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Chromogranin A as a Novel Biomarker of Irritable Bowel Syndrome in Adults: A Systematic Review and Meta-Analysis
Virly Nanda Muzellina1, Nicolas Daniel Widjanarko2, Jonathan Christianto Subagya2
1Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Central Jakarta, Indonesia.
Background:
Irritable bowel syndrome (IBS) is a chronic condition characterized by recurring abdominal discomfort and irregular bowel movements. Currently, IBS diagnosis lacks specific radiological, biochemical, or endoscopic markers. Chromogranin A (CgA), a gastrointestinal protein, shows variation between patients with IBS and healthy controls. This study aimed to evaluate differences in CgA concentrations between these groups.
Methods:
This review was conducted in 2023 using the PRISMA 2020 guidelines. All observational research was retrieved from MEDLINE, EBSCO-Host, ScienceDirect, and ProQuest electronic databases using a predefined search strategy. Study quality was assessed using the Newcastle-Ottawa Scale (NOS), and meta-analysis was conducted using Review Manager (RevMan) 5.4.
Results:
Nine out of 14 studies eligible for meta-analysis revealed significantly higher CgA cell density (P=0.0001) in all patients with IBS compared with controls. This difference persisted across colon regions (left: P=0.04, right: P=0.0009) and duodenum (P<0.00001). Subgroup analysis found no significant disparity in CgA cell density between diarrhea and constipation-predominant IBS within the duodenum or colon.
Conclusion:
CgA cell density showed trends toward IBS compared with control groups, with significant concentration differences found in the duodenum, left, and right colon. Therefore, current findings might offer a histopathological approach to confirm the IBS diagnosis.
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