Marilena Stamouli

Background: Persistent histologic inflammation may remain present in patients with inflammatory bowel disease (IBD) despite endoscopic remission. This study evaluated a clinically interpretable cytokine-based framework for risk stratification of residual histologic activity. Methods: In this prospective cohort study, 59 patients with IBD undergoing colonoscopy were included. Primary analyses were restricted to patients with ulcerative colitis (UC) in endoscopic remission (n = 31). Histologic activity was assessed using the Geboes score. Serum interleukin-10 (IL-10), interleukin-23 (IL-23), and C-reactive protein (CRP) were measured prior to endoscopy. Receiver operating characteristic (ROC) analysis and ROC-derived thresholds were used to evaluate biomarker performance and construct a cytokine-based risk stratification framework. Results: Among patients with UC in endoscopic remission, 14/31 (45.2%) demonstrated persistent histologic activity. IL-10 showed the strongest discriminatory performance for histologic activity (AUC 0.850), with a threshold < 3.9 pg/mL associated with sensitivity of 84.6% and specificity of 77.8%. Similar performance was observed using raw assay-reported IL-10 values (AUC 0.906). IL-23 showed limited overall discrimination (AUC 0.615). A combined IL-10/IL-23 framework stratified patients into progressively higher-risk subgroups, with histologic activity observed in 1/14 patients (7.1%) in the low-risk subgroup, 1/2 patients (50.0%) in the Intermediate A subgroup, 9/12 patients (75.0%) in the Intermediate B subgroup, and 3/3 patients (100%) in the high-risk subgroup (p < 0.001), although estimates for smaller subgroups should be interpreted cautiously. Reduced IL-10 levels were independently associated with histologic activity, whereas IL-23 primarily refined subgroup classification without substantially improving discrimination. Conclusions: An exploratory cytokine-based framework incorporating IL-10 and IL-23 may support risk stratification of residual histologic activity in UC during endoscopic remission. Larger multicenter studies are required to validate these findings and define their clinical utility.

Background: The current pandemic due to novel SARS-CoV-2 virus dramatically affected health care systems and public health worldwide. The present study aimed to evaluate two analytical methods, colloidal gold antigen rapid test vs reference PCR for the detection of SARS-CoV-2. The patients enrolled in the trial were admitted at the emergency department of a tertiary care hospital, with symptoms of suspected COVID-19 disease. Methods: A total of 300 patients participated in the study. Patients’ age, gender and result from the Colloidal antigen rapid test were recorded. PCR detection for SARS-CoV-2 was then applied, according to the manufacturer’s instructions. Statistical analysis of all collected data was performed for sensitivity, specificity, ROC curves, PV+, PV- and Cohen’s kappa coefficient. McNemar’s chi-squared test and p-values were also tested. Results: A p-value=0.045 from McNemar’s chi-squared test for CI 95% was observed, so H0 marginally is not rejected. The sensitivity of colloidal gold antigen rapid test was 79%, the specificity 96%, PV+89%, PV-91% and the kappa coefficient=0.79 (>0.5) that correlates to substantial agreement according to Cohen’s Kappa interpretation. Conclusions: Through the methodological comparisons and according to WHO guidelines for the sensitivity, specificity and kappa coefficient that correlates to substantial agreement the Colloidal Gold Antigen Rapid Test for SARS-CoV-2 meet the needs of clinical test in the emergency unit playing an important role in the context of mass patient screening and screening in remote areas.