Measurement of prostaglandin metabolites is useful in diagnosis of small bowel ulcerations

doi:10.3748/wjg.v25.i14.1753

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Apr 14, 2019; 25(14): 1753-1763
Published online Apr 14, 2019. doi: 10.3748/wjg.v25.i14.1753

Measurement of prostaglandin metabolites is useful in diagnosis of small bowel ulcerations

Yuichi Matsuno, Junji Umeno, Motohiro Esaki, Yoichiro Hirakawa, Yuta Fuyuno, Yasuharu Okamoto, Atsushi Hirano, Shigeyoshi Yasukawa, Fumihito Hirai, Toshiyuki Matsui, Shuhei Hosomi, Kenji Watanabe, Naoki Hosoe, Haruhiko Ogata, Tadakazu Hisamatsu, Shunichi Yanai, Shuji Kochi, Koichi Kurahara, Tsuneyoshi Yao, Takehiro Torisu, Takanari Kitazono, Takayuki Matsumoto

Yuichi Matsuno, Junji Umeno, Yoichiro Hirakawa, Yuta Fuyuno, Yasuharu Okamoto, Atsushi Hirano, Takehiro Torisu, Takanari Kitazono, Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan

Motohiro Esaki, Department of Endoscopic Diagnostics and Therapeutic, Saga University Hospital, Saga 849-8501, Japan

Yoichiro Hirakawa, Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan

Shigeyoshi Yasukawa, Fumihito Hirai, Toshiyuki Matsui, Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino 818-8502, Japan

Shuhei Hosomi, Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka 545-8586, Japan

Kenji Watanabe, Department of Intestinal Inflammation Research, Hyogo College of Medicine, Nishinomiya 663-8501, Japan

Naoki Hosoe, Haruhiko Ogata, Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University, Tokyo 160-0016, Japan

Tadakazu Hisamatsu, the Third Department of Internal Medicine, Kyorin University School of Medicine, Mitaka 181-8611, Japan

Shunichi Yanai, Takayuki Matsumoto, Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University, Morioka 020-8505, Japan

Shuji Kochi, Koichi Kurahara, Division of Gastroenterology, Matsuyama Red Cross Hospital, Matsuyama 790-8524, Japan

Tsuneyoshi Yao, Department of Gastroenterology, Sada Hospital, Fukuoka 810-0004, Japan

Author contributions: All authors helped to perform the research; Umeno J, Esaki M and Matsumoto T conceived the study; Matsuno Y and Hirakawa Y contributed to statistical analysis and data interpretation; Matsuno Y, Umeno J, Torisu T and Esaki M drafted the manuscript; Matsuno Y, Umeno J, Esaki M, Fuyuno Y, Okamoto Y, Hirano A, Yasukawa S, Hirai F, Matsui T, Hosomi S, Watanabe K, Hosoe N, Ogata H, Hisamatsu T, Yanai S, Kochi S, Kurahara K, Yao T, and Torisu T were responsible for recruitment and phenotyping of the patients; Kitazono T and Matsumoto T revised the manuscript; all authors approved the final version of the manuscript.

Supported by the Practical Research Project for Rare/Intractable Diseases from the Japan Agency for Medical Research and Development (AMED), No. 15ek0109053h0002 to Matsumoto T, and by grants from the Japan Society for the Promotion of Science (JSPS) KAKENHI, No. 25460953, to Umeno J, Esaki M, and Matsumoto T.

Institutional review board statement: This study was approved by the institutional review board at each collecting site in accordance with the Declaration of Helsinki Principles.

Informed consent statement: All urine and blood samples were collected after obtaining written informed consent.

Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.

Data sharing statement: No additional data are available.

STROBE statement: The authors have read the STROBE Statement checklist of items, and the manuscript was prepared according to the STROBE Statement-checklist of items.

Corresponding author: Takayuki Matsumoto, MD, PhD, Professor, Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, Japan. tmatsumo@iwate-med.ac.jp

Telephone: +81-196515111 (ext. 2314) Fax: +81-196526664

Received: February 3, 2019
Peer-review started: February 6, 2019
First decision: February 21, 2019
Revised: February 27, 2019
Accepted: March 11, 2019
Article in press: March 12, 2019
Published online: April 14, 2019
Processing time: 72 Days and 23.5 Hours

ARTICLE HIGHLIGHTS

Research background

Chronic enteropathy associated with SLCO2A1 gene (CEAS) is a rare small intestinal disease, but distinct clinical condition from Crohn’s disease (CD). To date, we can make a correct diagnosis of CEAS by combination of clinical features and genetic analysis. However, CEAS is sometimes misdiagnosed as CD, because these diseases have some clinical features in common.

Research motivation

A more convenient and non-invasive screening test will help to diagnose CEAS correctly.

Research objectives

To investigate the usefulness of prostaglandin E-major urinary metabolites (PGE-MUM) to distinguish CEAS from CD.

Research methods

Participants were diagnosed CEAS and CD by clinical diagnostic criteria and genetic analysis. All participants’ PGE-MUM concentrations were measured by radioimmunoassay. We analyzed differentiating ability of PGE-MUM measurement between CEAS and CD.

Research results

Twenty patients with CEAS and 98 patients with CD were enrolled. It was found that the PGE-MUM concentrations of patients with CEAS were significantly higher than those of patients with CD and this correlation was still statistically significant after adjusting the possible confounding factors. Additionally, the present study showed the provisional cut-off value (48.9 μg/g × Cre) of PGE-MUM had a differentiating ability with 95.0% sensitivity and 79.6% specificity (area under the curve 0.90).

Research conclusions

The measurement of PGE-MUM can serve as a useful biomarker to differentiate CEAS from CD, although genetic analysis is mandatory for the diagnosis of CEAS.

Research perspectives

Our study showed the usefulness of PGE-MUM to differentiate CEAS from CD. In the present research, the sample size of the patients with CEAS were relatively small, the cut-off value for the distinction of CEAS from CD should be validated with large sample size of patients with CEAS in the future research.