Brief Article
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World J Gastroenterol. Dec 21, 2013; 19(47): 9049-9056
Published online Dec 21, 2013. doi: 10.3748/wjg.v19.i47.9049
Serum concentrations of insulin-like growth factor-binding protein 5 in Crohn’s disease
Gupse Adali, Elif Yorulmaz, Seyma Ozkanli, Celal Ulasoglu, Baris Bayraktar, Alev Orhun, Yasar Colak, Ilyas Tuncer
Gupse Adali, Elif Yorulmaz, Celal Ulasoglu, Yasar Colak, Ilyas Tuncer, Department of Gastroenterology, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Doktor Erkin Caddesi Kadikoy, Istanbul 34730, Turkey
Seyma Ozkanli, Department of Pathology, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Doktor Erkin Caddesi Kadikoy, Istanbul 34730, Turkey
Baris Bayraktar, Department of General Surgery, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Doktor Erkin Caddesi Kadikoy, Istanbul 34730, Turkey
Alev Orhun, Department of Biochemistry, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Doktor Erkin Caddesi Kadikoy, Istanbul 34730, Turkey
Author contributions: Adali G designed the research, performed the statistical analysis and wrote the manuscript; Ozkanli S and Orhun A performed the experiments; Yorulmaz E and Bayraktar B provided the collection of all the human material; Colak Y, Ulasoglu C and Tuncer I contributed to writing the manuscript.
Correspondence to: Gupse Adali, MD, Department of Gastroenterology, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Doktor Erkin Caddesi Kadikoy, Istanbul 34730, Turkey. gupseadali@gmail.com
Telephone: +90-216-5666600 Fax: +90-216-5666628
Received: July 8, 2013
Revised: September 1, 2013
Accepted: September 15, 2013
Published online: December 21, 2013
Processing time: 198 Days and 10.9 Hours
Abstract

AIM: To investigate serum insulin-like growth factor-binding protein 5 (IGFBP-5) levels and intestinal IGFBP-5 expression in patients with Crohn’s disease (CD).

METHODS: We analyzed the serum concentrations and intestinal expression of IGFBP-5 in 42 patients with CD, of whom 26 had endoscopically or radiologically proven stricture formation. Nine of the 42 patients had active disease, with a Crohn’s disease activity index > 150. Serum IGFBP-5 levels were analyzed in 20 healthy controls matched by sex and age to the CD patients. Serum IGFBP-5 was measured using an enzyme-linked immunosorbent assay. Intestinal tissue was obtained from patients through endoscopic biopsies. IGFBP-5 expression was detected using immunohistochemistry and was scored semiquantitatively.

RESULTS: The median serum IGFBP-5 concentrations of CD patients were significantly lower compared with healthy controls [median 7.2 (IQR: 5.5-11.3) ng/mL vs 11.3 (8.0-44.6) ng/mL, P < 0.001]. There was no significant difference between median serum IGFBP-5 levels in CD patients with or without stricture formation [6.9 (5.5-11.3) ng/mL vs 7.8 (5.3-10.1) ng/mL, P = 0.815]. The serum IGFBP-5 levels were not significantly different between patients with active disease and inactive disease [7.2 (6.5-7.6) ng/mL vs 7.2 (5.5-11.3) ng/mL, P = 0.890]. However, a significant correlation was observed between serum IGFBP-5 levels and platelet count (PLT) (r = 0.319, P = 0.0395). No significant correlation was found between tissue IGFBP-5 immunohistochemical staining intensity scores and serum IGFBP-5 levels. No significant difference was found when comparing the serum IGFBP-5 levels among the patients with different tissue IGFBP-5 staining scores (absent/very weak, weak, moderate or strong). There was a significant correlation between tissue IGFBP-5 staining scores and white blood cell count (r = 0.391, P = 0.01) and PLT (r = 0.356, P = 0.021).

CONCLUSION: Our results indicate that serum IGFBP-5 concentrations were lower in CD patients compared to healthy controls regardless of disease activity or the presence of stricture formation.

Keywords: Crohn’s disease; Insulin-like growth factor-binding protein 5; Stricture; Immunohistochemistry; Enzyme-linked immunosorbent assay

Core tip: Previous studies have suggested that insulin-like growth factors are important for the growth and development of visceral smooth muscle. In particular, increased insulin-like growth factor-binding protein 5 expression has been described in inflamed and fibrotic intestinal tissue. In this study, we aim to investigate the possible role of insulin-like growth factor-binding protein 5 in Crohn’s disease with stricture involvement. Crohn’s disease patients had lower serum levels of IGFBP-5 compared to healthy controls. The results of the study suggest that additional research is necessary to explain the low circulating levels of IGFBP-5 in Crohn’s disease patients.