Serum Leucine-Rich α2 Glycoprotein: A Novel Biomarker for Transmural Inflammation in Crohn's Disease
Serum Leucine-Rich α2 Glycoprotein: A Novel Biomarker for Transmural Inflammation in Crohn's Disease
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DOI：
10.14309/ajg.0000000000002127
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发表时间：
2023-06-01
影响因子：
9.8
通讯作者：
Okamoto, Ryuichi
中科院分区：
文献类型：
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作者：
Takenaka, Kento;Kitazume, Yoshio;Okamoto, Ryuichi
简介：富含亮氨酸的 α-2 糖蛋白 (LRG) 是一种新研究的炎症性疾病生物标志物。本研究旨在探讨 LRG 是否可用于评估克罗恩病 (CD) 患者的透壁活性。 方法：我们从 2020 年 6 月至 2021 年 8 月对连续 227 名 CD 患者进行了磁共振肠造影 (MRE)。我们前瞻性地将 MRE 结果与包括 LRG 在内的临床和实验室数据进行比较。使用 2 个经过验证的评分系统评估 MRE，透壁炎症定义为最大简化磁共振活动指数 (sMaRIA) 评分分别 >= 4 和 5 分分类评分 >= 9。 结果：LRG 与总 MRE 评分之间呈正相关（sMaRIA 评分 r = 0.576，P < 0.01，5 点分类 r = 0.633）评分，P < 0.01）。随着 MRE 评分的增加，LRG 的血清浓度显着增加（P < 0.01）。 sMaRIA评分>= 4和5分评分>= 9的LRG曲线下面积分别为0.845和0.869，显着高于CDAI（P < 0.01）或C反应蛋白（P < 0.01）。 LRG 水平 >= 14 mg/mL 对于 v4 sMaRIA 评分有 67% 的敏感性和 90% 特异性，对于 >= 9 的 5 分评分有 73% 的敏感性和 89% 特异性。与 LRG 水平低的患者相比，高 LRG 水平的患者也与 CD 相关的住院、手术和临床复发密切相关（所有患者均 P < 0.01）。讨论：LRG 是一种高度相关的疾病。用于检测 CD 患者跨壁活性的准确血清生物标志物。结果需要在进一步的多中心研究中得到验证。
INTRODUCTION: Leucine-rich alpha-2 glycoprotein (LRG) is a newly studied biomarker for inflammatory diseases. This study aimed to investigate whether LRG can be used for evaluating transmural activity in patients with Crohn's disease (CD).METHODS: We performed magnetic resonance enterography (MRE) in 227 consecutive patients with CD from June 2020 to August 2021. We prospectively compared MRE findings with clinical and laboratory data including LRG. MRE was evaluated using 2 validated scoring systems, and transmural inflammation was defined as having a maximum simplified magnetic resonance index of activity (sMaRIA) score of >= 4 and a 5-point classification score of >= 9, respectively.RESULTS: The correlation between LRG and the total MRE score showed a positive correlation (r = 0.576 for the sMaRIA score, P < 0.01, and r = 0.633 for the 5-point score, P < 0.01). Serum concentrations of LRG significantly increased as MRE scores increased (P < 0.01). The area under the curve of LRG for a sMaRIA score of >= 4 and a 5-point score of >= 9 was 0.845 and 0.869, respectively, which was significantly higher than that of CDAI (P < 0.01) or C-reactive protein (P < 0.01). LRG levels of >= 14 mg/mL had a 67% sensitivity and 90% specificity for a sMaRIA score of v4 and a 73% sensitivity and 89% specificity for a 5-point score of >= 9. Patients with high LRG levels were also strongly associated with CD-related hospitalization, surgery, and clinical relapse compared with those with low LRG levels (P < 0.01 for all).DISCUSSION: LRG is a highly accurate serum biomarker for detecting transmural activity in patients with CD. Results need to be validated in further multicenter studies.