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 TorisuTakanari Kitazono, Takayuki Matsumoto

Research output: Contribution to journalArticle

Abstract

BACKGROUND We recently reported on a hereditary enteropathy associated with a gene encoding a prostaglandin transporter and referred to as chronic enteropathy associated with SLCO2A1 gene (CEAS). Crohn's disease (CD) is a major differential diagnosis of CEAS, because these diseases share some clinical features. Therefore, there is a need to develop a convenient screening test to distinguish CEAS from CD. AIM To examine whether prostaglandin E major urinary metabolites (PGE-MUM) can serve as a biomarker to distinguish CEAS from CD. METHODS This was a transactional study of 20 patients with CEAS and 98 patients with CD. CEAS was diagnosed by the confirmation of homozygous or compound heterozygous mutation of SLCO2A1. We measured the concentration of PGE-MUM in spot urine by radioimmunoassay, and the concentration was compared between the two groups of patients. We also determined the optimal cut-off value of PGE-MUM to distinguish CEAS from CD by receiver operating characteristic (ROC) curve analysis. RESULTS Twenty Japanese patients with CEAS and 98 patients with CD were enrolled. PGE-MUM concentration in patients with CEAS was significantly higher than that in patients with CD (median 102.7 vs 27.9 μg/g × Cre, P < 0.0001). One log unit increase in PGE-MUM contributed to 7.3 increase in the likelihood for the diagnosis of CEAS [95% confidence interval (CI) 3.2-16.7]. A logistic regression analysis revealed that the association was significant even after adjusting confounding factors (adjusted odds ratio 29.6, 95%CI 4.7-185.7). ROC curve analysis revealed the optimal PGE-MUM cut-off value for the distinction of CEAS from CD to be 48.9 μg/g × Cre with 95.0% sensitivity and 79.6% specificity. CONCLUSION PGE-MUM measurement is a convenient, non-invasive and useful test for the distinction of CEAS from CD.

Original languageEnglish
Pages (from-to)1753-1763
Number of pages11
JournalWorld Journal of Gastroenterology
Volume25
Issue number14
DOIs
Publication statusPublished - 2019 Jan 1

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Prostaglandins
Crohn Disease
Prostaglandins E
Genes
ROC Curve
Confidence Intervals
Radioimmunoassay
Differential Diagnosis
Biomarkers
Logistic Models
Odds Ratio
Regression Analysis
Urine
Sensitivity and Specificity
Mutation

Keywords

  • Chronic enteropathy associated with SLCO2A1 gene
  • Chronic nonspecific multiple ulcers of the small intestine
  • Crohn's disease
  • Prostaglandin E major urinary metabolites
  • Small intestine

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Matsuno, Y., Umeno, J., Esaki, M., Hirakawa, Y., Fuyuno, Y., Okamoto, Y., ... Matsumoto, T. (2019). Measurement of prostaglandin metabolites is useful in diagnosis of small bowel ulcerations. World Journal of Gastroenterology, 25(14), 1753-1763. https://doi.org/10.3748/wjg.v25.i14.1753

Measurement of prostaglandin metabolites is useful in diagnosis of small bowel ulcerations. / Matsuno, Yuichi; Umeno, Junji; Esaki, Motohiro; Hirakawa, Yoichiro; Fuyuno, Yuta; Okamoto, Yasuharu; Hirano, Atsushi; Yasukawa, Shigeyoshi; Hirai, Fumihito; Matsui, Toshiyuki; Hosomi, Shuhei; Watanabe, Kenji; Hosoe, Naoki; Ogata, Haruhiko; Hisamatsu, Tadakazu; Yanai, Shunichi; Kochi, Shuji; Kurahara, Koichi; Yao, Tsuneyoshi; Torisu, Takehiro; Kitazono, Takanari; Matsumoto, Takayuki.

In: World Journal of Gastroenterology, Vol. 25, No. 14, 01.01.2019, p. 1753-1763.

Research output: Contribution to journalArticle

Matsuno, Y, Umeno, J, Esaki, M, Hirakawa, Y, 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, Torisu, T, Kitazono, T & Matsumoto, T 2019, 'Measurement of prostaglandin metabolites is useful in diagnosis of small bowel ulcerations', World Journal of Gastroenterology, vol. 25, no. 14, pp. 1753-1763. https://doi.org/10.3748/wjg.v25.i14.1753
Matsuno, Yuichi ; Umeno, Junji ; Esaki, Motohiro ; Hirakawa, Yoichiro ; Fuyuno, Yuta ; Okamoto, Yasuharu ; Hirano, Atsushi ; Yasukawa, Shigeyoshi ; Hirai, Fumihito ; Matsui, Toshiyuki ; Hosomi, Shuhei ; Watanabe, Kenji ; Hosoe, Naoki ; Ogata, Haruhiko ; Hisamatsu, Tadakazu ; Yanai, Shunichi ; Kochi, Shuji ; Kurahara, Koichi ; Yao, Tsuneyoshi ; Torisu, Takehiro ; Kitazono, Takanari ; Matsumoto, Takayuki. / Measurement of prostaglandin metabolites is useful in diagnosis of small bowel ulcerations. In: World Journal of Gastroenterology. 2019 ; Vol. 25, No. 14. pp. 1753-1763.
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abstract = "BACKGROUND We recently reported on a hereditary enteropathy associated with a gene encoding a prostaglandin transporter and referred to as chronic enteropathy associated with SLCO2A1 gene (CEAS). Crohn's disease (CD) is a major differential diagnosis of CEAS, because these diseases share some clinical features. Therefore, there is a need to develop a convenient screening test to distinguish CEAS from CD. AIM To examine whether prostaglandin E major urinary metabolites (PGE-MUM) can serve as a biomarker to distinguish CEAS from CD. METHODS This was a transactional study of 20 patients with CEAS and 98 patients with CD. CEAS was diagnosed by the confirmation of homozygous or compound heterozygous mutation of SLCO2A1. We measured the concentration of PGE-MUM in spot urine by radioimmunoassay, and the concentration was compared between the two groups of patients. We also determined the optimal cut-off value of PGE-MUM to distinguish CEAS from CD by receiver operating characteristic (ROC) curve analysis. RESULTS Twenty Japanese patients with CEAS and 98 patients with CD were enrolled. PGE-MUM concentration in patients with CEAS was significantly higher than that in patients with CD (median 102.7 vs 27.9 μg/g × Cre, P < 0.0001). One log unit increase in PGE-MUM contributed to 7.3 increase in the likelihood for the diagnosis of CEAS [95{\%} confidence interval (CI) 3.2-16.7]. A logistic regression analysis revealed that the association was significant even after adjusting confounding factors (adjusted odds ratio 29.6, 95{\%}CI 4.7-185.7). ROC curve analysis revealed the optimal PGE-MUM cut-off value for the distinction of CEAS from CD to be 48.9 μg/g × Cre with 95.0{\%} sensitivity and 79.6{\%} specificity. CONCLUSION PGE-MUM measurement is a convenient, non-invasive and useful test for the distinction of CEAS from CD.",
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T1 - Measurement of prostaglandin metabolites is useful in diagnosis of small bowel ulcerations

AU - Matsuno, Yuichi

AU - Umeno, Junji

AU - Esaki, Motohiro

AU - Hirakawa, Yoichiro

AU - Fuyuno, Yuta

AU - Okamoto, Yasuharu

AU - Hirano, Atsushi

AU - Yasukawa, Shigeyoshi

AU - Hirai, Fumihito

AU - Matsui, Toshiyuki

AU - Hosomi, Shuhei

AU - Watanabe, Kenji

AU - Hosoe, Naoki

AU - Ogata, Haruhiko

AU - Hisamatsu, Tadakazu

AU - Yanai, Shunichi

AU - Kochi, Shuji

AU - Kurahara, Koichi

AU - Yao, Tsuneyoshi

AU - Torisu, Takehiro

AU - Kitazono, Takanari

AU - Matsumoto, Takayuki

PY - 2019/1/1

Y1 - 2019/1/1

N2 - BACKGROUND We recently reported on a hereditary enteropathy associated with a gene encoding a prostaglandin transporter and referred to as chronic enteropathy associated with SLCO2A1 gene (CEAS). Crohn's disease (CD) is a major differential diagnosis of CEAS, because these diseases share some clinical features. Therefore, there is a need to develop a convenient screening test to distinguish CEAS from CD. AIM To examine whether prostaglandin E major urinary metabolites (PGE-MUM) can serve as a biomarker to distinguish CEAS from CD. METHODS This was a transactional study of 20 patients with CEAS and 98 patients with CD. CEAS was diagnosed by the confirmation of homozygous or compound heterozygous mutation of SLCO2A1. We measured the concentration of PGE-MUM in spot urine by radioimmunoassay, and the concentration was compared between the two groups of patients. We also determined the optimal cut-off value of PGE-MUM to distinguish CEAS from CD by receiver operating characteristic (ROC) curve analysis. RESULTS Twenty Japanese patients with CEAS and 98 patients with CD were enrolled. PGE-MUM concentration in patients with CEAS was significantly higher than that in patients with CD (median 102.7 vs 27.9 μg/g × Cre, P < 0.0001). One log unit increase in PGE-MUM contributed to 7.3 increase in the likelihood for the diagnosis of CEAS [95% confidence interval (CI) 3.2-16.7]. A logistic regression analysis revealed that the association was significant even after adjusting confounding factors (adjusted odds ratio 29.6, 95%CI 4.7-185.7). ROC curve analysis revealed the optimal PGE-MUM cut-off value for the distinction of CEAS from CD to be 48.9 μg/g × Cre with 95.0% sensitivity and 79.6% specificity. CONCLUSION PGE-MUM measurement is a convenient, non-invasive and useful test for the distinction of CEAS from CD.

AB - BACKGROUND We recently reported on a hereditary enteropathy associated with a gene encoding a prostaglandin transporter and referred to as chronic enteropathy associated with SLCO2A1 gene (CEAS). Crohn's disease (CD) is a major differential diagnosis of CEAS, because these diseases share some clinical features. Therefore, there is a need to develop a convenient screening test to distinguish CEAS from CD. AIM To examine whether prostaglandin E major urinary metabolites (PGE-MUM) can serve as a biomarker to distinguish CEAS from CD. METHODS This was a transactional study of 20 patients with CEAS and 98 patients with CD. CEAS was diagnosed by the confirmation of homozygous or compound heterozygous mutation of SLCO2A1. We measured the concentration of PGE-MUM in spot urine by radioimmunoassay, and the concentration was compared between the two groups of patients. We also determined the optimal cut-off value of PGE-MUM to distinguish CEAS from CD by receiver operating characteristic (ROC) curve analysis. RESULTS Twenty Japanese patients with CEAS and 98 patients with CD were enrolled. PGE-MUM concentration in patients with CEAS was significantly higher than that in patients with CD (median 102.7 vs 27.9 μg/g × Cre, P < 0.0001). One log unit increase in PGE-MUM contributed to 7.3 increase in the likelihood for the diagnosis of CEAS [95% confidence interval (CI) 3.2-16.7]. A logistic regression analysis revealed that the association was significant even after adjusting confounding factors (adjusted odds ratio 29.6, 95%CI 4.7-185.7). ROC curve analysis revealed the optimal PGE-MUM cut-off value for the distinction of CEAS from CD to be 48.9 μg/g × Cre with 95.0% sensitivity and 79.6% specificity. CONCLUSION PGE-MUM measurement is a convenient, non-invasive and useful test for the distinction of CEAS from CD.

KW - Chronic enteropathy associated with SLCO2A1 gene

KW - Chronic nonspecific multiple ulcers of the small intestine

KW - Crohn's disease

KW - Prostaglandin E major urinary metabolites

KW - Small intestine

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