LRG - a reliable serum marker of disease activity in Inflammatory Bowel Disease
LRG – a reliable serum marker of disease activity in Inflammatory Bowel Disease: Inflammatory Bowel disease (IBD) like Crohn´s disease and ulcerative colitis affects millions of people worldwide. IBD is characterized by a chronic intestinal inflammation causing pain and swelling. The exact cause of IBD is not yet fully understood but it may involve the immune system, as well as genetic, and environmental factors. Research has shown that the immune system attacks harmless microorganisms or food in the gut that causes inflammation that leads to bowel injury.
Currently, the gold standard for assessing IBD disease activity are imaging tests, in particular endoscopy. The use of non-invasive biomarkers could be useful in clinical practice to monitor disease activity and to predict mucosal healing. CRP is often been used to evaluate IBD activity but research has shown that its specificity and low cut off value may not be ideal for use in clinical practice (1). Alternative biomarkers that more likely reflect intestinal inflammation are under investigation.
LRG – a reliable serum marker of disease activity in Inflammatory Bowel Disease
Leucine-rich α2 glycoprotein (LRG) is a protein that is produced by hepatocytes, neutrophils, and macrophages. It is a biomarker that is stimulated by inflammatory cytokines e.g. TNF-alpha, IL-1 beta, IL-11 and IL-6. However, studies have shown that release of LRG into the circulation does not depend on IL-6 and thus has a different mechanism from that of CRP. Therefore, LRG may better reflect intestinal inflammation better than LRG (3).
Recent studies have demonstrated that LRG is useful for predicting mucosal healing and is a reliable serum biomarker for disease evaluation of clinical and endoscopic disease activity in individuals with inflammatory bowel disease (4-6).
HOW CAN LRG BE MEASURED?
Leucine-rich α2 glycoprotein (LRG) can easily and reliably be measured in serum, plasma, urine and cell culture samples with a conventional ELISA (enzyme-linked immunosorbant assay) assay.
LRG ELISA – developed and manufactured by BIOMEDICA
- RELIABLE – validated following international quality guidelines (FDA, EMA, ICH) . The validation data can be found here.
- REFERENCE values provided for normal and pathological samples
- OPTIMIZED – assay range optimized for clinical samples, no additional testing required
- EASY – results in 3.5 h (protocol booklet)
- CONVENIENT – all reagents included; 7 pre-diluted standards/calibrators, 2 controls and sufficient assay buffer
Organizations for the study of IBD
- International Organization For the Study of Inflammatory Bowel Disease
- European Crohn’s and Colitis Organisation (ECCO)
- World Gastroenterology Organisation
- Leucine-rich alpha-2 glycoprotein as a marker of mucosal healing in inflammatory bowel disease. Yasutomi E, Inokuchi T, Hiraoka S, Takei K, Igawa S, Yamamoto S, Ohmori M, Oka S, Yamasaki Y, Kinugasa H, Takahara M, Harada K, Furukawa M, Itoshima K, Okada K, Otsuka F, Tanaka T, Mitsuhashi T, Kato J, Okada H. Sci Rep. 2021; 27;11(1):11086.
- Leucine-Rich Alpha-2 Glycoprotein Is a Reliable Serum Biomarker for Evaluating Clinical and Endoscopic Disease Activity in Inflammatory Bowel Disease. Shimoyama T, Yamamoto T, Yoshiyama S, Nishikawa R, Umegae S. Inflamm Bowel Dis. 2023; 29(9):1399-1408.
- Positioning and Usefulness of Biomarkers in Inflammatory Bowel Disease. Sakurai T, Saruta M. Digestion. 2023;104(1):30-41.
- Usefulness of Serum Leucine-rich Alpha 2 Glycoprotein in Crohn’s Disease: Is There Any Difference between Small Intestine and Colonic Lesions? Matsumoto S et al., Crohns Colitis 360. 2023; 23; 5(3):otad028. Conclusions: “LRG is more useful than CRP for predicting mucosal healing in patients with type L1. The superiority of LRG to CRP differs between small intestinal and colonic lesions.”
- Leucine-Rich Alpha-2 Glycoprotein Is a Reliable Serum Biomarker for Evaluating Clinical and Endoscopic Disease Activity in Inflammatory Bowel Disease. Shimoyama T, Yamamoto T, Yoshiyama S, Nishikawa R, Umegae S.. Inflamm Bowel Dis. 2023; 29(9):1399-1408. Conclusions: “Leucine-rich alpha-2 glycoprotein is a reliable serum biomarker for the assessment of clinical and endoscopic disease activity in patients with IBD. It can be an alternative to CRP for the assessment of UC.”
- Leucine-rich alpha-2 glycoprotein is a potential biomarker to monitor disease activity in inflammatory bowel disease receiving adalimumab: PLANET study Shinzaki S et al., J Gastroenterol. 2021; 56(6):560-569. Conclusions: “Serum LRG is a useful biomarker of endoscopic activity both in CD and UC during the adalimumab treatment.”