Abstract
The described research focused on the diagnostic usefulness of sulfated glycosaminoglycans (sGAG), hyaluronan (HA), and extracellular part of syndecan-1 (sCD138) as new markers related to extracellular matrix (ECM) remodeling in the intestine during the two most common forms of inflammatory bowel diseases (IBD), i.e., ulcerative colitis (UC) and Crohn’ disease (CD). Inflammatory markers belonging to ECM components were assessed in serum of patients with IBD using an immunoenzymatic method (HA and sCD138) and a method based on the reaction with dimethylmethylene blue (sulfated GAG). Measurements were carried out twice: at baseline and after one year of therapy with prednisone (patients with CD) or adalimumab (patients with UC). No quantitative changes were observed in serum sGAG, HA, and sCD138 concentrations between patients newly diagnosed with CD and the healthy group. In the case of patients with UC, the parameter which significantly differentiated healthy subjects and patients with IBD before biological therapy was HA. Significant correlation between serum HA level and inflammation activity, expressed as Mayo score, was also observed in patients with UC. Moreover, the obtained results have confirmed that steroid therapy with prednisone significantly influenced the circulating profile of all examined ECM components (sGAG, HA, and sCD138), whereas adalimumab therapy in patients with UC led to a significant change in only circulating sGAG levels. Moreover, the significant differences in serum HA levels between patients with UC and CD indicate that quantification of circulating HA may be useful in the differential diagnosis of CD and UC.
Highlights
In the last decades, global, dynamic growth in the frequency of chronic inflammatory bowel diseases (IBD) has been observed, further highlighting the role of environmental factors in this disease
Quantitative changes in the composition and structure of extracellular matrix (ECM) components has been described as playing a significant role in the pathogenesis of inflammatory bowel diseases
The significant difference between HA concentration in the serum of patients newly diagnosed with CD and the concentration of this glycan in the serum of patients with UC before treatment suggests the possibility of measuring HA levels during the differential diagnosis of these two very similar types of bowel inflammation, Crohn’s disease and ulcerative colitis
Summary
Global, dynamic growth in the frequency of chronic inflammatory bowel diseases (IBD) has been observed, further highlighting the role of environmental factors in this disease. Among the inflammatory bowel diseases, the two most significant ones from a clinical standpoint are Crohn’s disease (CD) and ulcerative colitis (UC). This group of diseases was most likely already recognized in ancient times, which is implied by the preserved descriptions. There is still a lack of non-invasive, reliable, and objective methods supporting diagnostic methods that allow differentiation, assessment of disease activity, and monitoring of treatment and prognosis of the disease course. Quantitative changes in the composition and structure of ECM components has been described as playing a significant role in the pathogenesis of inflammatory bowel diseases. Establishing the relationship between the level of the circulating matrix component and the progression of IBD might be an argument for the implementation of its determination in the assessment of the activity and progression of IBD [6,7,8,9,10]
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