title: Serum regenerating islet-derived 3-alpha is a biomarker of mucosal enteropathies.
abstract: BACKGROUND
  The clinical presentation of organic and functional intestinal disorders can overlap and clinicians often rely on invasive and time-consuming procedures to make a final diagnosis. Regenerating islet-derived 3-alpha (Reg3α) is detectable in the circulation of patients with intestinal graft-versus host disease and patients with inflammatory bowel disease (IBD).
  
  
  OBJECTIVE
  To determine whether serum Reg3α testing is useful for discriminating mucosal enteropathies from functional intestinal disorders.
  
  
  METHODS
  We prospectively included 47 patients with active coeliac disease (ACD), 13 patients with refractory coeliac disease (RCD), seven patients with common variable immunodeficiency (CVID), 72 patients with active Crohn's disease, 22 patients with active ulcerative colitis (UC) and 28 patients with irritable bowel syndrome (IBS)-related diarrhoea. Sera were also taken from 10 CD patients before and after 6-12 months of a gluten-free diet (GFD) and from 14 patients with IBD before and after induction therapy with Infliximab (IFX). Sera of 119 healthy volunteers were used to determine the cut-off value. Reg3α levels were measured by a commercial ELISA kit.
  
  
  RESULTS
  Levels of Reg3α exceeded the cut-off value of the assay in 43/47(91%) ACD patients, 13/13(100%) RCD patients, 7/7(100%) CVID patients, 65/72(90%) Crohn's disease patients, 17/22(77%) UC patients and one patient with IBS(4%). Reg3α levels distinguished mucosal enteropathies from IBS with a sensitivity of 90% and a specificity of 96%. Reg3α levels significantly decreased in CD patients following a GFD and in IBD patients after treatment with IFX.
  
  
  CONCLUSIONS
  Reg3α is a serum biomarker of intestinal damage that, combined with clinical data, identifies patients who should undergo invasive tests for diagnosing enteropathies.
authors.affiliation: Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Marafini
authors.forename: A
authors.initials: A
authors.lastname: Di Sabatino
authors.forename: F
authors.initials: F
authors.lastname: Zorzi
authors.forename: I
authors.initials: I
authors.lastname: Monteleone
authors.forename: S
authors.initials: S
authors.lastname: Sedda
authors.forename: M L
authors.initials: ML
authors.lastname: Cupi
authors.forename: C
authors.initials: C
authors.lastname: Antenucci
authors.forename: P
authors.initials: P
authors.lastname: Biancheri
authors.forename: P
authors.initials: P
authors.lastname: Giuffrida
authors.forename: M
authors.initials: M
authors.lastname: Di Stefano
authors.forename: G R
authors.initials: GR
authors.lastname: Corazza
authors.forename: F
authors.initials: F
authors.lastname: Pallone
authors.forename: G
authors.initials: G
authors.lastname: Monteleone
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood*; D002446:Celiac Disease / Q000097:blood* / Q000175:diagnosis; D003093:Colitis, Ulcerative / Q000097:blood* / Q000175:diagnosis; D017074:Common Variable Immunodeficiency / Q000097:blood* / Q000175:diagnosis; D003424:Crohn Disease / Q000097:blood* / Q000175:diagnosis; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000097:blood* / Q000175:diagnosis; D037181:Lectins, C-Type / Q000097:blood*; D008297:Male; D008875:Middle Aged; D000073718:Pancreatitis-Associated Proteins; D055815:Young Adult
chemical_list: D000951:Antigens, Neoplasm; D015415:Biomarkers; D014408:Biomarkers, Tumor; D037181:Lectins, C-Type; D000073718:Pancreatitis-Associated Proteins; C000612141:REG3A protein, human