Serum Leucine-Rich Alpha-2 Glycoprotein in Quiescent Crohn’s Disease as a Potential Surrogate Marker for Small-Bowel Ulceration detected by Capsule Endoscopy

Omori, Teppei; Sasaki, Yasutsuna; Koroku, Miki; Murasugi, Shun; Yonezawa, Maria; Nakamura, Shinichi; Tokushige, Katsutoshi

doi:10.3390/jcm11092494

Cited by 11 publications

(15 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[41] Omori et al revealed the LRG cutoff value of 14 μg/mL for detecting the presence of small intestinal ulcerative lesions (≥0.5 cm) using small bowel capsule endoscopy in patients with CD in clinical remission and CRP values of <0.5 mg/dL. [42] Our results of the LRG cutoff value were higher than those in previous reports. We consider that the differences in the LRG cutoff values are because of the modality tool for intestinal activity assessment.…”

Section: Discussioncontrasting

confidence: 69%

Serum leucine-rich alpha-2 glycoprotein levels for predicting active ultrasonographic findings in intestinal lesions of patients with Crohn’s disease in clinical remission

et al. 2023

View full text Add to dashboard Cite

This study aimed to investigate the cutoff value of leucine-rich alpha-2 glycoprotein (LRG) in predicting active intestinal ultrasonography (IUS) findings in patients with Crohn’s disease (CD) in clinical remission. Data were retrospectively collected from patients with CD evaluated using LRG and undergoing IUS from September 2020 to August 2022. Patients with a Harvey–Bradshaw Index of ≤4 were included and those who underwent intestinal resection were excluded. Bowel wall thickness and stratification and blood flow signal using superb microvascular imaging (SMI) were used to assess ultrasonography findings. SMI signals were categorized into 4 grades following the Limberg score. Receiver operating characteristic curves were constructed and the area under the curve was calculated to determine the LRG cutoff values for predicting active IUS findings and were compared with those of C-reactive protein. This study included 213 patients. The LRG cutoff values to predict active bowel wall thickness, loss of bowel wall stratification, and SMI of ≥1, ≥2, and 3 were 14.6 μg/mL, 14.6 μg/mL, 14.6 μg/mL, 14.6 μg/mL, and 16.9 μg/mL, respectively, with significantly higher areas under the curve in SMI of ≥1 and 3 than in C-reactive protein. The best LRG cutoff value for predicting active IUS findings was 14.6 μg/mL in patients with CD in clinical remission, suggesting that LRG is better than C-reactive protein for detecting active IUS findings in CD.

show abstract

Section: Discussioncontrasting

confidence: 69%

Serum leucine-rich alpha-2 glycoprotein levels for predicting active ultrasonographic findings in intestinal lesions of patients with Crohn’s disease in clinical remission

et al. 2023

View full text Add to dashboard Cite

show abstract

“…Previous studies have used only one imaging examination to assess their correlation with biomarkers [9,30]. Two recent studies reported the usefulness of LRG in predicting the presence of small bowel lesions in CD, as assessed by BAE [18][19][20] or CE [21] alone. However, BAE may not be the most appropriate modality for a considerable proportion of patients because it cannot detect transmural inflammation or lesions beyond its reach.…”

Section: Discussionmentioning

confidence: 99%

“…C-reactive protein (CRP) and faecal calprotectin (FC) have been widely used as biomarkers for IBD and have been reported as treatment targets [15,16]. Recently, leucine-rich alpha-2 glycoprotein (LRG) was discovered as a novel biomarker [17], and its usefulness in CD has been suggested [18][19][20][21]. However, it is unclear whether LRG is more useful than CRP and/or FC, specifically for small bowel lesions.…”

Section: Introductionmentioning

confidence: 99%

Optimal Use of Serum Leucine-Rich Alpha-2 Glycoprotein as a Biomarker for Small Bowel Lesions of Crohn’s Disease

Asonuma¹,

Kikkawa²,

Nakano³

et al. 2023

Inflamm Intest Dis

View full text Add to dashboard Cite

Introduction: A large proportion of small bowel lesions in Crohn’s disease (CD) may exist beyond the reach of ileocolonoscopy and there is no gold standard imaging modality to screen them, suggesting the need for optimal biomarkers. We aimed to compare the usefulness of C-reactive protein (CRP), faecal calprotectin (FC), and leucine-rich alpha-2 glycoprotein (LRG) in determining small bowel lesions of CD. Methods: This was a cross-sectional observational study. CRP, FC, and LRG were prospectively measured in patients with quiescent CD who underwent imaging examinations (capsule or balloon-assisted endoscopy, magnetic resonance enterography, or intestinal ultrasound) selected by the physician in clinical practice. Mucosal healing (MH) of the small bowel was defined as a lack of ulcers. Patients with a CD activity index >150 and active colonic lesions were excluded. Results: A total of 65 patients (27, MH; 38, small bowel inflammation) were analysed. The area under the curve (AUC) of CRP, FC, and LRG was 0.74 (95% confidence interval: 0.61–0.87), 0.69 (0.52–0.81), and 0.77 (0.59–0.85), respectively. The AUC of FC and LRG in a subgroup of 61 patients with CRP <3 mg/L (26, MH; 32, small bowel inflammation) was 0.68 (0.50–0.81) and 0.74 (0.54–0.84), respectively. The cut-off of 16 μg/mL of LRG showed the highest positive predictive value of 1.00 with specificity of 1.00, while negative predictive value was highest (0.71) with sensitivity of 0.89 at the cut-off of 9 μg/mL. Conclusion: LRG can accurately detect and/or exclude the small bowel lesions with two cut-off values.

show abstract

“…On the contrary, the prognosis of the treatment group is not described. Omori et al also reported a correlation between LRG and endoscopic activity of the small intestine using SBCE, but they did not investigate the course of symptoms after performing SBCE 15 . Miyazu et al reported the association between severities classified by CECDAI and treatment intervention, but did not investigate the course of symptoms after treatment change 16 .…”

Section: Discussionmentioning

confidence: 99%

Monitoring of leucine‐rich alpha‐2‐glycoprotein and assessment by small bowel capsule endoscopy are prognostic for Crohn's disease patients

Ito,

Dai,

Horiuchi

et al. 2023

JGH Open

View full text Add to dashboard Cite

Background and AimEndoscopy is important to determine the effectiveness of treatment for Crohn's disease (CD), but searching the entire small intestine is difficult. Thus, we investigated the usefulness of leucine‐rich alpha‐2 glycoprotein (LRG), a new biomarker for predicting mucosal activity, in evaluating the activity of CD small intestinal lesions. This will further determine whether the results of small bowel capsule endoscopy (SBCE) affect the prognosis of patients with CD.MethodsA total of 114 patients with CD who underwent SBCE were included. We analyzed the correlation between LRG and Capsule Endoscopy Crohn's Disease Activity Index (CECDAI). The cutoff value of LRG to achieve mucosal healing was calculated using the receiver operating characteristic curve. Then, we compared the presence or absence of intervention and the relapse rate of patients who could not achieve mucosal healing.ResultsThe CECDAI correlated with LRG. The calculated LRG value for achieving mucosal healing was ≤11.9. Ninety‐one patients were in clinical remission at the time of SBCE. During the follow‐up period, 17 patients relapsed. As a result of SBCE, when no treatment intervention was performed in the case of CECDAI ≥3.5, the relapse rate was significantly higher than when CECDAI <3.5 or intervention was performed in the case of CECDAI ≥3.5.ConclusionsThe results reveal that LRG correlates with the activity of the entire small intestine and that SBCE assessment and therapeutic intervention can influence patient prognosis.

show abstract

Serum Leucine-Rich Alpha-2 Glycoprotein in Quiescent Crohn’s Disease as a Potential Surrogate Marker for Small-Bowel Ulceration detected by Capsule Endoscopy

Cited by 11 publications

References 20 publications

Serum leucine-rich alpha-2 glycoprotein levels for predicting active ultrasonographic findings in intestinal lesions of patients with Crohn’s disease in clinical remission

Serum leucine-rich alpha-2 glycoprotein levels for predicting active ultrasonographic findings in intestinal lesions of patients with Crohn’s disease in clinical remission

Optimal Use of Serum Leucine-Rich Alpha-2 Glycoprotein as a Biomarker for Small Bowel Lesions of Crohn’s Disease

Monitoring of leucine‐rich alpha‐2‐glycoprotein and assessment by small bowel capsule endoscopy are prognostic for Crohn's disease patients

Contact Info

Product

Resources

About