title: Soluble Syndecan-1: A Novel Biomarker of Small Bowel Mucosal Damage in Children with Celiac Disease.
abstract: Syndecan-1 (SDC1) is essential for maintaining normal epithelial barrier. Shedding of SDC1 ectodomain, reflected by serum soluble syndecan-1 (SSDC1) levels, is regulated by inflammation. Increased intestinal permeability plays a central role in celiac disease (CD). The association between SSDC1 levels and mucosal damage in CD has not been evaluated.
  
  
  
  To evaluate serum SSDC1 levels in children with CD and to determine its relationship with histological grading classified by modified Marsh criteria.
  
  
  
  This is a cross-sectional, pilot study, in which serum SSDC1 was analyzed by ELISA in a cohort of 49 untreated children with CD and 15 children with nonspecific abdominal pain (AP). CD was diagnosed based on positive celiac serology and small intestinal biopsy. SSDC1 levels at the time of biopsy were correlated with Marsh grading. Controls were defined by AP, negative celiac serology, normal upper endoscopy, and small intestinal biopsies.
  
  
  
  SSDC1 levels were significantly higher in CD patients compared to AP controls (116.2 ± 161 vs. 41.3 ± 17.5 ng/ml, respectively, p < 0.01). SSDC1 levels were significantly higher in patients with Marsh 3c lesion compared to AP controls (170.6 ± 201 vs. 41.3 ± 17.5 ng/ml, respectively, p < 0.05). SSDC1 concentrations displayed a significant correlation with mucosal damage defined by Marsh (r = 0.39, p < 0.05).
  
  
  
  This is the first study demonstrating elevated levels of serum SSDC1 in children with CD. Our results suggest that SSDC1 is a potentially novel marker of intestinal mucosal damage in patients with CD. Its applicability as a surrogate biomarker in CD remains to be determined.
authors.affiliation: Department of Gastroenterology, Chaim Sheba Medical Center, Tel Hashomer, Israel. doronyab@gmail.com.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. doronyab@gmail.com.
authors.forename: D
authors.identifier: 0000-0001-6191-9270
authors.initials: D
authors.lastname: Yablecovitch
authors.affiliation: Pediatric Endocrinology and Diabetes, Tel Aviv Medical Center, Tel Aviv, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Oren
authors.affiliation: Department of Gastroenterology, Chaim Sheba Medical Center, Tel Hashomer, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: S
authors.initials: S
authors.lastname: Ben-Horin
authors.affiliation: Department of Gastroenterology, Chaim Sheba Medical Center, Tel Hashomer, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: E
authors.initials: E
authors.lastname: Fudim
authors.affiliation: Department of Gastroenterology, Chaim Sheba Medical Center, Tel Hashomer, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: R
authors.initials: R
authors.lastname: Eliakim
authors.affiliation: Shalvata Mental Health Care Center, Hod Hasharon, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: T
authors.initials: T
authors.lastname: Saker
authors.affiliation: Gastroenterology, Meir Medical Center, Kfar Saba, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: F M
authors.initials: FM
authors.lastname: Konikoff
authors.affiliation: Department of Gastroenterology, Chaim Sheba Medical Center, Tel Hashomer, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: U
authors.initials: U
authors.lastname: Kopylov
authors.affiliation: AESKU.KIPP Institute, Wendelsheim, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Matthias
authors.affiliation: B. Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Lerner
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D001706:Biopsy / Q000379:methods; D002446:Celiac Disease / Q000097:blood / Q000175:diagnosis / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology*; D007421:Intestine, Small / Q000473:pathology*; D007557:Israel; D008297:Male; D010865:Pilot Projects; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013223:Statistics as Topic; D053668:Syndecan-1 / Q000097:blood*
chemical_list: D015415:Biomarkers; C508241:SDC1 protein, human; D053668:Syndecan-1
keywords: Biomarker; Celiac disease; Epithelial barrier; Soluble syndecan-1