Prostaglandin E-major Urinary Metabolite as a Biomarker for Pediatric Ulcerative Colitis Activity
Shin-Ichiro Hagiwara1, Isao Okayasu, Mutsunori Fujiwara
1*Division of General Pediatrics, Saitama Children's Medical Center †Department of Pathology, Kitasato University School of Medicine ‡Department of Clinical Pathology, Japanese Red Cross Medical Center §Teikyo University Graduate School of Public Health ||Healthtec, Inc ¶IDAC Theranostics, Inc #Division of Pathology, Saitama Children's Medical Center.
Insights
Prostaglandin E-major urinary metabolite (PGE-MUM) effectively measures pediatric ulcerative colitis (UC) activity. This biomarker correlates well with UC severity, outperforming C-reactive protein and erythrocyte sedimentation rate.
Area of Science:
- Gastroenterology
- Pediatric Gastroenterology
- Biomarker Research
Background:
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease affecting children.
- Accurate assessment of pediatric UC activity is crucial for effective management.
- Existing biomarkers like C-reactive protein and erythrocyte sedimentation rate have limitations in reflecting disease activity.
Purpose of the Study:
- To evaluate Prostaglandin E-major urinary metabolite (PGE-MUM) as a biomarker for pediatric UC activity.
- To compare the efficacy of PGE-MUM in predicting UC activity against C-reactive protein and erythrocyte sedimentation rate.
- To determine if PGE-MUM reflects endoscopic and histologic disease activity in pediatric UC.
Main Methods:
- Twenty-nine pediatric UC patients (8-18 years) and 29 healthy controls were enrolled.
- UC activity was assessed using the Pediatric Ulcerative Colitis Activity Index, Mayo endoscopic scoring, and Matts histologic grading.
- PGE-MUM levels were measured via radioimmunoassay and compared with C-reactive protein and erythrocyte sedimentation rate.
Main Results:
- PGE-MUM levels were significantly elevated in active pediatric UC patients compared to those in remission or controls.
- PGE-MUM showed significant positive correlations with various UC activity scores, particularly total colon inflammation (sum of Mayo and sum of Matts).
- C-reactive protein did not correlate with any UC activity scores, and erythrocyte sedimentation rate showed limited correlation.
Conclusions:
- PGE-MUM is a reliable biomarker for assessing both endoscopic and histologic activity of the entire colon in pediatric UC.
- PGE-MUM demonstrates superior efficacy in reflecting overall disease activity compared to CRP and ESR in pediatric UC.
- This finding supports the potential clinical utility of PGE-MUM in monitoring pediatric ulcerative colitis.
Objectives:
Prostaglandin E-major urinary metabolite (PGE-MUM) is a useful biomarker for adult ulcerative colitis (UC) activity. In the present study, we evaluated whether PGE-MUM can also be a biomarker of pediatric UC activity and compared its efficacy in predicting UC activity with that of C-reactive protein and erythrocyte sedimentation rate.
Methods:
Twenty-nine pediatric patients with UC (8-18 years) and 29 healthy age- and sex-matched subjects were enrolled. UC activity was evaluated using the Pediatric Ulcerative Colitis Activity Index, highest Mayo endoscopic scoring (Mayo), and Matts grading (Matts) for histologic scoring, and the sum of Mayo (total of 6 segments) and Matts in all patients with UC. PGE-MUM levels were measured using a radioimmunoassay.
Results:
PGE-MUM levels were elevated in endoscopically and histologically active UC patients, but not in patients with endoscopic and histologic remission or controls. PGE-MUM levels positively and significantly correlated with UC activity. PGE-MUM levels were positively correlated with Pediatric Ulcerative Colitis Activity Index (r = 0.594), highest Mayo (r = 0.462), the sum of Mayo (r = 0.694), and the sum of Matts (r = 0.613), but not with highest Matt (r = 0.352). The sum of Mayo and the sum of Matts, which reflect total colon inflammation, showed highest correlation with PGE-MUM. C-reactive protein levels did not correlate with any UC activity scores. Erythrocyte sedimentation rate exhibited correlation (r = 0.490) with the sum of Mayo only.
Conclusions:
PGE-MUM is a reliable biomarker that reflects both the endoscopic and histologic activity of the entire colon in pediatric UC.
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