Guha R, Banerjee A. Letter to the Editor: Leucine-rich α-2-glycoprotein in Taiwanese inflammatory bowel disease: Strengths and limitations of a novel serum marker. World J Gastroenterol 2026; 32(18): 117611 [DOI: 10.3748/wjg.v32.i18.117611]
Corresponding Author of This Article
Aditi Banerjee, PhD, Associate Professor, Department of Pediatrics, University of Maryland School of Medicine, 655 West Baltimore Street, Baltimore, MD 21201, United States. aditi.banerjee@som.umaryland.edu
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Gastroenterology & Hepatology
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May 14, 2026 (publication date) through May 6, 2026
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World Journal of Gastroenterology
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1007-9327
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Guha R, Banerjee A. Letter to the Editor: Leucine-rich α-2-glycoprotein in Taiwanese inflammatory bowel disease: Strengths and limitations of a novel serum marker. World J Gastroenterol 2026; 32(18): 117611 [DOI: 10.3748/wjg.v32.i18.117611]
World J Gastroenterol. May 14, 2026; 32(18): 117611 Published online May 14, 2026. doi: 10.3748/wjg.v32.i18.117611
Letter to the Editor: Leucine-rich α-2-glycoprotein in Taiwanese inflammatory bowel disease: Strengths and limitations of a novel serum marker
Rupa Guha, Aditi Banerjee
Rupa Guha, Department of Radiation Oncology, University of California, San Francisco, CA 94143, United States
Aditi Banerjee, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201, United States
Aditi Banerjee, Cancer Comprehensive Center, University of Maryland, Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, MD 21201, United States
Author contributions: Guha R wrote the original work and prepared the figures, reviewed and edited the manuscript; Banerjee A conceptualized the work, wrote the original draft, and reviewed and approved the final version.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Aditi Banerjee, PhD, Associate Professor, Department of Pediatrics, University of Maryland School of Medicine, 655 West Baltimore Street, Baltimore, MD 21201, United States. aditi.banerjee@som.umaryland.edu
Received: December 11, 2025 Revised: February 2, 2026 Accepted: March 3, 2026 Published online: May 14, 2026 Processing time: 146 Days and 10.3 Hours
Abstract
Endoscopy and fecal calprotectin remain the reference standards for assessing inflammatory bowel disease activity, but their invasiveness and inconvenience have stimulated interest in serum biomarkers that better reflect mucosal inflammation. In their prospective study, Chen et al published a study in World Journal of Gastroenterology evaluated leucine-rich α-2-glycoprotein (LRP), a 50-kilodalton protein released from neutrophils, as a predictor of endoscopic activity in Taiwanese patients with ulcerative colitis and Crohn’s disease. LRP showed significant correlations with established markers and incremental diagnostic value when combined with C-reactive protein, hemoglobin, and albumin, particularly in ulcerative colitis with low C-reactive protein. Building on this data, this Letter discusses methodological and clinical considerations for interpreting LRP performance across inflammatory bowel disease phenotypes and burdens, including the impact of disease distribution, treatment exposure, and assay cutoffs on diagnostic accuracy. However, limitations of the study include its single-center cohort in Taiwan and the relatively modest performance of LRP compared with fecal calprotectin.
Core Tip: Leucine-rich α-2-glycoprotein (LRG) is an emerging serum biomarker that showed modest but incremental value for predicting endoscopic activity in Taiwanese patients with ulcerative colitis and Crohn’s disease, particularly when combined with C-reactive protein, hemoglobin, and albumin. This Letter highlights methodological issues and clinical implications of LRG testing, including its lower accuracy than fecal calprotectin, single-center data, and lack of standardized cutoffs, and argues that future multicenter, multi-ethnic studies should position LRG within composite biomarker panels and stepwise algorithms for noninvasive assessment of inflammatory bowel disease activity.
