trypsinogen and Colitis--Ulcerative

Inflammatory bowel disease (IBD) is a chronic intestinal inflammatory disease. Crone's disease (CD) and ulcerative colitis (UC) are types of IBD. There is a need for a more accurate, noninvasive biomarker to distinguish CD from UC.. To verify the diagnostic value of combined serum trypsin 2 (PRSS2) and serum amyloid P component (SAP) evaluation in distinguishing CD from UC.. The subjects included 28 normal controls (NC) as well as 44 UC, 72CD, 16 colorectal cancer (CRC), 10 colorectal polyps, and 10 cancer cases. Serum SAP, PRSS2, CRP, and CEA were measured and compared.. The concentration of CEA in CRC and other gastrointestinal tumors was significantly higher than that in UC, CD, and colorectal polyps. The concentration of CRP was significantly higher in UC and CD than that in the healthy group, but there were no significant differences when compared to the intestinal polyp group. Serum PRSS2 concentration was significantly higher in the UC and CD groups than that in the colorectal polyp group, and the average serum concentration of SAP in CD was significantly higher compared to UC. In patients with colorectal polyps, there was no correlation between PRSS2 and CRP. ROC curve analysis showed that the AUC of PRSS2 used to distinguish IBD patients from healthy controls or colorectal polyp patients was 0.730 and 0.774, respectively. The AUC of SAP used to distinguish CD from UC was 0.706. The AUC of combined PRSS2 and SAP was not different from the AUC for individual SAP. Finally, we demonstrated that the expression of SAP in CD patient tissues was significantly higher than that in UC patients.. The combined analysis of serum SAP and PRSS2 has differential diagnostic value for CD and UC.

Topics: Colitis, Ulcerative; Crohn Disease; Diagnosis, Differential; Humans; Inflammatory Bowel Diseases; ROC Curve; Serum Amyloid P-Component; Trypsin; Trypsinogen

To investigate whether matrix metalloproteinases-9 (MMP-9) or trypsinogens could serve as histological markers for an aggressive disease course in pediatric ulcerative colitis (UC).. We identified 24 patients with pediatric onset (≤ 16 years) UC who had undergone surgery during childhood/adolescence a median of 2.1 years (range 0.1-7.4 years) after the diagnosis (between 1990 and 2008) in Children's Hospital, Helsinki, Finland. We also identified 27 conservatively treated UC patients and matched them based on their age at the time of diagnosis and follow-up at a median of 6 years (range 3-11 years) to serve as disease controls. Twenty children for whom inflammatory bowel disease (IBD) had been excluded as a result of endoscopy served as non-IBD controls. Colon biopsies taken by diagnostic endoscopy before the onset of therapy were stained using immunohistochemistry to study the expression of MMP-9, trypsinogen-1 (Tryp-1), Tryp-2, and a trypsin inhibitor (TATI). The profiles of these proteases and inhibitor at diagnosis were compared between the surgery group, the conservatively treated UC patients and the non-IBD controls.. The proportions of Tryp-1 and Tryp-2 positive samples in the colon epithelium and in the inflammatory cells of the colon stroma were comparable between the studied groups at diagnosis. Interestingly, the immunopositivity of Tryp-1 (median 1; range 0-3) was significantly lower in the epithelium of the colon in the pediatric UC patients undergoing surgery when compared to that of the conservatively treated UC patients (median 2; range 0-3; P = 0.03) and non-IBD controls (median 2; range 0-3; P = 0.04). For Tryp-2, there was no such difference. In the inflammatory cells of the colon stroma, the immunopositivities of Tryp-1 and Tryp-2 were comparable between the studied groups at diagnosis. Also, the proportion of samples positive for TATI, as well as the immunopositivity, was comparable between the studied groups in the colon epithelium. In the stromal inflammatory cells of the colon, TATI was not detected. In UC patients, there were significantly more MMP-9 positive samples and a higher immunopositivity in the stromal inflammatory cells of the colon when compared to the samples from the non-IBD patients (P = 0.006 and P = 0.002, respectively); the immunopositivity correlated with the histological grade of inflammation (95%CI: 0.22-0.62; P = 0.0002), but not with the other markers of active disease. There were no differences in the immunopositivity or in the proportions of MMP-9 positive samples when examined by epithelial staining. The staining profiles in the ileal biopsies were comparable between the studied groups for all of the studied markers.. For pediatric UC patients who require surgery, the immunopositivity of Tryp-1 at diagnosis is lower when compared to that of patients with a more benign disease course.

Topics: Adolescent; Biomarkers; Biopsy; Case-Control Studies; Child; Child, Preschool; Colectomy; Colitis, Ulcerative; Colon; Colonoscopy; Disease Progression; Down-Regulation; Female; Humans; Immunohistochemistry; Male; Matrix Metalloproteinase 9; Predictive Value of Tests; Severity of Illness Index; Trypsin; Trypsin Inhibitors; Trypsinogen