Leucine-rich Alpha-2 glycoprotein is a serum biomarker of mucosal healing in ulcerative colitis

Shinichiro Shinzaki, Katsuyoshi Matsuoka, Hideki Iijima, Shinta Mizuno, Satoshi Serada, Minoru Fujimoto, Norimitsu Arai, Noriyuki Koyama, Eiichi Morii, Mamoru Watanabe, Toshifumi Hibi, Takanori Kanai, Tetsuo Takehara, Tetsuji Naka

Research output: Contribution to journalArticlepeer-review

94 Citations (Scopus)


Background and Aims: Although several noninvasive and easily accessible biomarkers for inflammatory bowel disease [IBD] are available, their sensitivity and specificity are not adequate to be used as single markers and do not overrule the need for endoscopic evaluation. We previously reported that serum leucine-rich alpha-2 glycoprotein [LRG] was a novel biomarker for rheumatoid arthritis and IBD. We herein investigated whether LRG could indicate endoscopic activity in patients with ulcerative colitis [UC]. Methods: Serum LRG concentrations were determined by enzyme-linked immunosorbent assay [ELISA] in consecutive 129 patients with UC in two tertiary care hospitals, and associations of LRG with clinical and endoscopic activities were evaluated. Clinical activity index [CAI] < 6 was defined as clinical remission, and mucosal healing [MH] and complete mucosal healing were defined as Matts' endoscopic grades of 1 or 2 and grade of 1, respectively. Results: Serum LRG levels were significantly increased and correlated with clinical and endoscopic activities in patients with UC. LRG levels were associated with both clinical and endoscopic activities even in patients with normal serum C-reactive protein [CRP] levels. Furthermore, LRG levels were significantly lower in patients with complete MH and deep remission. Serial measurements of LRG levels in a subset of patients demonstrated that LRG was significantly elevated during the endoscopically active stage compared with that during the MH stage. Conclusions: Serum LRG is a novel biomarker for detecting MH during disease course in patients with UC and a surrogate marker of endoscopic inflammation in patients with normal CRP levels.

Original languageEnglish
Pages (from-to)84-91
Number of pages8
JournalJournal of Crohn's and Colitis
Issue number1
Publication statusPublished - 2017 Jan 1


  • Biomarker
  • C-reactive protein
  • Leucine-rich alpha-2 glycoprotein
  • Mucosal healing

ASJC Scopus subject areas

  • Gastroenterology


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