Krishnan A. Leucine-rich alpha-2 glycoprotein for detecting small bowel lesions in Crohn’s disease: A critical review and the path forward. World J Gastrointest Endosc 2025; 17(4): 106671 [DOI: 10.4253/wjge.v17.i4.106671]
Corresponding Author of This Article
Arunkumar Krishnan, MD, Department of Supportive Oncology, Atrium Health Levine Cancer, 1021 Morehead Medical Drive, Suite 70100, Charlotte, NC 28204, United States. dr.arunkumar.krishnan@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Apr 16, 2025; 17(4): 106671 Published online Apr 16, 2025. doi: 10.4253/wjge.v17.i4.106671
Leucine-rich alpha-2 glycoprotein for detecting small bowel lesions in Crohn’s disease: A critical review and the path forward
Arunkumar Krishnan
Arunkumar Krishnan, Department of Supportive Oncology, Atrium Health Levine Cancer, Charlotte, NC 28204, United States
Author contributions: Krishnan A contributed to the concept of the study, drafted the manuscript, and performed the review and editing. The manuscript was critically revised for important intellectual content and finalized by Krishnan A.
Conflict-of-interest statement: The author report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Arunkumar Krishnan, MD, Department of Supportive Oncology, Atrium Health Levine Cancer, 1021 Morehead Medical Drive, Suite 70100, Charlotte, NC 28204, United States. dr.arunkumar.krishnan@gmail.com
Received: March 4, 2025 Revised: March 20, 2025 Accepted: April 2, 2025 Published online: April 16, 2025 Processing time: 41 Days and 13.3 Hours
Abstract
The study by Ohno et al provides valuable insights into the role of leucine-rich alpha-2-glycoprotein (LRG) as a potential biomarker for identifying small bowel lesions in Crohn's disease (CD). However, several methodological challenges hinder its immediate use in clinical practice. Notably, the current research was retrospective, lacks comparative studies with fecal calprotectin, and did not provide long-term predictive data. Further prospective studies are needed to improve the applicability of LRG. Moreover, integrating LRG with additional biomarkers and employing artificial intelligence techniques may improve its effectiveness in disease monitoring. Future research should address interobserver variability, assess LRG's cost-effectiveness, and standardize endoscopic healing definitions to ensure broader applicability. Advancing these areas is vital for establishing LRG's role in precision medicine strategies for the management of CD.
Core Tip: A recent study by Ohno et al indicated that leucine-rich alpha-2 glycoprotein (LRG) has potential as a biomarker for identifying small bowel lesions in Crohn's disease. However, several methodological challenges are required to be addressed. The retrospective nature, the lack of direct comparisons with fecal calprotectin, and the absence of long-term data highlight the need for further validation. Moreover, there is potential for improving the utility of LRG by integrating it with other biomarkers and artificial intelligence to improve its effectiveness in disease monitoring. Future research should address interobserver variability, assess the cost-effectiveness, and standardize definitions for endoscopic healing.
