Plasma LBP associated with pediatric IBD activity, particularly ulcerative colitis

Researchers examined plasma lipopolysaccharide-binding protein (LBP) as an indirect marker of systemic exposure to bacterial endotoxins and a proxy for intestinal permeability in pediatric inflammatory bowel disease (IBD). The analysis included 1,083 longitudinal plasma samples from prospective cohorts comprising 61 children with newly diagnosed ulcerative colitis (UC), 115 with Crohn’s disease (CD), 33 IBD-negative controls and 28 healthy controls. Median follow-up was 628 days. Investigators assessed associations with clinicopathological measures and plasma immune proteomics.

LBP was elevated and associated with disease activity in treatment-naive UC and CD. In UC, but not CD, it related to disease extent and independently correlated with endoscopic and histological activity, adding explanatory value beyond blood biomarkers and inflammatory mediators, including CRP and IL-6. LBP also correlated with disease-specific immune profiles linked to severe disease. Levels decreased after corticosteroid induction in UC and after exclusive enteral nutrition or anti-TNF therapy in CD, but not after corticosteroids in CD. Associations with disease activity persisted during follow-up, particularly in UC.

These findings suggest LBP could complement existing blood biomarkers when monitoring pediatric UC. However, this observational analysis does not establish clinical utility or directly measure intestinal permeability. The available abstract provides no effect sizes, diagnostic thresholds or predictive performance estimates; full text was unavailable for assessment.