title: Altered levels of fecal chromogranins and secretogranins in IBS: relevance for pathophysiology and symptoms?
abstract: OBJECTIVE
  Chromogranins (Cg) and secretogranins (Sg) are proteins ubiquitous in secretory cells of the enteric, endocrine, and immune systems, and may reflect activity of these systems. We therefore performed a hypothesis generating study to evaluate the association between fecal levels of CgA, CgB, SgII, and SgIII, with the clinical and pathophysiological phenotype of irritable bowel syndrome (IBS) patients.
  
  
  METHODS
  Analyses of CgA, CgB, SgII, SgIII, and calprotectin in fecal samples of 82 IBS patients and 29 healthy controls were performed. All IBS subjects completed validated questionnaires to assess gastrointestinal and psychological symptom severity, and underwent rectal barostat test and colonic transit time measurement.
  
  
  RESULTS
  IBS patients demonstrated higher levels of fecal CgA (P=0.009), SgII (P<0.001), and SgIII (P<0.001), but lower levels of CgB (P<0.001) compared with controls. SgII had good discriminative validity to positively identify IBS patients, with an area under the receiver operating characteristics (ROC) curve (AUROC) of 0.86 (95% confidence interval (CI): 0.78-0.94). SgIII and CgB both had fairly good discriminative validity to positively identify IBS patients, with an AUROC of 0.79 (95% CI: 0.71-0.87) and 0.78 (95% CI: 0.69-0.87), respectively. There were negative correlations between the colonic transit time and fecal levels of CgA (r=-0.53, P<0.001), SgII (r=-0.55, P<0.001), and SgIII (r=-0.28, P=0.03). Perceived abdominal pain was moderately associated with levels of CgA (r=0.32, P=0.004), SgII (r=0.31, P=0.006), and SgIII (r=0.24, P=0.04). Calprotectin levels were not associated with the levels of granins or with the clinical or pathophysiological phenotype of IBS patients.
  
  
  CONCLUSIONS
  Fecal levels of Cg and Sg may be related to the underlying pathophysiology of IBS and of potential importance for symptoms of the patients. Granins also show promise to serve as future biomarkers of IBS. Further studies are needed to explore the potential role of granins in IBS patients.
authors.affiliation: Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. lena.ohman@microbio.gu.se
authors.forename: Lena
authors.initials: L
authors.lastname: Ohman
authors.forename: Mats
authors.initials: M
authors.lastname: Stridsberg
authors.forename: Stefan
authors.initials: S
authors.lastname: Isaksson
authors.forename: Pernilla
authors.initials: P
authors.lastname: Jerlstad
authors.forename: Magnus
authors.initials: M
authors.lastname: Simrén
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D002864:Chromogranins / Q000378:metabolism*; D005243:Feces / Q000737:chemistry*; D005260:Female; D005772:Gastrointestinal Transit; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000378:metabolism* / Q000503:physiopathology*; D039841:Leukocyte L1 Antigen Complex / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D012372:ROC Curve; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers; D002864:Chromogranins; D039841:Leukocyte L1 Antigen Complex