Abstract

The inflammatory bowel diseases (IBD), which include mainly Crohn's disease (CD) and ulcerative colitis (UC), are common chronic inflammatory conditions of the digestive system. The diagnosis of IBD relies on the use of a combination of factors including symptoms, endoscopy and levels of serum proteins such as C-reactive protein (CRP) or faecal calprotectin. Currently there is no single reliable biomarker to determine IBD. Galectins are a family of galactoside-binding proteins that are commonly altered in the circulation of disease conditions such as cancer and inflammation. This study investigated serum galectin levels as possible biomarkers in determining IBD and IBD disease activity. Levels of galectins-1, -2, -3, -4, -7 and -8 were analysed in 208 samples from ambulant IBD patients (97 CD, 71 UC) patients and 40 from healthy people. Disease activity was assessed using Harvey-Bradshaw Index for CD and simple clinical colitis activity index for UC. The relationship of each galectin in determining IBD and IBD disease activity were analysed and compared with current IBD biomarker CRP. It was found that serum level of galectin-1 and -3, but not galectins-2, -4, -7 and -8, were significantly higher in IBD patients than in healthy people. At cut-off of 4.1ng/ml, galectin-1 differentiated IBD from healthy controls with 71% sensitivity and 87% specificity. At cut-off of 38.5ng/ml, galectin-3 separated IBD from healthy controls with 53% sensitivity and 87% specificity. None of the galectins however were able to distinguish active disease from remission in UC or CD. Thus, levels of galectins-1 and -3 are significantly elevated in both UC and CD patients compared to healthy people. Although the increased galectin levels are not able to separate active and inactive UC and CD, they may have the potential to be developed as useful biomarkers for IBD diagnosis either alone or in combination with other biomarkers.

Highlights

  • Inflammatory bowel diseases (IBD) are common chronic inflammatory conditions of the digestive system

  • Of the IBD patients, 70 (72.2%) Crohn’s disease (CD) patients and 30 (43.3%) ulcerative colitis (UC) patients were in clinical remission as defined by Harvey-Bradshaw index (HBI) 4 or SCCAI 2

  • Serum levels of galectin-2, -4, -7 and -8 showed no significant differences in UC and CD than in the healthy controls, their levels in IBD patients were numerically higher

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Summary

Introduction

Inflammatory bowel diseases (IBD) are common chronic inflammatory conditions of the digestive system. Galectins are a family of 15 (so far) mammalian galactoside-binding proteins that share a consensus amino acid sequence in their carbohydrate recognition domains (CRDs)[8] Based on their structural differences, galectin family members are classified into three subgroups of proto-, chimeric- and tandem-repeat-types. Level of serum galectin-3 was reported to be higher in IBD patients compared to healthy controls[22] It is not known whether levels of any other galectin members are altered in the circulation of IBD patients and whether serum galectins could be used as potential biomarkers for determining IBD and disease activity. We compared the serum levels of galectins-1, -2–3, -4, -7 and -8 in patients with UC, CD and healthy people and analyzed the relationship of galectin levels with disease activity in IBD patients

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