The following is a summary of “Plasminogen Activator Inhibitor 1 Is a Novel Faecal Biomarker for Monitoring Disease Activity and Therapeutic Response in Inflammatory Bowel Diseases,” published in the March 2024 issue of Gastroenterology by Jójárt et al.
Chronic inflammatory bowel diseases (IBD) like Crohn’s disease (CD) and ulcerative colitis (UC) necessitate ongoing treatment and monitoring, prompting the search for novel IBD biomarkers due to the limitations of current options.
Researchers conducted a retrospective study to comprehensively evaluate PAI-1’s selectivity in IBD, its relationship with disease activity, and its potential to predict treatment response.
They utilized blood, colon biopsy, organoid cultures (OC), and fecal samples obtained from active and inactive IBD patients and control subjects. Serpin E1 gene expressions and PAI-1 protein levels and localization in serum, biopsy, and fecal samples were assessed through qRT-PCR, ELISA, and immunostaining, respectively.
The results showed 132 IBD patients, 56 with CD and 76 with UC, alongside 40 non-IBD patients. It was demonstrated that serum, mucosal, and fecal PAI-1 concentrations were elevated in IBD patients, indicating clinical and endoscopic activity. In responders [decrease of eMayo ≥3 in UC; or SES-CD 50% in CD], the initial PAI-1 level significantly decreased upon successful therapy. OCs derived from active IBD patients exhibited higher concentrations of PAI-1 compared to controls, suggesting epithelial cells as a source of PAI-1. Furthermore, fecal PAI-1 selectively increased in involved IBD but not in other organic gastrointestinal diseases.
Investigators concluded that PAI-1 in feces emerged as a promising non-invasive biomarker for monitoring IBD activity and treatment response.