Elevated Serum Podoplanin Levels Correlate with Disease Severity and Inflammation in Ulcerative Colitis: A Cross-Sectional Study.

Abstract

Objective: Podoplanin is a transmembrane glycoprotein that is primarily expressed in lymphatic endothelial cells, fibroblasts, and certain epithelial cells. Although it has been implicated in various physiological and pathological processes, its role in ulcerative colitis (UC) remains unclear. This study aimed to investigate the association between serum podoplanin levels and disease severity in patients with UC, and its potential involvement in coagulation and inflammation in patients with UC.

Methods: This cross-sectional study compared serum podoplanin levels in patients with remission-UC (n = 115), active-UC (n = 94), and healthy controls (n = 150). Active-UC patients were further classified as mild (n = 37), moderate (n = 31), or severe (n = 26) based on their Mayo scores. Clinical, inflammatory, and coagulation markers were measured and analyzed using one-way ANOVA, ROC analysis, and Pearson's correlation. Podoplanin expression in human tissues was examined using the BioGPS database (https://biogps.org/).

Results: Serum podoplanin levels were significantly elevated in patients with UC (n=209) compared to healthy controls (n=150), with higher levels observed in patients with moderate (n=31) and severe (n=26) disease than in those with mild UC (n=37). Correlation analysis revealed that serum podoplanin levels were positively associated with coagulation markers-platelet count (r=0.247, p<0.001), erythrocyte sedimentation rate (ESR; r=0.695, p<0.001), D-dimer (r=0.765, p<0.001), and fibrinogen (r=0.490, p<0.001) as well as inflammatory markers, including C-reactive protein (CRP; r=0.767, p<0.001), interleukin-1beta (IL-1β; r=0.744, p<0.001), interleukin-6 (IL-6; r=0.786, p<0.001), interleukin-17A (IL-17A; r=0.788, p<0.001), tumor necrosis factor-α (TNF-α; r=0.784, p<0.001), and Mayo score (r=0.912, p<0.001).

Conclusion: Elevated serum podoplanin levels are closely associated with disease activity, inflammation, and hypercoagulability in patients with UC, suggesting that it may serve as a reliable biomarker for monitoring disease severity and guiding clinical management.