Novel Utility of Leucine-Rich Alpha-2-Glycoprotein as a Biomarker in Ulcerative Colitis: A Predictor of Endoscopic Remission Independent of Symptoms
Introduction: Leucine-rich alpha-2-glycoprotein (LRG) is a potential biomarker for disease activity and reflects mucosal healing in patients with ulcerative colitis (UC). However, only a few studies have described a detailed sensitivity analysis of LRG in predicting mucosal healing in patients. This...
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| Format: | Article |
| Language: | English |
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Karger Publishers
2023-10-01
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| Series: | Inflammatory Intestinal Diseases |
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| Online Access: | https://beta.karger.com/Article/FullText/534001 |
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| author | Tomoyuki Hayashi Kazuya Kitamura Masaaki Usami Masaki Miyazawa Masaki Nishitani Akihiro Dejima Makoto Yamamoto Shotaro Kawase Masaya Funaki Noriaki Orita Hidetoshi Nakagawa Koki Morita Noriho Iida Akihiro Seki Kouki Nio Hidenori Kido Hideo Takayama Yuta Takeuchi Shinya Yamada Hajime Takatori Mari Shimada Hiroto Saito Daisuke Yamamoto Tadashi Toyama Taro Yamashita |
| author_facet | Tomoyuki Hayashi Kazuya Kitamura Masaaki Usami Masaki Miyazawa Masaki Nishitani Akihiro Dejima Makoto Yamamoto Shotaro Kawase Masaya Funaki Noriaki Orita Hidetoshi Nakagawa Koki Morita Noriho Iida Akihiro Seki Kouki Nio Hidenori Kido Hideo Takayama Yuta Takeuchi Shinya Yamada Hajime Takatori Mari Shimada Hiroto Saito Daisuke Yamamoto Tadashi Toyama Taro Yamashita |
| author_sort | Tomoyuki Hayashi |
| collection | DOAJ |
| description | Introduction: Leucine-rich alpha-2-glycoprotein (LRG) is a potential biomarker for disease activity and reflects mucosal healing in patients with ulcerative colitis (UC). However, only a few studies have described a detailed sensitivity analysis of LRG in predicting mucosal healing in patients. This study aimed to evaluate the association between LRG and the endoscopic activity of UC and its predictability for mucosal healing and explore the utility and clinical application of LRG. Methods: The diagnostic accuracy of biomarkers, including LRG, in predicting the endoscopic activity of UC was evaluated. All consecutive patients who underwent total colonoscopy between April 2021 and September 2022 were included. The Mayo endoscopic subscore (MES) was used for assessing endoscopic activity. Furthermore, endoscopic remission was defined as an MES of ≤1. Clinical activity was evaluated based on stool frequency and bloody stool. Receiver operating characteristic curve analysis and binary logistic regression were performed to assess the diagnostic accuracy of the biomarkers. We evaluated LRG trends and treatment response in patients with MES ≥2 who underwent induction therapy. Results: This study comprised 214 patients. The proportions of endoscopically and clinically active patients were 33.6% and 49.1%, respectively. LRG had an area under the curve (AUC) of 0.856, with a higher diagnostic accuracy than other biomarkers, such as C-reactive protein, leukocyte, neutrophil, platelet, and albumin. The cutoff value for LRG was 15.6 μg/mL (sensitivity, 72.2%; specificity, 86.6%). Using the MES, patients with higher scores had higher LRG levels than those with lower scores. The cutoff value, AUC, sensitivity, and specificity varied with a higher AUC for left-sided colitis and pancolitis than for proctitis. Logistic regression analysis showed that LRG was an independent predictor of endoscopic remission using multivariate analysis, even with the factor of clinical activity. The change ratio of LRG pre- and post-treatment was statistically significant in the higher LRG group. Conclusion: LRG reflected endoscopic activity independently, regardless of clinical symptoms. An LRG below the cutoff value could indicate a significantly low probability of endoscopic activity in asymptomatic patients, and follow-up endoscopy (not for cancer screening) may be unnecessary. Furthermore, a higher LRG level might be more useful as an indicator of treatment efficacy. |
| first_indexed | 2024-03-11T13:44:17Z |
| format | Article |
| id | doaj.art-7de3a8a913a349b0ae400359edf2e9c2 |
| institution | Directory Open Access Journal |
| issn | 2296-9365 |
| language | English |
| last_indexed | 2024-03-11T13:44:17Z |
| publishDate | 2023-10-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Inflammatory Intestinal Diseases |
| spelling | doaj.art-7de3a8a913a349b0ae400359edf2e9c22023-11-02T10:50:46ZengKarger PublishersInflammatory Intestinal Diseases2296-93652023-10-0111010.1159/000534001534001Novel Utility of Leucine-Rich Alpha-2-Glycoprotein as a Biomarker in Ulcerative Colitis: A Predictor of Endoscopic Remission Independent of SymptomsTomoyuki Hayashi0Kazuya Kitamura1Masaaki Usami2Masaki Miyazawa3Masaki Nishitani4Akihiro Dejima5Makoto Yamamoto6Shotaro Kawase7Masaya Funaki8Noriaki Orita9Hidetoshi Nakagawa10Koki Morita11Noriho Iida12Akihiro Seki13Kouki Nio14Hidenori Kido15Hideo Takayama16Yuta Takeuchi17Shinya Yamada18Hajime Takatori19Mari Shimada20Hiroto Saito21Daisuke Yamamoto22Tadashi Toyama23Taro Yamashita24Inflammatory Bowel Disease Center, Kanazawa University Hospital, Kanazawa, JapanInflammatory Bowel Disease Center, Kanazawa University Hospital, Kanazawa, JapanInflammatory Bowel Disease Center, Kanazawa University Hospital, Kanazawa, JapanInflammatory Bowel Disease Center, Kanazawa University Hospital, Kanazawa, JapanInflammatory Bowel Disease Center, Kanazawa University Hospital, Kanazawa, JapanInflammatory Bowel Disease Center, Kanazawa University Hospital, Kanazawa, JapanInflammatory Bowel Disease Center, Kanazawa University Hospital, Kanazawa, JapanInflammatory Bowel Disease Center, Kanazawa University Hospital, Kanazawa, JapanInflammatory Bowel Disease Center, Kanazawa University Hospital, Kanazawa, JapanInflammatory Bowel Disease Center, Kanazawa University Hospital, Kanazawa, JapanInflammatory Bowel Disease Center, Kanazawa University Hospital, Kanazawa, JapanInflammatory Bowel Disease Center, Kanazawa University Hospital, Kanazawa, JapanInflammatory Bowel Disease Center, Kanazawa University Hospital, Kanazawa, JapanInflammatory Bowel Disease Center, Kanazawa University Hospital, Kanazawa, JapanInflammatory Bowel Disease Center, Kanazawa University Hospital, Kanazawa, JapanInflammatory Bowel Disease Center, Kanazawa University Hospital, Kanazawa, JapanInflammatory Bowel Disease Center, Kanazawa University Hospital, Kanazawa, JapanInflammatory Bowel Disease Center, Kanazawa University Hospital, Kanazawa, JapanEndoscopy Center, Kanazawa University, Kanazawa, JapanEndoscopy Center, Kanazawa University, Kanazawa, JapanInflammatory Bowel Disease Center, Kanazawa University Hospital, Kanazawa, JapanInflammatory Bowel Disease Center, Kanazawa University Hospital, Kanazawa, JapanInflammatory Bowel Disease Center, Kanazawa University Hospital, Kanazawa, JapanInnovative Clinical Research Center, Kanazawa University, Kanazawa, JapanInflammatory Bowel Disease Center, Kanazawa University Hospital, Kanazawa, JapanIntroduction: Leucine-rich alpha-2-glycoprotein (LRG) is a potential biomarker for disease activity and reflects mucosal healing in patients with ulcerative colitis (UC). However, only a few studies have described a detailed sensitivity analysis of LRG in predicting mucosal healing in patients. This study aimed to evaluate the association between LRG and the endoscopic activity of UC and its predictability for mucosal healing and explore the utility and clinical application of LRG. Methods: The diagnostic accuracy of biomarkers, including LRG, in predicting the endoscopic activity of UC was evaluated. All consecutive patients who underwent total colonoscopy between April 2021 and September 2022 were included. The Mayo endoscopic subscore (MES) was used for assessing endoscopic activity. Furthermore, endoscopic remission was defined as an MES of ≤1. Clinical activity was evaluated based on stool frequency and bloody stool. Receiver operating characteristic curve analysis and binary logistic regression were performed to assess the diagnostic accuracy of the biomarkers. We evaluated LRG trends and treatment response in patients with MES ≥2 who underwent induction therapy. Results: This study comprised 214 patients. The proportions of endoscopically and clinically active patients were 33.6% and 49.1%, respectively. LRG had an area under the curve (AUC) of 0.856, with a higher diagnostic accuracy than other biomarkers, such as C-reactive protein, leukocyte, neutrophil, platelet, and albumin. The cutoff value for LRG was 15.6 μg/mL (sensitivity, 72.2%; specificity, 86.6%). Using the MES, patients with higher scores had higher LRG levels than those with lower scores. The cutoff value, AUC, sensitivity, and specificity varied with a higher AUC for left-sided colitis and pancolitis than for proctitis. Logistic regression analysis showed that LRG was an independent predictor of endoscopic remission using multivariate analysis, even with the factor of clinical activity. The change ratio of LRG pre- and post-treatment was statistically significant in the higher LRG group. Conclusion: LRG reflected endoscopic activity independently, regardless of clinical symptoms. An LRG below the cutoff value could indicate a significantly low probability of endoscopic activity in asymptomatic patients, and follow-up endoscopy (not for cancer screening) may be unnecessary. Furthermore, a higher LRG level might be more useful as an indicator of treatment efficacy.https://beta.karger.com/Article/FullText/534001leucine-rich alpha-2-glycoproteinulcerative colitisendoscopic remissionbiomarker |
| spellingShingle | Tomoyuki Hayashi Kazuya Kitamura Masaaki Usami Masaki Miyazawa Masaki Nishitani Akihiro Dejima Makoto Yamamoto Shotaro Kawase Masaya Funaki Noriaki Orita Hidetoshi Nakagawa Koki Morita Noriho Iida Akihiro Seki Kouki Nio Hidenori Kido Hideo Takayama Yuta Takeuchi Shinya Yamada Hajime Takatori Mari Shimada Hiroto Saito Daisuke Yamamoto Tadashi Toyama Taro Yamashita Novel Utility of Leucine-Rich Alpha-2-Glycoprotein as a Biomarker in Ulcerative Colitis: A Predictor of Endoscopic Remission Independent of Symptoms Inflammatory Intestinal Diseases leucine-rich alpha-2-glycoprotein ulcerative colitis endoscopic remission biomarker |
| title | Novel Utility of Leucine-Rich Alpha-2-Glycoprotein as a Biomarker in Ulcerative Colitis: A Predictor of Endoscopic Remission Independent of Symptoms |
| title_full | Novel Utility of Leucine-Rich Alpha-2-Glycoprotein as a Biomarker in Ulcerative Colitis: A Predictor of Endoscopic Remission Independent of Symptoms |
| title_fullStr | Novel Utility of Leucine-Rich Alpha-2-Glycoprotein as a Biomarker in Ulcerative Colitis: A Predictor of Endoscopic Remission Independent of Symptoms |
| title_full_unstemmed | Novel Utility of Leucine-Rich Alpha-2-Glycoprotein as a Biomarker in Ulcerative Colitis: A Predictor of Endoscopic Remission Independent of Symptoms |
| title_short | Novel Utility of Leucine-Rich Alpha-2-Glycoprotein as a Biomarker in Ulcerative Colitis: A Predictor of Endoscopic Remission Independent of Symptoms |
| title_sort | novel utility of leucine rich alpha 2 glycoprotein as a biomarker in ulcerative colitis a predictor of endoscopic remission independent of symptoms |
| topic | leucine-rich alpha-2-glycoprotein ulcerative colitis endoscopic remission biomarker |
| url | https://beta.karger.com/Article/FullText/534001 |
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