SERUM TRANSGLUTAMINASE IN CHILDREN WITH INFLAMMATORY BOWEL DISEASE

Abstract

21 Background: The clinical activity of inflammatory bowel diseases(IBD) is based on clinical and laboratory findings that do not always reflect the pathogenic processes taking place in the intestine. There is evidence that Factor XIIIa, a plasma born transglutaminase (TG), plays a key role in the extracellular matrix assembly in damaged tissue following various intestinal injuries. We previously found that TG levels are decreased in serum of adult patients with IBD and demonstrated in a rat model of chronic colitis that serum TG is closely related to the severity of intestinal mucosal damage.Aims: The aim of this study was to extend our findings to children and to examine whether serum TG levels are related to the endoscopic activity index in children with IBD. Patients/Methods: Serum was collected from 16 children with Crohn's disease (mean age, 12.2±3 years; range, 8-17); from 11 children with ulcerative colitis (mean age, 10.4±3.3 years; range, 9-15); and from 9 age-matched healthy controls (mean age, 8±3.4 years; range, 5-16). Besides scoring clinical parameters, the disease activity of each patient was endoscopically evaluated as inactive(0-3), milde/moderate (3-5) or severe (5-10) scoring on a 0-2 scale the erythema, friability, granularity erosions and ulcerations. Serum TG activity was assayed by a radioenzymatic method. Results: Serum TG was significantly lower in patients with active disease compared with inactive disease or normal subjects (0.66±0.17 vs 1.34±0.62, p<0.001, and 0.66±0.17 vs 1.36±0.40, p<0.001; respectively). Serum TG showed a negative correlation with endoscopic scores both in children with Crohn's disease (r = -0.77, p<0.001) and ulcerative colitis (r = -0.74, p<0.01). Conclusions: These data raise the possibility that TG assay may prove useful in management of IBD in children as a new serological non-invasive indicator of intestinal mucosal status.