Clinical significance of urinary glycosaminoglycan excretion in inflammatory bowel disease patients.

Abstract

The research focused on the diagnostic usefulness of urinary glycosaminoglycans excretion as new markers related to the ECM remodeling in the intestine. Their possible suitability in the diagnosis, differential diagnosis and treatment monitoring in the course of the two most common forms of inflammatory bowel diseases (IBD), i.e. ulcerative colitis (UC) and Crohn's disease (CD) were assessed in this study. Urinary excretion of total sulfated glycosaminoglycans (TGAG) and fraction of chondroitin sulfates (CS) were analysed in 47 patiens with IBD, including 31 patients with UC and 16 patients with CD at baseline and after one year of therapy. Sulfated GAGs excreted in urine were quantitated using standardized dye-binding method. A several-fold increase in urinary excretion of total GAG and CS fraction in both UC and CD patients compared to healthy subjects indicates the potential usefulness of quantitative urinary GAG analysis in the diagnosis of IBD. No differences were found in the amount of GAG excreted in the urine in patients with UC and CD. Adalimumab resulted in a decrease in the activity of the inflammatory process and the activity of the disease expressed in the Mayo scale, which was accompanied by an increase in the amount of CS excreted in the urine of UC patients. Moreover, significant correlation was found between Mayo scale and urinary total GAG and CS excretion in UC patients. The quantitative assessment of total glycosaminoglycans and chondroitin sulfates fraction in urine may be a marker helpful in the early diagnosis of IBD.