<span style="background: white;">Leucine-Rich Alpha-2 Glycoprotein 1 as a Biomarker for Evaluation of Inflammatory Bowel Disease Activity in Children

Background: Leucine rich &alpha;-2 glycoprotein (LRG) is a 50 kDa glycoprotein that is an acute-phase protein produced by neutrophils, macrophages, hepatocytes, and intestinal epithelial cells. This study aimed to determine the serum LRG (s-LRG) and urine LRG (u-LRG) expression levels in children with inflammatory bowel disease (IBD) and evaluated their correlation with clinical disease activity, other inflammatory markers, laboratory results, and endoscopic activity scoring. Methods: This prospective observational study was conducted at a tertier centre and included children with IBD. Disease activation was defined based on clinical activity scoring, laboratory results, and endoscopic evaluation. Serum and urine LRG levels were measured via commercial enzyme-linked immunosorbent assay kits. The results were compared between the active IBD and remission groups. Results: Forty-two (50%) patients with active IBD and 42 (50%) patients in remission, were included in this study. Serum LRG concentrations were elevated in the active IBD patients compared with those in IBD patients in remission (p = 0.020). However, there was no difference in the u-LRG level between the two groups (p = 0.407). In patients with IBD, positive correlations were observed between s-LRG, platelet count, C-reactive protein (CRP), and the erythrocyte sedimentation rate. The serum LRG was negative correlated with albumin and hemoglobin levels. Urine LRG was not correlated with s-LRG in any IBD patients included or in IBD patients with active IBD. The cutoff value for s- LRG (77.03 &mu;g/mL) had sensitivity and specificity of 40.4% (95% CI 25.6&ndash;56.7%) and 88.1% (95% CI 74.3&ndash;96.0%), respectively. It was found that s-LRG was a more significant parameter than CRP in predicting disease activation. Conclusion: This prospective study demonstrated that the s-LRG level is a useful biomarker for predicting disease activation in children with IBD and appears to be a more significant parameter than the CRP level. However, the u-LRG level is not effective in predicting disease activation in children with IBD.