Serum leucine-rich alpha-2 glycoprotein in monitoring disease activity and intestinal mucosal healing for biotherapy-naive cases with ulcerative colitis

Background and AimSerum leucine-rich alpha-2 glycoprotein level has been reported to be a useful biomarker in assessing mucosal healing in patients undergoing biotherapy, where mucosal lesions caused by ulcerative colitis are difficult to assess endoscopically. However, no such reports have been reported in biotherapy-naive cases. MethodsSixty-eight patients with ulcerative colitis (UC) who were biotherapy-naive at Kindai University Hospital between October 2021 and October 2022 were enrolled. We prospectively examined the correlation between leucine-rich alpha-2 glycoprotein (LRG), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and Geboes scores with clinical endoscopic activity using the Mayo endoscopic subscore (MES). ResultsMucosal healing was achieved in 39 (57%) patients. Univariate analysis revealed that the factors associated with mucosal healing were LRG (P = 0.0024), CRP (P = 0.1078), ESR (P = 0.0372), and Geboes scores (P = 0.0075). Logistic regression analysis identified LRG and Geboes scores as independent factors associated with mucosal healing assessed using MES (P = 0.0431 for LRG and P = 0.0166 for Geboes scores). ConclusionLRG was found to be the easiest marker to monitor disease activity and mucosal inflammation in UC patients with biotherapy-naive cases, with a performance equivalent to that of Geboes scores.