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The Correlation Between C-Reactive Protein (CRP) and Interleukin-33 (IL-33) Levels in Ulcerative Colitis Patients with and without Entamoebiasis in Al-Najaf Governorate
Published: 2026-05-31
Abstract
Background: The disease of Ulcerative Colitis (UC) is chronic mucosal ulcer formation. In endemic areas such as the Al-Najaf Governorate, double infections with protozoa like Entamoeba histolytica are common and complicate the clinical presentation. Objective: To evaluate and compare the diagnosis relevance of systemic C-reactive protein (CRP) and mucosal IL-33 in UC patients with and without comorbid entamoebiasis. Methods: A comparative cross-section study was conducted on 90 individuals, aged 10-40 years, were taken from Gastroenterology Center, Al-Zahra Teaching Hospital and Al-Sadr Teaching Hospital at the city of Al-Najaf in the period from December 2025 to May 2026. The subjects were divided into three equal groups of 30 each: group 1 (Entamoebiasis only), group 2 (UC only), group 3 (UC and Entamoebiasis co-infection). Serum CRP and IL-33 concentrations were measured by automated immunoturbidimetry and Enzyme-Linked Immunosorbent Assay (ELISA), respectively. Diagnostic performance was assessed by Receiver Operating Characteristic (ROC) curve analysis. Results: The serum CRP and IL-33 were markedly increased in co-infection group (48.62±8.34 mg/L and 214.50±35.20 pg/mL, respectively) in comparison with Group 1 and Group 2 (P<0.001). Highly significant strong positive association was observed between CRP and IL-33 in co-infected group (r=0.742, P<0.001). ROC curve analysis demonstrated that serum IL-33 had the best diagnostic value to predict parasitic co-infection in UC subjects (AUC = 0.912, Sensitivity = 90.0%, Specificity = 86.7%) at cut off value of >172.45 pg/mL. Conclusion: Entamoebiasis co-existing with ulcerative colitis and negatively influencing systemic and mucosal inflammation in those patients. The combined monitoring of CRP and IL-33 levels is a dependable non-invasive tool to detect parasitic complications in the context of acute UC relapses, thus avoiding detrimental clinical errors.
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