Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Inflammatory Bowel Disease Center, Toho University Sakura Medical Center, Chiba, Japan.
J Gastroenterol. 2021 Jun;56(6):560-569. doi: 10.1007/s00535-021-01793-0. Epub 2021 May 3.
This multicenter prospective study (UMIN000019958) aimed to evaluate the usefulness of serum leucin-rich alpha-2 glycoprotein (LRG) levels in monitoring disease activity in inflammatory bowel disease (IBD).
Patients with moderate-to-severe IBD initiated on adalimumab therapy were enrolled herein. Serum LRG, C-reactive protein (CRP), and fecal calprotectin (fCal) levels were measured at week 0, 12, 24, and 52. Colonoscopy was performed at week 0, 12, and 52 for ulcerative colitis (UC), and at week 0, 24, and 52 for Crohn's disease (CD). Endoscopic activity was assessed using the Simple Endoscopic Score for Crohn's Disease (SES-CD) for CD and the Mayo endoscopic subscore (MES) for UC.
A total of 81 patients was enrolled. Serum LRG levels decreased along with improvements in clinical and endoscopic outcomes upon adalimumab treatment (27.4 ± 12.6 μg/ml at week 0, 15.5 ± 7.7 μg/ml at week 12, 15.7 ± 9.6 μg/ml at week 24, and 14.5 ± 6.8 μg/ml at week 52), being correlated with endoscopic activity at each time point (SES-CD: r = 0.391 at week 0, r = 0.563 at week 24, r = 0.697 at week 52; MES: r = 0.534 at week 0, r = 0.429 at week 12, r = 0.335 at week 52). Endoscopic activity better correlated with LRG compared to CRP and fCal on pooled analysis at all time points (SES-CD: LRG: r = 0.636, CRP: r = 0.402, fCal: r = 0.435; MES: LRG: r = 0.568, CRP: 0.389, fCal: r = 0.426).
Serum LRG is a useful biomarker of endoscopic activity both in CD and UC during the adalimumab treatment.
本多中心前瞻性研究（UMIN000019958）旨在评估血清亮氨酸丰富的α-2 糖蛋白（LRG）水平在监测炎症性肠病（IBD）疾病活动中的有用性。
本研究纳入了开始接受阿达木单抗治疗的中重度 IBD 患者。在第 0、12、24 和 52 周时测量血清 LRG、C 反应蛋白（CRP）和粪便钙卫蛋白（fCal）水平。对于溃疡性结肠炎（UC），在第 0、12 和 52 周行结肠镜检查，对于克罗恩病（CD），在第 0、24 和 52 周行结肠镜检查。采用克罗恩病简单内镜评分（SES-CD）评估 CD 的内镜活动，采用 UC 的 Mayo 内镜亚评分（MES）评估 UC 的内镜活动。
共纳入 81 例患者。血清 LRG 水平随着阿达木单抗治疗后临床和内镜结局的改善而降低（第 0 周时为 27.4±12.6μg/ml，第 12 周时为 15.5±7.7μg/ml，第 24 周时为 15.7±9.6μg/ml，第 52 周时为 14.5±6.8μg/ml），并与各时间点的内镜活动相关（SES-CD：第 0 周时 r=0.391，第 24 周时 r=0.563，第 52 周时 r=0.697；MES：第 0 周时 r=0.534，第 12 周时 r=0.429，第 52 周时 r=0.335）。 pooled 分析显示，在所有时间点，与 CRP 和 fCal 相比，内镜活动与 LRG 的相关性更好（SES-CD：LRG：r=0.636，CRP：r=0.402，fCal：r=0.435；MES：LRG：r=0.568，CRP：0.389，fCal：r=0.426）。
在阿达木单抗治疗期间，血清 LRG 是 CD 和 UC 内镜活动的一种有用的生物标志物。
