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We perform a study that integrates metabolomic profiling, 16S rRNA, and metagenomic sequencing on serum and fecal samples from 23 active state UC patients, 24 remission state UC patients, and 20 healthy volunteers from China, aiming to explore a non\u2010invasive integrative biochemical index to quantitatively track and monitor pathological activity of UC. Besides the known associations of microbes such as\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>Fusobacterium nucleatum<\/jats:italic>\n                    <\/jats:styled-content>\n                    and\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>Clostridium symbiosum<\/jats:italic>\n                    <\/jats:styled-content>\n                    with UC, we found several bile acid\u2010transforming species, including 7\u03b1\u2010dehydroxygenase and 7\u03b1\/\u03b2\u2010dehydrogenase expressing microbiota, were significantly correlated with UC pathological activity. We identified 2 bacterial gene markers related to secondary bile acid synthesis besides\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>Clostridium scindens<\/jats:italic>\n                    <\/jats:styled-content>\n                    that differentiated active and remission stage UC and healthy control microbiomes. Relevantly, reduced serum deoxycholic acid (DCA)\/cholic acid (CA) species ratio and increased fecal ursodeoxycholic acid (UDCA)\/chenodeoxycholic acid (CDCA) ratio were associated with the pathological activity of UC. Moreover, receiver operating characteristic analysis based on serum\/fecal bile acid ratios was much more accurate in the prediction of active and remission stage outcomes. This species\u2010specific temporal change and bile acid dysregulation pattern linked to disease severity indicate that integrated microbiome\u2013bile acid profiles may be implied for disease activity prediction and that targeting microbiome\u2010mediated gut flora and bile acid homeostasis may be implicative of therapy efficacy. These insights will help improve clinical diagnosis and optimize existing medical treatments.\n                  <\/jats:p>","DOI":"10.1096\/fj.202501078r","type":"journal-article","created":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T15:13:55Z","timestamp":1754061235000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Integrated Microbiota\u2013Bile Acid Analysis as Potential NonInvasive Biomarkers for Ulcerative Colitis Staging Diagnose"],"prefix":"10.1096","volume":"39","author":[{"given":"Tianyu","family":"He","sequence":"first","affiliation":[{"name":"State Key Laboratory of Natural Medicines China Pharmaceutical University  Nanjing P.R. China"},{"name":"Jiangsu Provincial Key Laboratory of Targetome and Innovative Drugs Institute of Innovative Drug Discovery and Development, China Pharmaceutical University  Nanjing P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Wang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Natural Medicines China Pharmaceutical University  Nanjing P.R. China"},{"name":"Jiangsu Provincial Key Laboratory of Targetome and Innovative Drugs Institute of Innovative Drug Discovery and Development, China Pharmaceutical University  Nanjing P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Zhao","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Natural Medicines China Pharmaceutical University  Nanjing P.R. China"},{"name":"Jiangsu Provincial Key Laboratory of Targetome and Innovative Drugs Institute of Innovative Drug Discovery and Development, China Pharmaceutical University  Nanjing P.R. 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