Evaluation of Interleukin-23 as a Non-Invasive Marker of Disease Severity in Patients with Ulcerative Colitis in Syria

The role of interleukin-23 (IL-23) as a non-invasive biomarker in patients with ulcerative colitis (UC) remains controversial across studies. To evaluate IL-23 as a non-invasive marker in patients with ulcerative colitis and to assess the potential correlation between elevated IL-23 levels and disease severity. This case-control study included 61 patients from Al-Mouwasat University Hospital and the National University Hospital, who were diagnosed with ulcerative colitis based on lower gastrointestinal endoscopy and biopsy findings. The Mayo score and serum IL-23 levels were measured for each patient. Among UC patients, 8.6% had mild disease, 57.1% had moderate disease, and 34.3% had severe disease according to the Mayo score. The mean serum IL-23 level was 13.18 pg/mL in the control group and 100.72 pg/mL in the UC group, with a statistically significant difference between the two groups (p < 0.00001). The mean IL-23 levels were 15.79 pg/mL in the mild UC group, 19.34 pg/mL in the moderate group, and 257.59 pg/mL in the severe group, with statistically significant differences between each pair of severity categories (p < 0.00001). Our study identified a statistically significant difference in IL-23 levels between UC patients and healthy controls, as well as among different disease severity levels based on the Mayo score. These findings suggest that IL-23 plays an important role in UC pathogenesis and may serve as a useful marker of disease activity in affected patients.