The Diagnostic and Prognostic Significance of Inflammatory and Oxidative Stress Markers in Gastrointestinal Pathologies

Abstract

Although gastrointestinal disorders (GI) present with a diverse array of clinical symptoms, they are fundamentally linked by an underlying biological crosstalk between oxidative stress and chronic inflammation, making it exceptionally difficult to predict disease trajectory or tailor effective treatments. The study aimed to identify and validate a panel of serum- or tissue-based biomarkers that specifically correlate with the severity of inflammation and oxidative stress in patients with different GI diagnoses. This case-control study, conducted from September to December 2025, investigated inflammatory and oxidative stress biomarkers in 128 participants (88 GI patients and 40 healthy controls) at the Hospital of Digestive Diseases in Al-Najaf Al-Ashraf, Iraq. All participants underwent upper gastrointestinal endoscopy, with demographic and clinical data systematically collected. The determination of serum interleukin-6 (IL-6), 8-hydroxy-2′-deoxyguanosine (8-OHdG), and malondialdehyde (MDA) via ELISA, alongside comprehensive biochemical profiling and Helicobacter pylori assessment. Results indicated that GI patients showed significantly higher glucose, TG, NLR, IL-6, MDA, and 8-OHdG levels and decreased hemoglobin and HDL compared to controls (p < 0.05). Specific GI disease subgroups, notably Crohn's disease and ulcerative colitis, demonstrated pronounced elevations in inflammatory and oxidative stress markers. Linear regression highlighted significant associations of 8-OHdG with various clinical and biochemical parameters. Furthermore, multinomial logistic regression identified IL-6 as a significant predictor for Crohn's disease (odds ratio [OR] = 1.34, p = 0.046), while IL-6 (OR = 1.37, p = 0.023), 8-OHdG (OR = 1.01, p = 0.024), and Nes-1 (OR = 0.61, p = 0.007) were predictive for ulcerative colitis. ROC analysis revealed excellent diagnostic performance for IL-6 (AUC = 0.96) and MDA (AUC = 0.89) in distinguishing GI patients from healthy controls. These findings emphasise the vital function of inflammatory and oxidative stress pathways in GI pathologies and suggest these biomarkers hold promise for diagnostic and prognostic applications.