofilm, antioxidant, and anticancer activities
  197. Corrigendum
  198. Corrigendum to “Utilization of convolutional neural networks to analyze microscopic images for high-throughput screening of mesenchymal stem cells”
  199. Corrigendum to “Effects of Ire1 gene on virulence and pathogenicity of Candida albicans”
  200. Retraction
  201. Retraction of “Down-regulation of miR-539 indicates poor prognosis in patients with pancreatic cancer”
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