Serum 1,3-beta-D-glucan as a noninvasive test to predict histologic activity in patients with inflammatory bowel disease

doi:10.3748/wjg.v27.i9.866

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 27, Issue 9

This Article

Academic Content and Language Evaluation of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Supplementary Materials of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (10301)

All Articles published online

The chart showing PDF series, WORD series, HTML series, Figures (1-5) series, Tables (1-4) series.

Item

Count

PDF

522

WORD

268

HTML

4357

Figures (1-5)

567

Tables (1-4)

869

Sum=6583

Featured Article

The chart showing Browse series, Download series.

Item

Count

Browse

457

Download

763

Sum=1220

Publishing Process of This Article

Item

Count

Browse

628

Download

1870

Sum=2498

Mar 7, 2021 (publication date) through Oct 30, 2025

Times Cited of This Article

Times Cited (6)

Journal Information of This Article

Publication Name

World Journal of Gastroenterology

ISSN

1007-9327

Publisher of This Article

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

- Full Article with Cover (PDF)
- Full Article (XML)

Observational Study

World J Gastroenterol. Mar 7, 2021; 27(9): 866-885
Published online Mar 7, 2021. doi: 10.3748/wjg.v27.i9.866

Table 1 Patient demographics and medical characteristics

Parameters	Controls (n = 82)	Crohn’s disease (n = 115)	Ulcerative colitis (n = 51)
Women	57 (69.5%)	58 (50.4%)	27 (52.9%)
Age (yr), median (IQR)	51.5 (36.5-60)	42 (28-58)	44 (37-56)
Disease duration (yr), median (IQR)		6 (3-11)	9 (3-14)
Age at diagnosis (yr)
A1; A2; A3, n (%)		10 (8.7); 57 (49.6); 48 (41.7)	8 (15.7); 29 (56.9); 14 (27.5)
Disease behavior
B1; B2; B3, n (%)		53 (46.1); 20 (17.4); 42 (36.5)	-
Disease location
L1; L2; L3/E1; E2; E3, n (%)		16 (13.9); 39 (33.9); 60 (52.2)	14 (27.5); 17 (33.3); 20 (39.2)
Perianal disease		23 (20.0%)	-
EIM		12 (10.4%)	3 (5.9%)
PSC		6 (5.2%)	5 (9.8%)
Previous surgery		36 (31.3%)	2 (3.9%)
Medical therapy
Biologicals		38 (33.0%)	5 (9.8%)
Immunosuppressants		66 (57.4%)	22 (43.1%)
Steroids		17 (14.8%)	3 (5.9%)
Salicylates		18 (15.7%)	26 (51.0%)
Clinically active		60 (52.2%)	33 (64.7%)
Endoscopically active		77 (66.9%)	35 (68.6%)
Histologically active		33/71 (46.5%)	9/29 (31.0%)
CRP, mg/L	1.65 (1.4-6.0)	2.8 (1.6-8.1)	4.3 (2.0-7.6)
ESR, mm/h	22 (10-30)	22 (10-42)	35 (19-67)
Fecal calprotectin, µg/g	122 (45-201)	199 (52-325)	218 (115-370)
Beta-glucan, µg/mL	17 (8-33)	35 (17-74)	23 (9-54)

The values are presented as numbers (percentages) or medians interquartile range; age at diagnosis: A1, < 17; A2, 17-40; A3, > 40; Disease behavior in Crohn’s disease: B1: Inflammatory; B2: Fibrostenosing; B3: Penetrating; Disease location in Crohn’s disease: L1: Ileal; L2: Colonic; L3: Ileo-colonic; Disease location in ulcerative colitis: E1: Proctitis; E2: Left sided colitis; E3: Extensive colitis; EIM: Extraintestinal manifestations; PSC: Primary sclerosing cholangitis; CRP: C-reactive protein; ESR: Erythrocyte sedimentation rate.

Full Size Table

Table 2 Performance analysis of different cutoff values of serum beta-glucan for patients with Crohn’s disease in relation to endoscopic and histological criteria

Predicted outcome		Cutoff	Sensitivity	Specificity	PPV	NPV	Accuracy
Endoscopic inflammation	Beta-glucan	40	50.0 (39.0-61.0)	71.8 (56.2-83.5)	77.5 (64.1-87.0)	42.4 (31.2-54.4)	57.4 (48.3-66.0)
	(μg/mL)	60	34.2 (24.5-45.4)	87.2 (73.3-94.4)	83.9 (67.4-92.9)	40.5 (30.6-51.2)	52.2 (43.1-61.1)
	Calprotectin	100	75.0 (56.6-87.3)	53.3 (30.1-75.2)	75.0 (56.6-87.3)	53.3 (30.1-75.2)	67.4 (52.5-79.5)
	(μg/g)	200	53.6 (35.8-70.5)	66.7 (41.7-84.8)	75.0 (53.1-88.8)	43.5 (25.6-63.2)	58.1 (43.3-71.6)
	CRP	3	49.2 (37.1-61.4)	50.0 (31.4-68.6)	71.4 (56.4-82.8)	27.9 (16.7-42.7)	49.4 (39.0-59.8)
	(mg/L)	5	34.4 (23.7-46.9)	66.7 (46.7-82.0)	72.4 (54.3-85.3)	28.6 (18.4-41.5)	43.5 (33.5-54.1)
Histological inflammation	Beta-glucan	40	78.8 (62.2-89.3)	60.5 (44.7-74.4)	63.4 (48.1-76.4)	76.7 (59.1-88.2)	69.0 (57.5-78.6)
	(μg/mL)	60	57.6 (40.8-72.8)	76.3 (60.8-87.0)	67.9 (49.3-82.1)	67.5 (52.5-79.5)	67.6 (56.1-77.3)
	Calprotectin	100	69.2 (42.4-87.3)	41.7 (19.3-68.0)	56.2 (33.2-76.9)	55.6 (26.7-81.1)	56.0 (37.1-73.3)
	(μg/g)	200	46.1 (23.2-70.9)	50.0 (25.4-74.6)	50.0 (25.4-74.6)	46.1 (23.2-70.9)	48.0 (30.0-66.5)
	CRP	3	57.7 (38.9-74.5)	62.1 (44.0-77.3)	57.7 (38.9-74.5)	62.1 (44.0-77.3)	60.0 (46.8-71.9)
	(mg/L)	5	53.8 (35.5-71.2)	79.3 (61.6-90.1)	70.0 (48.1-85.4)	65.7 (49.1-79.2)	67.3 (54.1-78.2)

Endoscopic criteria based on the Simple Endoscopic Score-Crohn’s disease endoscopic subscore; Histological criteria based on a modified Global Histologic disease activity score; Parentheses show lower-upper 95% confidence interval. CRP: C-reactive protein; PPV: Positive predictive value; NPV: Negative predictive value.

Full Size Table

Table 3 Performance analysis of different cutoff values of serum beta-glucan for patients with ulcerative colitis in relation to endoscopic and histological criteria

Predicted outcome		Cutoff	Sensitivity	Specificity	PPV	NPV	Accuracy
Endoscopic inflammation	Beta-glucan	40	40.0 (25.6-56.4)	87.5 (64.0-96.5)	87.5 (64.0-96.5)	40.0 (25.6-56.4)	54.9 (41.4-67.7)
	(μg/mL)	60	22.9 (12.1-39.0)	87.5 (64.0-96.5)	80.0 (49.0-94.3)	34.1 (21.6-49.4)	43.1 (30.5-56.7)
	Calprotectin	100	81.2 (57.0-93.4)	20.0 (3.6-62.4)	76.5 (52.7-90.4)	25.0 (4.6-69.9)	66.7 (45.4-82.8)
	(μg/g)	200	62.5 (38.6-81.5)	80.0 (37.5-96.4)	90.9 (62.3-98.4)	40.0 (16.8-68.7)	66.7 (45.4-82.8)
	CRP	3	60.9 (40.8-77.8)	20.0 (5.7-51.0)	63.7 (42.9-80.3)	18.2 (5.1-47.7)	48.5 (32.5-64.8)
	(mg/L)	5	43.5 (25.6-63.2)	60.0 (31.3-83.2)	71.4 (45.3-88.3)	31.6 (15.4-54.0)	48.5 (32.5-64.8)
Histological inflammation	Beta-glucan	40	66.7 (35.4-87.9)	90.0 (69.9-97.2)	75.0 (40.9-92.8)	85.7 (65.4-95.0)	82.8 (65.5-92.4)
	(μg/mL)	60	55.6 (26.7-81.1)	95.0 (76.4-99.1)	83.3 (43.6-97.0)	82.6 (62.9-93.0)	82.8 (65.5-92.4)
	Calprotectin	100	100.0 (64.6-100.0)	25.0 (7.1-59.1)	53.8 (29.1-76.8)	100.0 (34.2-100.0)	60.0 (35.7-80.2)
	(μg/g)	200	85.7 (48.7-97.4)	50.0 (21.5-78.5)	60.0 (31.3-83.2)	80.0 (37.5-96.4)	66.7 (41.7-84.8)
	CRP	3	57.1 (25.0-84.2)	33.3 (13.8-60.9)	33.3 (13.8-60.9)	57.1 (25.0-84.2)	42.1 (23.1-63.7)
	(mg/L)	5	42.9 (15.8-74.9)	58.3 (31.9-80.7)	37.5 (13.7-69.4)	63.6 (35.4-84.8)	52.6 (31.7-72.7)

Endoscopic criteria based on the Mayo endoscopic subscore; Histological criteria based on the Geboes score. Parentheses show lower-upper 95% confidence interval. CRP: C-reactive protein; PPV: Positive predictive value; NPV: Negative predictive value.

Full Size Table

Table 4 Patient demographics and medical characteristics of the subgroup for the analysis of noninvasive markers

Parameters	Control group (n = 15)	Crohn’s disease group (n = 28)	Ulcerative colitis group (n = 25)	P value
Women, n (%)	11 (73)	12 (43)	16 (64)	0.110
Age (yr), median (IQR)	57 (37-63)	36 (26-58)	41 (33-56)	0.158
Disease duration (yr), median (IQR)		6 (2-12.5)	9 (3-10.5)	0.521
Age at diagnosis (yr)
A1; A2; A3, n (%)		3 (11); 14 (50); 11 (39)	5 (20); 15 (60); 5 (20)	0.269
Disease behavior
B1; B2; B3, n (%)		16 (57); 4 (14); 8 (29)	-	-
Disease location
L1; L2; L3/E1; E2; E3, n (%)		5 (18); 9 (32); 14 (50)	5 (20); 12 (48); 8 (32)	-
Perianal disease, n (%)		5 (18)	-	-
EIM, n (%)		4 (14)	2 (8)	0.391
PSC, n (%)		1 (3.6)	3 (12)	0.263
Previous surgery, n (%)		9 (32)	1 (4.0)	0.010
Medical therapy, n (%)
Biologicals		10 (36)	2 (8.0)	0.017
Immunosuppressants		18 (64)	5 (20)	0.001
Steroids		8 (29)	1 (4.0)	0.019
Salicylates		6 (21)	14 (56)	0.010
Clinically active, n (%)		13 (46)	21 (84)	0.005
Endoscopically active, n (%)		23 (82)	17 (68)	0.191
Histologically active, n (%)		14/22 (64)	4/14 (29)	0.043
Beta-glucan, µg/mL	26 (8-43)	79 (30-183)	23 (9-69)	0.0003^a
LBP, pg/mL	19.2 (16.4-22.7)	27.3 (24.3-28.6)	21.8 (19.8-24.6)	0.002^b
Zonulin, pg/mL	16.4 (15.3-17.1)	17.6 (16.6-19.0)	17.2 (16.6-18.7)	0.09
IL-17 (10²), pg/mL	0.04 (0.0-1.50)	0.08 (0.0-1.75)	0.00 (0.00-0.60)	0.2479
IFN-gamma, pg/mL	0.00 (0.00-0.690)	0.021 (0.00-0.66)	0.25 (0.001-0.92)	0.5276
TNF-alpha (10²), pg/mL	0.00 (0.00-1.00)	0.10 (0.00-7.80)	0.00 (0.00-20.01)	0.9004
IL-10, pg/mL	0.00 (0.00-0.00)	0.00 (0.00-4.56)	1.35 (0.00-3.66)	0.4801
IL-6, pg/mL	3.27 (2.38-9.05)	5.70 (0.31-35.73)	4.35 (2.28-15.91)	0.4149
IL-4, pg/mL	0.055 (0.00-6.81)	0.00 (0.00-0.087)	0.00 (0.00-1.31)	0.2597
IL-2, pg/mL	0.00 (0.00-0.052)	0.00 (0.00-0.010)	0.00 (0.00-0.04)	0.9204

In pairwise comparisons:

^a,bCrohn’s disease > Control. Values are presented as number (percentage) or median (IQR: Interquartile range); age at diagnosis: A1, < 17; A2, 17-40; A3, > 40; Disease behavior in Crohn’s disease: B1: Inflammatory; B2: Fibrostenosing; B3: Penetrating; Disease location in Crohn’s disease: L1: Ileal; L2: Colonic; L3: Ileo-colonic; Disease location in ulcerative colitis: E1: Proctitis; E2: Left sided colitis; E3: Extensive colitis; EIM: Extraintestinal manifestations; PSC: Primary sclerosing cholangitis; LBP: Lipopolysaccharide-binding protein.

Full Size Table

Citation: Farias e Silva K, Nanini HF, Cascabulho CM, Rosas SLB, Santana PT, Carneiro AJV, Anaissie E, Nucci M, de Souza HSP. Serum 1,3-beta-D-glucan as a noninvasive test to predict histologic activity in patients with inflammatory bowel disease. World J Gastroenterol 2021; 27(9): 866-885
URL: https://www.wjgnet.com/1007-9327/full/v27/i9/866.htm
DOI: https://dx.doi.org/10.3748/wjg.v27.i9.866