title: Syndecan-1 and heparanase: potential markers for activity evaluation and differential diagnosis of Crohn's disease.
abstract: BACKGROUND
  Syndecan-1 (SDC1) and its endo-beta-D-glucuronidase heparanase (HPA) are implicated in the maintenance of intestinal barrier function, but their detailed functions in Crohn's disease (CD) are not fully investigated. The aim of this study was to determine alteration patterns of SDC1 and HPA and their potential roles in evaluating disease activity and differentiating CD from intestinal tuberculosis (ITB).
  
  
  METHODS
  Tissue and serum specimens were obtained from 89 patients, including 15 patients with functional bowel disorders, 18 active patients with ITB, and 56 patients with CD (remission = 19, active = 37). Basic clinical data were collected and routine blood tests were analyzed. SDC1 and HPA were measured by immunohistochemistry, enzyme-linked immunosorbent assay, reverse transcriptase polymerase chain reaction, and western blot. Colonic epithelial cells were incubated with recombinant HPA, tumor necrosis factor alpha (TNF-α), and mycobacterium tuberculosis culture filtrate protein to detect the alterations of SDC1 and HPA.
  
  
  RESULTS
  In the CD group, SDC1 was significantly decreased in mucosa and increased in serum, whereas HPA level in both were elevated. Such alterations were associated with clinicopathological features representing disease activity and injury severity and were not available in functional bowel disorder and ITB groups. Recombinant HPA incubation increased soluble SDC1 in culture supernatants (P = 2 × 10(-4)), and low-dose TNF-α effectively enhanced HPA's activity (P = 3 × 10(-6)). Exogenous TNF-α destroyed cellular SDC1 and raised HPA expressions dose dependently, whereas mycobacterium tuberculosis culture filtrate protein showed no effects.
  
  
  CONCLUSIONS
  Unique alterations of SDC1 and HPA are shown in both patients with CD and in vitro model. The results indicate SDC1 and HPA are potential markers for CD in evaluating its disease activity and differentiating it from ITB.
authors.affiliation: Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Shaoheng
authors.initials: S
authors.lastname: Zhang
authors.forename: Qing
authors.initials: Q
authors.lastname: Qing
authors.forename: Qunying
authors.initials: Q
authors.lastname: Wang
authors.forename: Jun
authors.initials: J
authors.lastname: Xu
authors.forename: Fachao
authors.initials: F
authors.lastname: Zhi
authors.forename: Pyong W
authors.initials: PW
authors.lastname: Park
authors.forename: Yali
authors.initials: Y
authors.lastname: Zhang
authors.forename: Ye
authors.initials: Y
authors.lastname: Chen
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D015153:Blotting, Western; D003424:Crohn Disease / Q000097:blood / Q000175:diagnosis* / Q000235:genetics; D003937:Diagnosis, Differential; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D005966:Glucuronidase / Q000097:blood* / Q000235:genetics; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D009169:Mycobacterium tuberculosis / Q000472:pathogenicity*; D011379:Prognosis; D012333:RNA, Messenger / Q000235:genetics; D060888:Real-Time Polymerase Chain Reaction; D020133:Reverse Transcriptase Polymerase Chain Reaction; D053668:Syndecan-1 / Q000097:blood* / Q000235:genetics; D014385:Tuberculosis, Gastrointestinal / Q000097:blood / Q000175:diagnosis* / Q000382:microbiology; D000099175:Heparanase
chemical_list: D015415:Biomarkers; D005966:Glucuronidase; D012333:RNA, Messenger; D053668:Syndecan-1; D000099175:Heparanase