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This study aims to characterize the immune response in acute severe ulcerative colitis (ASUC) and understand steroid resistance mechanisms.

OP36Longitudinal multi-omic profiling of peripheral blood in acute severe ulcerative colitis reveals a myeloid-driven, steroid-resistant, upadacitinib-sensitive cellular phenotype

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This study aims to characterize the immune response in acute severe ulcerative colitis (ASUC) and understand steroid resistance mechanisms.
Longitudinal multi-omic profiling of peripheral blood from patients with ASUC and controls.
Analyses included single-cell RNA-seq, bulk RNA-seq, and ALAMAR NULISA proteomics.
Temporal sampling captured immune signatures pre- and post-steroid treatment for comparative analysis.
Differential cell-type abundance and pathway enrichment analyses were conducted.
Myeloid cells contributed significantly to the variance in ASUC immune profiles with notable transcriptional changes pre- and post-treatment.
IL-6/JAK/STAT3 signaling pathways were up-regulated and resistant to corticosteroid suppression in ASUC myeloid cells.
Myeloid signature increased in patients who required colectomy, suggesting progressive steroid resistance over time.

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Longitudinal profiling uncovers immune signatures in ulcerative colitis, indicating new treatment strategies.

Pakpoor et al. (2026) studied this question.

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