Colon to Rectum
Inflamm Bowel Dis. 2025;31(3):647-654
Continuous monitoring of CRP, IL-6, and calprotectin in inflammatory bowel disease using a perspiration-based wearable device
Background: Wearable sensor devices represent a non-invasive technology to continuously track biomarkers linked to inflammatory bowel disease (IBD). The authors assessed the inflammatory markers associated with IBD in human perspiration.
Methods: Participants with IBD were monitored for 40 to 130 minutes with a proprietary wearable sensor device used to measure C-reactive protein (CRP), interleukin-6, and calprotectin. Sensor response using electrochemical impedance spectroscopy and serum samples were measured on the same day. The Mann-Whitney test was used to analyze the relationship between active and remission IBD in serum and perspiration, classified according to endoscopic reports and serum biomarker levels. Asynchronously collected fecal calprotectin from a subset of the population was similarly analyzed.
Results: A total of 33 subjects were enrolled. Expression of calprotectin was significantly elevated in the active cohort compared with the remission cohort in perspiration (p < 0.05; median 906.69 ng/ml; active 95% confidence interval [CI]: 466.0–1833 ng/ml; remission 95% CI: 328.4–950.8 ng/ml), serum (median 1860.82 ng/ml; active 95% CI: 1705–2985 ng/ml; remission 95% CI: 870.2–1786 ng/ml), and stool (p < 0.05; median 126.74 µg/g; active 95% CI: 77.08–347.1 µg/g; remission 95% CI: 5.038–190.4 µg/g). Expression of CRP in perspiration and serum was comparable between the active and remission cohorts (perspiration: p > 0.05; median = 970.83 pg/ml; active 95% CI: 908.7–992 pg/ml; remission 95% CI: 903.3–991.9 pg/ml; serum: median 2.34 µg/ml; active 95% CI: 1.267–4.492 µg/ml; remission 95% CI: 1.648–4.287 µg/ml). Expression of interleukin-6 in perspiration was non-significant in the active cohort compared with the remission cohort and was significantly elevated in serum (perspiration: p < 0.05; median 2.13 pg/ml; active 95% CI: 2.124–2.44 pg/ml; remission 95% CI: 1.661–2.451 pg/ml; serum: median 1.15 pg/ml; active 95% CI: 1.549–3.964 pg/ml; remission 95% CI: 0.4301–1.257 pg/ml). Analysis of the linear relationship between perspiration and serum calprotectin (R2 = 0.7195), CRP (R2 = 0.615), and interleukin-6 (R2 = 0.5411) demonstrated a strong to moderate relationship across mediums.
Conclusions: The authors demonstrate the clinical utility of perspiration as a non-invasive medium for continuous measurement of inflammatory markers in inflammatory bowel disease and find that the measures correlate with serum and stool markers across a range of disease activity.
DOI: 10.1093/ibd/izae054