The role of serum bilirubin in the pathogenesis of Crohn’s disease in children and assessment of its activity

Introduction. The article is devoted to the identification of a marker of imbalance of oxidative stress and the antioxidant system in children with Crohn’s disease. The putative level of total bilirubin as an integrative method for assessing Crohn’s disease activity is highly correlated with indicators of oxidative stress and the antioxidant system (ischemia, modifying albumin, malondialdehyde, catalase, sulfhydryl groups and glutathione). Purpose: to explain the relationship between the level of total bilirubin and the activity of the inflammatory process in Crohn’s disease, which allows the introduction of the studied integrative indicator in clinical practice. Materials and methods. Based on the results of scientific studies of biomarkers of oxidative stress (albumin-modifying ischemia - plasma IMA, malondialdehyde - plasma MDA) and the antioxidant system (plasma SH-groups, catalase and reduced erythrocyte glutathione), as well as a simultaneous study of the level of total bilirubin in children diagnosed with Crohn’s disease. To search for a differential method for assessing the level of Crohn’s disease activity by the degree of bilirubin, use binary logistic regression. Results and survey. The results of the study showed a clear relationship between the increase in bilirubin levels and the severity of oxidative stress. It has been established that with a decrease in the level of total bilirubin, there is a predominance of oxidative stress over the antioxidant system, which leads to an increase in inflammation activity. It has been proven that the level of total bilirubin can be used in the complex activity of diseases as a minimally invasive, as well as an objective and acute marker. The sensitivity and specific sensitivity of this protocol is 90.9% and 93.3% respectively, which allows the use of total bilirubin as a marker of inflammation in Crohn’s disease.