Illustration of colonic lining repair with keratin, symbolizing cancer risk reduction.

Decoding Colitis: Can Keratin Levels Predict Cancer Risk?

Author's portrait.
Avery Sinclair in Health & Wellness December 2025 • 4 min read.

"New research suggests that monitoring keratin regulation during colitis remission may be key to assessing future cancer risk, offering a potential new avenue for preventative strategies."


Ulcerative colitis (UC) is a chronic inflammatory bowel disease that increases the risk of developing colorectal cancer. While the severity and duration of inflammation are known risk factors, new research is uncovering the importance of cellular changes during periods of remission. These changes within the cells lining the colon could provide clues about future cancer development.

Keratins, essential proteins that form the structural framework of these cells, are now under the spotlight. A recent study published in BMJ Open Gastroenterology investigates how keratin levels and their modifications fluctuate in UC patients with varying degrees of cancer risk. The study's findings suggest that the way keratin levels are restored during remission may significantly influence subsequent cancer risk.

This article will explore the key findings of this research, explaining how inflammation impacts keratin levels, why their restoration during remission matters, and how this knowledge could potentially lead to new strategies for assessing and mitigating cancer risk in UC patients. We'll translate the complex science into understandable insights, offering a glimpse into the future of personalized preventative care.

Keratins: The Unsung Heroes of Gut Health

Illustration of colonic lining repair with keratin, symbolizing cancer risk reduction.

Keratins are the major structural proteins in epithelial cells, like those lining the colon. They're not just passive building blocks; they actively maintain the integrity of the intestinal lining, protecting it from damage and regulating cell signaling pathways. Think of them as the scaffolding that keeps everything in order, allowing the cells to function correctly.

Previous research has hinted at the importance of keratins in gut health: Mice lacking a specific keratin (K8) develop colitis, and mutations in keratin genes have been found in some IBD patients. Moreover, vimentin, another structural protein, is elevated in aggressive colorectal cancers.

Here's what the new study reveals about keratin levels in ulcerative colitis:
  • Acute Inflammation: Active inflammation significantly reduces keratin levels (K8, K18, K19) and vimentin in the colonic mucosa.
  • Remission Matters: In patients with long-standing UC who are in remission, keratin levels tend to be higher compared to controls, suggesting a restoration process.
  • Dysplasia Danger: However, in patients with dysplasia (precancerous changes), this restoration of keratin levels appears inadequate, indicating a potential link to increased cancer risk.
The researchers also discovered that a process called phosphorylation, which modifies keratin function, is reduced during active inflammation. Interestingly, different forms of K8 were observed, with progressive disease showing reduced K8 phosphorylation alongside an increase in the vimentin to K8 ratio.

Keratin Regulation: A New Frontier in Colitis Management

This study sheds light on the dynamic changes in keratin levels during the course of ulcerative colitis and suggests that monitoring these changes, especially during remission, could offer a new way to assess cancer risk. It appears that merely achieving remission is not enough; the way the body restores its cellular infrastructure, specifically keratin networks, matters too.

While more research is needed, the findings suggest that measuring vimentin to K8 ratios, phosphorylated K8 levels, or even identifying novel keratin forms could serve as potential biomarkers for aggressive disease phenotypes. Further studies will determine whether repeated inflammation hinders keratin recovery, increasing cancer risk.

Ultimately, understanding how to modulate keratin expression could lead to targeted strategies for preventing colitis-associated cancer. This research paves the way for a future where personalized interventions, focused on optimizing cellular recovery, improve long-term outcomes for UC patients.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1136/bmjgast-2014-000024, Alternate LINK

Title: Inflammation Decreases Keratin Level In Ulcerative Colitis; Inadequate Restoration Associates With Increased Risk Of Colitis-Associated Cancer

Subject: Gastroenterology

Journal: BMJ Open Gastroenterology

Publisher: BMJ

Authors: Bernard M Corfe, Debabrata Majumdar, Arash Assadsangabi, Alexandra M R Marsh, Simon S Cross, Joanne B Connolly, Caroline A Evans, Alan J Lobo

Published: 2015-12-31

Everything You Need To Know

1

What exactly are keratins, and why are they important for gut health, especially in the context of ulcerative colitis?

Keratins are structural proteins found in epithelial cells, such as those lining the colon. They play a vital role in maintaining the integrity of the intestinal lining, protecting it from damage, and regulating cell signaling pathways. Think of keratins as the 'scaffolding' that supports the cells and ensures they function correctly. Vimentin is another structural protein that may be elevated in aggressive colorectal cancers.

2

How does active inflammation in ulcerative colitis affect keratin levels and other related processes in the colonic mucosa?

During active inflammation in ulcerative colitis, levels of specific keratins (K8, K18, K19) and vimentin are significantly reduced in the colonic mucosa. This decrease reflects the damage and disruption occurring within the intestinal lining due to the inflammatory process. Phosphorylation, a process that modifies keratin function, is also reduced during active inflammation.

3

What does the new research suggest about keratin levels during remission in ulcerative colitis patients, and what are the implications for cancer risk?

The study suggests that in ulcerative colitis patients achieving remission, keratin levels tend to increase compared to individuals without the condition, indicating a restoration process is underway. However, in patients with dysplasia (precancerous changes), this restoration of keratin levels appears inadequate, which may point to an elevated risk of cancer development. Monitoring keratin restoration could give crucial insights.

4

What did the study find regarding the relationship between keratin phosphorylation, the vimentin to K8 ratio, and progressive disease in ulcerative colitis?

The study revealed that progressive disease showed reduced K8 phosphorylation along with an increase in the vimentin to K8 ratio. This suggests that the balance between these proteins and their modification states is disrupted as the condition progresses toward cancer. Further research is needed to fully understand the mechanisms and implications of these changes.

5

How could monitoring keratin regulation in ulcerative colitis patients potentially revolutionize preventative care for colitis-associated cancer?

Monitoring keratin regulation, especially during remission in ulcerative colitis patients, could offer a new way to assess cancer risk. It appears that achieving remission is not enough; the way the body restores its cellular infrastructure, specifically keratin networks, matters too. By tracking keratin levels and their modifications, healthcare professionals may be able to identify patients at higher risk of developing colitis-associated cancer and implement preventative strategies.

Newsletter Subscribe

Subscribe to get the latest articles and insights directly in your inbox.