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Original Articles

IBD

Leucine-rich alpha-2 glycoprotein is useful in predicting clinical relapse in patients with Crohn’s disease during biological remission: Naohiro Nakamura, Yusuke Honzawa, Yuka Ito, Yasuki Sano, Naoto Yagi, Sanshiro Kobayashi, Mamiko Aoi, Takashi Tomiyama, Tomomitsu Tahara, Norimasa Fukata, Toshiro Fukui, Makoto Naganuma; Intest Res 2025;23(2):170-181. Published online August 19, 2024; DOI: https://doi.org/10.5217/ir.2024.00042

Abstract PDF PubReader ePub

Background/Aims
Serum leucine-rich alpha-2 glycoprotein (LRG) is a potential biomarker of Crohn’s disease (CD). This study aimed to evaluate the usefulness of LRG in predicting clinical relapse in patients in remission with CD.
Methods
This retrospective observational study assessed the relationships among patient-reported outcome (PRO2), LRG, and other blood markers. The influence of LRG on clinical relapse was assessed in patients in remission with CD.
Results
Data of 94 patients tested for LRG between January 2021 and May 2023 were collected. LRG level did not correlate with PRO2 score (ρ = 0.06); however, it strongly correlated with C-reactive protein (CRP) level (r=0.79) and serum albumin level (r=–0.70). Among 69 patients in clinical remission, relapse occurred in 22 patients (31.9%). In the context of predicting relapse, LRG showed the highest area under the curve, followed by CRP level, platelet count, and albumin level. Multivariate analysis revealed that only LRG (P= 0.02) was an independent factor for predicting clinical remission. The cumulative non-relapse rate was significantly higher in patients with LRG < 13.8 μg/mL than in patients in remission with LRG ≥ 13.8 μg/mL and normal CRP level (P= 0.002) or normal albumin level (P= 0.001). Cumulative non-relapse rate was also higher in patients with LRG < 13.8 μg/mL compared to those with LRG ≥ 13.8 μg/mL in patients with L3 or B2+B3 of Montreal calcification.
Conclusions
LRG is useful in predicting clinical relapse in patients with CD during biological remission. LRG is a useful biomarker for predicting prognosis, even in patients with intestinal stenosis, or previous/present fistulas.

Citations

Citations to this article as recorded by

Alpha-2 Glycoprotein in Serum as Noninvasive Biomarker of Inflammatory Bowel Diseases Severity in Children
Andrey N. Surkov, Olga B. Gordeeva, Olga E. Krasnova, Sadig T. Fatullaev, Natalya A. Izotova, Evgeniy E. Bessonov, Irine Dzharkava, Albina V. Dobrotok, Albina D. Guseynova, Mariya S. Rudneva, Elizaveta N. Il’yashenko, Leyla S. Namazova-Baranova
Pediatric pharmacology.2026; 22(6): 672. CrossRef
Leucine-rich alpha-2 glycoprotein as a blood biomarker in inflammatory bowel disease: clinical implications and future perspectives
Takayuki Yamamoto
Expert Review of Gastroenterology & Hepatology.2026; 20(2): 147. CrossRef
Effectiveness and Tolerability of Anti-Tumor Necrosis Factor Alpha Therapy in Refractory Intestinal Behçet’s Disease: A Large Single-Center Study
Ji Young Chang, Jiwoo Kim, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jae Hee Cheon, Jihye Park
Gut and Liver.2026; 20(2): 305. CrossRef

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216 Download
2 Web of Science
3 Crossref

IBD

Efficacy of serum leucine-rich alpha-2 glycoprotein in predicting findings of Crohn’s disease small bowel lesion in capsule endoscopy: Teppei Omori, Miki Koroku, Shun Murasugi, Ayumi Ito, Maria Yonezawa, Shinichi Nakamura, Katsutoshi Tokushige; Intest Res 2024;22(4):464-472. Published online May 7, 2024; DOI: https://doi.org/10.5217/ir.2023.00139

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Small bowel capsule endoscopy (SBCE) is an evaluation method for small bowel (SB) lesions in Crohn’s disease (CD). However, the relationship between SBCE findings and the serological biomarker leucine-rich alpha-2 glycoprotein (LRG) remains unclear. We aimed to establish appropriate cutoff values of LRG to predict the presence of SB lesions in CD through SBCE.
Methods
Patients with CD with SB lesions who had undergone SBCE and LRG measurements 1 month before and after the SBCE were included. The LRG values for ulcers ≥0.5 cm and other inflammatory lesions noted in SBCE were determined using the Youden Index, and the sensitivity and specificity were calculated. Additionally, the correlation between the SBCE scores (CD Activity in Capsule Endoscopy) and LRG values was evaluated.
Results
Forty patients without active colorectal lesions were included in the study. When the cutoff value of LRG for SB ulcers ≥ 0.5 cm was set at 14 μg/mL, the sensitivity was 92.3%, specificity was 81.5%, positive predictive value (PPV) was 70.6%, and negative predictive value (NPV) was 95.7%. In contrast, an LRG cutoff value of 12 μg/mL without inflammatory findings had a sensitivity of 91.7%, specificity of 82.1%, PPV of 68.8%, and NPV of 95.8%. CD Activity in Capsule Endoscopy correlated well with LRG values (Spearman’s rank correlation coefficient ρ = 0.681, P< 0.001).
Conclusions
An LRG cutoff value of 14 μg/mL may be useful in predicting the presence of SB ulcers ≥ 0.5 cm, and an LRG cutoff value of 12 μg/mL may be useful in predicting the absence of SB inflammatory findings.

Citations

Citations to this article as recorded by

Capsule Endoscopy in Inflammatory Bowel Disease: Current Status and Issues in Clinical Practice
Teppei Omori, Haruka Wada, Tatsuya Mitsui, Mari Hayashida, Noritaka Hibi, Daisuke Saito, Tadakazu Hisamatsu
DEN Open.2026;[Epub] CrossRef
Leucine-rich alpha-2 glycoprotein as a blood biomarker in inflammatory bowel disease: clinical implications and future perspectives
Takayuki Yamamoto
Expert Review of Gastroenterology & Hepatology.2026; 20(2): 147. CrossRef
Leucine-rich alpha-2 glycoprotein as a superior biomarker to C-reactive protein for detecting small bowel lesions in Crohn’s disease
Masashi Ohno, Atsushi Nishida, Akinori Otsuki, Yoshihiro Yokota, Takayuki Imai, Shigeki Bamba, Osamu Inatomi
World Journal of Gastrointestinal Endoscopy.2025;[Epub] CrossRef
Complete mucosal healing prevents stricture progression after endoscopic balloon dilation in Crohn's disease
Jun Owada, Kunihiko Oguro, Tomonori Yano, Yusuke Ono, Takuma Kobayashi, Shoko Miyahara, Hirotsugu Sakamoto, Hironori Yamamoto
DEN Open.2025;[Epub] CrossRef

5,690 View
223 Download
4 Web of Science
4 Crossref

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