Non-immunological biomarkers for assessment of villous abnormalities in patients with celiac disease
| Autor: | Vishnubhatla Sreenivas, Lalit Kumar, Raja Pramanik, Brusabhanu Nayak, Govind K. Makharia, Siddhartha Datta Gupta, Shyam Prakash, Vineet Ahuja, Prasenjit Das, Alka Singh, Anil K Verma |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Diagnostic accuracy Disease Fatty Acid-Binding Proteins Gastroenterology Fatty acid-binding protein Cohort Studies 03 medical and health sciences chemistry.chemical_compound Young Adult 0302 clinical medicine Predictive Value of Tests Internal medicine Lithostathine Citrulline Medicine Humans In patient Enteropathy Intestinal Mucosa Hepatology business.industry medicine.disease Small intestine Celiac Disease medicine.anatomical_structure chemistry 030220 oncology & carcinogenesis Biomarker (medicine) 030211 gastroenterology & hepatology Female business Biomarkers |
| Zdroj: | Journal of gastroenterology and hepatologyReferences. 35(3) |
| ISSN: | 1440-1746 |
| Popis: | Background and aim Demonstration of villous abnormalities is an essential component of diagnosis of celiac disease (CeD) that requires duodenal biopsies. There is a need for non-invasive biomarker(s) that can predict the presence of villous abnormalities. Methods Levels of plasma citrulline, plasma intestinal fatty acid binding protein (I-FABP), and serum regenerating gene 1α (Reg1α) were estimated in treatment naive patients with CeD and controls. The levels of these biomarkers and their cyclical pattern were validated in a predicted model of enteropathy. Optimum diagnostic cut-off values were derived, and the results were further validated in a prospective validation cohort. Results While level of plasma citrulline was significantly lower, the levels of plasma I-FABP and serum Reg1α were significantly higher in patients with CeD (n = 131) in comparison with healthy (n = 216) and disease controls (n = 133), and their levels reversed after a gluten-free diet (GFD). In the model of predicted enteropathy (n = 70), a sequential decrease and then increase in the level of plasma citrulline was observed; such a sequential change was not observed with I-FABP and Reg1α. The diagnostic accuracy for prediction of presence of villous abnormality was 89% and 78% if citrulline level was ≤ 30 μM/L and I-FABP levels were ≥ 1100 pg/mL, respectively. The results were validated in a prospective validation cohort (n = 104) with a sensitivity and specificity of 79.5% and 83.1%, respectively, for predicting villous abnormalities of modified Marsh grade > 2 at calculated cut-off values of citrulline and I-FABP. Conclusions Plasma citrulline ≤ 30 μM/L is the most consistent, highly reproducible non-invasive biomarker that can predict the presence of villous abnormality and has the potential for avoiding duodenal biopsies in 78% patients suspected to have CeD. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text