Combination of leucine-rich alpha-2 glycoprotein and fecal markers detect Crohn’s disease activity confirmed by balloon-assisted enteroscopy
Background/Aims Endoscopic activity confirmed by enteroscopy is associated with poor clinical outcome in Crohn’s disease (CD). We investigated which of the existing biomarkers best reflects endoscopic activity in CD patients including the small bowel, and whether their combined use can improve accur...
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| Format: | Article |
| Language: | English |
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Korean Association for the Study of Intestinal Diseases
2024-01-01
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| Series: | Intestinal Research |
| Subjects: | |
| Online Access: | http://irjournal.org/upload/pdf/ir-2023-00092.pdf |
| _version_ | 1797323667784335360 |
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| author | Ami Kawamoto Kento Takenaka Shuji Hibiya Yoshio Kitazume Hiromichi Shimizu Toshimitsu Fujii Eiko Saito Kazuo Ohtsuka Ryuichi Okamoto |
| author_facet | Ami Kawamoto Kento Takenaka Shuji Hibiya Yoshio Kitazume Hiromichi Shimizu Toshimitsu Fujii Eiko Saito Kazuo Ohtsuka Ryuichi Okamoto |
| author_sort | Ami Kawamoto |
| collection | DOAJ |
| description | Background/Aims Endoscopic activity confirmed by enteroscopy is associated with poor clinical outcome in Crohn’s disease (CD). We investigated which of the existing biomarkers best reflects endoscopic activity in CD patients including the small bowel, and whether their combined use can improve accuracy. Methods One hundred and four consecutive patients with ileal and ileocolonic type CD who underwent balloon-assisted enteroscopy (BAE) from October 2021 to August 2022 were enrolled, with clinical and laboratory data prospectively collected and analyzed. Results Hemoglobin, platelet count, C-reactive protein, leucine-rich alpha-2 glycoprotein (LRG), fecal calprotectin, and fecal hemoglobin all showed significant difference in those with ulcers found on BAE. LRG and fecal calprotectin showed the highest areas under the curve (0.841 and 0.853) for detecting ulcers. LRG showed a sensitivity of 78% and specificity of 80% at a cutoff value of 13 μg/mL, whereas fecal calprotectin showed a sensitivity of 91% and specificity of 67% at a cutoff value of 151 μg/g. Dual positivity for LRG and fecal calprotectin, as well as LRG and fecal hemoglobin, both predicted ulcers with an improved specificity of 92% and 100%. A positive LRG or fecal calprotectin/hemoglobin showed an improved sensitivity of 96% and 91%. Positivity for LRG and either of the fecal biomarkers was associated with increased risk of hospitalization, surgery, and relapse. Conclusions The biomarkers LRG, fecal calprotectin, and fecal hemoglobin can serve as noninvasive and accurate tools for assessing activity in CD patients confirmed by BAE, especially when used in combination. |
| first_indexed | 2024-03-08T05:31:53Z |
| format | Article |
| id | doaj.art-46b984fc0e7642fc856a0709f263f8f5 |
| institution | Directory Open Access Journal |
| issn | 1598-9100 2288-1956 |
| language | English |
| last_indexed | 2024-03-08T05:31:53Z |
| publishDate | 2024-01-01 |
| publisher | Korean Association for the Study of Intestinal Diseases |
| record_format | Article |
| series | Intestinal Research |
| spelling | doaj.art-46b984fc0e7642fc856a0709f263f8f52024-02-06T04:27:29ZengKorean Association for the Study of Intestinal DiseasesIntestinal Research1598-91002288-19562024-01-01221657410.5217/ir.2023.000921032Combination of leucine-rich alpha-2 glycoprotein and fecal markers detect Crohn’s disease activity confirmed by balloon-assisted enteroscopyAmi Kawamoto0Kento Takenaka1Shuji Hibiya2Yoshio Kitazume3Hiromichi Shimizu4Toshimitsu Fujii5Eiko Saito6Kazuo Ohtsuka7Ryuichi Okamoto8 Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan Department of Radiology, Tokyo Medical and Dental University, Tokyo, Japan Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, JapanBackground/Aims Endoscopic activity confirmed by enteroscopy is associated with poor clinical outcome in Crohn’s disease (CD). We investigated which of the existing biomarkers best reflects endoscopic activity in CD patients including the small bowel, and whether their combined use can improve accuracy. Methods One hundred and four consecutive patients with ileal and ileocolonic type CD who underwent balloon-assisted enteroscopy (BAE) from October 2021 to August 2022 were enrolled, with clinical and laboratory data prospectively collected and analyzed. Results Hemoglobin, platelet count, C-reactive protein, leucine-rich alpha-2 glycoprotein (LRG), fecal calprotectin, and fecal hemoglobin all showed significant difference in those with ulcers found on BAE. LRG and fecal calprotectin showed the highest areas under the curve (0.841 and 0.853) for detecting ulcers. LRG showed a sensitivity of 78% and specificity of 80% at a cutoff value of 13 μg/mL, whereas fecal calprotectin showed a sensitivity of 91% and specificity of 67% at a cutoff value of 151 μg/g. Dual positivity for LRG and fecal calprotectin, as well as LRG and fecal hemoglobin, both predicted ulcers with an improved specificity of 92% and 100%. A positive LRG or fecal calprotectin/hemoglobin showed an improved sensitivity of 96% and 91%. Positivity for LRG and either of the fecal biomarkers was associated with increased risk of hospitalization, surgery, and relapse. Conclusions The biomarkers LRG, fecal calprotectin, and fecal hemoglobin can serve as noninvasive and accurate tools for assessing activity in CD patients confirmed by BAE, especially when used in combination.http://irjournal.org/upload/pdf/ir-2023-00092.pdfcrohn diseaseleucine-rich alpha2-glycoprotein, humanleukocyte l1 antigen complexbiomarkersinflammatory bowel diseases |
| spellingShingle | Ami Kawamoto Kento Takenaka Shuji Hibiya Yoshio Kitazume Hiromichi Shimizu Toshimitsu Fujii Eiko Saito Kazuo Ohtsuka Ryuichi Okamoto Combination of leucine-rich alpha-2 glycoprotein and fecal markers detect Crohn’s disease activity confirmed by balloon-assisted enteroscopy Intestinal Research crohn disease leucine-rich alpha2-glycoprotein, human leukocyte l1 antigen complex biomarkers inflammatory bowel diseases |
| title | Combination of leucine-rich alpha-2 glycoprotein and fecal markers detect Crohn’s disease activity confirmed by balloon-assisted enteroscopy |
| title_full | Combination of leucine-rich alpha-2 glycoprotein and fecal markers detect Crohn’s disease activity confirmed by balloon-assisted enteroscopy |
| title_fullStr | Combination of leucine-rich alpha-2 glycoprotein and fecal markers detect Crohn’s disease activity confirmed by balloon-assisted enteroscopy |
| title_full_unstemmed | Combination of leucine-rich alpha-2 glycoprotein and fecal markers detect Crohn’s disease activity confirmed by balloon-assisted enteroscopy |
| title_short | Combination of leucine-rich alpha-2 glycoprotein and fecal markers detect Crohn’s disease activity confirmed by balloon-assisted enteroscopy |
| title_sort | combination of leucine rich alpha 2 glycoprotein and fecal markers detect crohn s disease activity confirmed by balloon assisted enteroscopy |
| topic | crohn disease leucine-rich alpha2-glycoprotein, human leukocyte l1 antigen complex biomarkers inflammatory bowel diseases |
| url | http://irjournal.org/upload/pdf/ir-2023-00092.pdf |
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