Evaluation of Pentraxin-3 and NADPH oxidase as diagnostic biomarkers in Iraqi Crohn’s disease patients: A case-control study

Background: Pentraxin-3 (PTX-3) and NADPH oxidase contributed to intestinal inflammation and oxidative stress pathways in Crohn’s disease (CD). However, their diagnostic performance in CD patients remains inadequately explored, especially in the Iraqi population. Aims of the study: This study aims to assess the serum PTX3 and NADPH oxidase activity in Iraqi CD patients and to determine their diagnostic utility. Materials and Methods: A case-control study was conducted at the Al-Yarmouk Teaching Hospital, Baghdad, Iraq. A total of 186 participants with an age range of 19-50 years were enrolled, including 126 CD and 60 healthy controls. PTX-3 concentrations were quantified using an enzyme-linked immunosorbent assay (ELISA), while NADPH oxidase activity was determined using the WST-8 colorimetric assay kit, with absorbance values determined using a microplate reader. Results: CD patients exhibited significantly higher levels of PTX-3 (4.5 ± 0.96 ng/mL vs. 2.5 ± 0.53 ng/mL, p < 0.001) and NADPH oxidase activity (105.7 ± 35.86 μmol/L vs. 62.8 ± 13.36 μmol/L, p < 0.001) compared to controls. PTX-3 showed high diagnostic performance with an area under the curve (AUC) of 0.97. NADPH oxidase also showed good discriminative ability with an AUC of 0.93. Furthermore, the combined biomarker model demonstrated outstanding diagnostic performance with an AUC of 0.99. The correlation analysis between PTX-3 and NADPH oxidase showed no statistically significant correlation (r = -0.039, p = 0.69). Conclusion: This study highlighted the promising role of PTX-3 and NADPH oxidase as non-invasive biomarkers that may aid in the diagnostic evaluation of CD. Future studies are required to validate their clinical applicability.