Abstract
Prostaglandin E-major urinary metabolite (PGE-MUM) and C-reactive protein (CRP) are useful biomarkers in patients with ulcerative colitis. However, whether changes in endoscopic scores over time are reflected in the values of these biomarkers has not been verified. This prospective observational study aimed to assess the relationship between changes in biomarker levels and endoscopic scores in patients with ulcerative colitis. A total of 100 colonoscopy intervals of patients with ulcerative colitis were enrolled. The relationship between variations in the Mayo endoscopic subscore over time and the accompanying changes in biomarker values were investigated. PGE-MUM levels showed a significant rise in the increased endoscopic score group (P = 0.007) and a decrease with reduced endoscopic score group (P = 0.023). CRP levels showed a significant decline with lower endoscopic values (P < 0.001); however, there was no corresponding increase with higher endoscopic scores (P = 0.141). Biomarker levels remained unchanged with stable endoscopic scores (P = 0.090 and P = 0.705). PGE-MUM levels varied significantly, and corresponded to the mucosal healing state (P = 0.019 and P = 0.009). The correlation between changes in PGE-MUM and the endoscopic score was stronger than that for CRP (r = 0.518, P < 0.001 vs. r = 0.444, P < 0.001, respectively). PGE-MUM reflected changes in endoscopic scores more accurately than CRP.
Highlights
Ulcerative colitis (UC) is a chronic idiopathic inflammatory bowel disease (IBD) characterized by symptoms such as diarrhoea, abdominal pain, and haemorrhagic s tools[1]
The Prostaglandin E-major urinary metabolite (PGE-MUM) values (Fig. 1a) showed a significant increase in the Mayo endoscopic subscore (MES)-increase subgroup and decrease in the MES-decrease subgroup (P = 0.007 and P = 0.023, respectively); no significant change was observed in the MESno change subgroup (P = 0.090)
The C-reactive protein (CRP) values (Fig. 1b) showed a significant decrease in the MES-decrease subgroup (P < 0.001); no significant changes were noted in the MES-increase and MES-no change subgroups (P = 0.0141 and P = 0.705, respectively)
Summary
Ulcerative colitis (UC) is a chronic idiopathic inflammatory bowel disease (IBD) characterized by symptoms such as diarrhoea, abdominal pain, and haemorrhagic s tools[1]. Prostaglandin E-major urinary metabolite (PGE-MUM) has been reported as a novel and effective biomarker for UC26. PGE-MUM is sourced from urinary s pecimens[27] and has been reported to be useful in paediatric patients with UC28. Compared with FIT, PGE-MUM is effective in patients with long-term U C30 and predicts possible relapse[31]. Only a few longitudinal observational studies have investigated the changes in biomarkers in relation to the endoscopic scores of patients with UC. Studies investigating changes in PGE-MUM in relation to changes in endoscopic scores of UC patients have yet to be reported. Changes in endoscopic scores and accompanying variations in the PGE-MUM and CRP values of UC patients were longitudinally analysed
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