Zhuang Xiaoduan, Jiang Huiyue, Fan Tingting, Luo Xiaoqi, Zhong Xuanfang, Guo Jian, Zhou Yaxian, Li Bingsheng, Wang Xinying
Department of Gastroenterology, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
Department of Gastroenterology, The People's Hospital of Baoan Shenzhen, Shenzhen, China.
Ann Med. 2025 Dec;57(1):2496404. doi: 10.1080/07853890.2025.2496404. Epub 2025 Apr 28.
Mucosal healing (MH) has established as a long-term therapeutic goal for inflammatory bowel disease (IBD). Regenerative Islet-derived Protein 1α (reg1α) was reported to be closely related to gastrointestinal mucosal injury; however, its potential in monitoring MH remains unexplored.
Serum reg1α levels were quantified in 156 consecutive IBD patients (January 2021-December 2023) and stratified by endoscopic findings into MH ( = 136) and non-mucosal healing (NMH) groups. Diagnostic performance of reg1α was evaluated and compared to C-reactive protein (CRP) using receiver operating characteristic analysis.
A total of 136 patients (85 with CD and 51 with UC) were finally included. Serum reg1α levels were significantly correlated with endoscopic activity. Patients in NMH group demonstrating markedly higher reg1α levels than those in MH group (92.6 . 55.5 ng/ml, < 0.001). In UC, reg1α outperformed CRP in sensitivity (82.4% . 55.9%, = 0.012) and accuracy (80.4% . 70.6%, = 0.001) for monitoring MH. This superiority persisted in UC subgroups with non-or mild clinical symptoms. Combined index (reg1α + CRP) and multivariate model (incorporating clinical indices, reg1α and CRP) also enhanced sensitivity and accuracy over CRP alone in UC (all < 0.05). However, reg1α showed no significantly higher efficacy in monitoring NMH compared to CRP in CD. In CRP-normal patients, patients with NMH had higher reg1α levels than those with MH in UC (77.6 . 49.8 ng/ml, = 0.018), but not in CD.
Reg1α represents as a novel and sensitive biomarker of endoscopic disease activity in patients with UC, even in patients with non- or mild clinical symptoms or normal CRP levels.
黏膜愈合（MH）已被确立为炎症性肠病（IBD）的长期治疗目标。据报道，再生胰岛衍生蛋白1α（reg1α）与胃肠道黏膜损伤密切相关；然而，其在监测黏膜愈合方面的潜力仍未得到探索。
对156例连续的IBD患者（2021年1月至2023年12月）的血清reg1α水平进行定量，并根据内镜检查结果分为黏膜愈合组（n = 136）和非黏膜愈合（NMH）组。使用受试者操作特征分析评估reg1α的诊断性能，并与C反应蛋白（CRP）进行比较。
最终纳入136例患者（85例克罗恩病患者和51例溃疡性结肠炎患者）。血清reg1α水平与内镜活动度显著相关。NMH组患者的reg1α水平明显高于MH组（92.6. 55.5 ng/ml，< 0.001）。在溃疡性结肠炎中，reg1α在监测黏膜愈合的敏感性（82.4%. 55.9%，= 0.012）和准确性（80.4%. 70.6%，= 0.001）方面优于CRP。这种优势在无或轻度临床症状的溃疡性结肠炎亚组中持续存在。联合指标（reg1α + CRP）和多变量模型（纳入临床指标、reg1α和CRP）在溃疡性结肠炎中也比单独使用CRP提高了敏感性和准确性（均< 0.05）。然而，在克罗恩病中，reg1α在监测NMH方面与CRP相比没有显著更高的疗效。在CRP正常的患者中，溃疡性结肠炎中NMH患者的reg1α水平高于MH患者（77.6. 49.8 ng/ml，= 0.018），但在克罗恩病中并非如此。
Reg1α是溃疡性结肠炎患者内镜疾病活动度的一种新型敏感生物标志物，即使在无或轻度临床症状或CRP水平正常的患者中也是如此。
