Prostaglandin E-Major Urinary Metabolite as a Biomarker for Inflammation in Ulcerative Colitis: Prostaglandins Revisited

Abstract Background Faecal calprotectin (FC) and faecal immunochemical tests (FIT) have the disadvantage of requiring faecal samples. It has been reported that prostaglandin E–major urinary metabolite (PGE-MUM) values correlate with Mayo endoscopic scores (MESs) for ulcerative colitis (UC). However, there has been no report that PGE-MUM can determine endoscopic remission under remission phase UC, nor comparative study of PGE-MUM with FC and FIT. Thus, we aimed to examine the association between PGE-MUM values and the colonoscopy (CS) results of patients in the remission phase of UC, and to compare the accuracy of using PGE-MUM vs. that of using FC or FIT values for determining endoscopic remission. Methods Patients diagnosed with UC who were under clinical remission and had planned to undergo CS from August 2017 to March 2019 were enrolled. FC levels were measured and FITs were performed on the day of CS; PGE-MUM was measured either the day before or after CS. Three physicians independently scored the CS findings (MES, Modified Mayo Endoscopic Score [MMES], and UC endoscopic index of severity [UCEIS]) while blinded from clinical information. We analysed the differences in PGE-MUM values between two groups, which were divided between those that did achieve and those that did not achieve the following scores: (1) MES 0 point, (2) MES 1 point, (3) modified MES 0 point, (4) modified MES ≤1 point, (5) UCEIS 0 point, (6) UCEIS ≤2 points. In addition, the accuracy of PGE-MUM, FC, and FIT with respect to determining the achievement of (1) through (6) were compared by using areas under the receiver operating characteristics curves. Patients with altered UC activity between the day of PGE-MUM measurement and CS, and those who received NSAIDs on the day of PGE-MUM measurement, were excluded from the analysis. Results Of the 125 enrolled subjects, 30 patients were excluded (urine specimens not submitted, 11; poor stool specimens, 6; NSAIDs users, 10; clearly altered UC activity, 3). The remaining 95 patients (average age 48.2 years, 57 males, and 54 patients with total colitis type), were eligible for analysis. The median PGE-MUM values (in µg/g·Cr) for groups that did or did not achieve (1) through (6) were as follows: (1) 14.6/17.2, p = 0.106; (2) 14.9/20.5, p = 0.039; (3) 14.5/17.4, p = 0.059; (4) 14.1/21.8, p < 0.001; 5) 14.5/17.4, p = 0.059; (6) 14.7/22.2, p = 0.003. The areas under the receiver operating characteristics curves for PGE-MUM/FC/FIT used for determining the achievement of 1) through 6) were as follows: (1) 0.597/0.664/0.682, (2) 0.692/0.74/0.825, (3) 0.613/0.686/0.692, (4) 0.794/0.82/0.786, (5) 0.613/0.686/0.692 and (6) 0.778/0.824/0.825. Conclusion PGE-MUM is equally as effective as FC and FIT for determining the achievement of endoscopic remission.

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Comparison between Prostaglandin E-major urinary metabolite and C-reactive protein levels to reflect endoscopic scores in patients with ulcerative colitis

Scientific Reports ◽

10.1038/s41598-021-95761-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Natsuki Ishida ◽

Satoshi Tamura ◽

Takahiro Miyazu ◽

Shinya Tani ◽

Mihoko Yamade ◽

...

Keyword(s):

Ulcerative Colitis ◽

Significant Rise ◽

Urinary Metabolite ◽

Prostaglandin E ◽

C Reactive Protein ◽

Reactive Protein ◽

Major Urinary Metabolite ◽

Endoscopic Score ◽

The Relationship ◽

Over Time

AbstractProstaglandin E-major urinary metabolite (PGE-MUM) and C-reactive protein (CRP) are useful biomarkers in patients with ulcerative colitis. However, whether changes in endoscopic scores over time are reflected in the values of these biomarkers has not been verified. This prospective observational study aimed to assess the relationship between changes in biomarker levels and endoscopic scores in patients with ulcerative colitis. A total of 100 colonoscopy intervals of patients with ulcerative colitis were enrolled. The relationship between variations in the Mayo endoscopic subscore over time and the accompanying changes in biomarker values were investigated. PGE-MUM levels showed a significant rise in the increased endoscopic score group (P = 0.007) and a decrease with reduced endoscopic score group (P = 0.023). CRP levels showed a significant decline with lower endoscopic values (P < 0.001); however, there was no corresponding increase with higher endoscopic scores (P = 0.141). Biomarker levels remained unchanged with stable endoscopic scores (P = 0.090 and P = 0.705). PGE-MUM levels varied significantly, and corresponded to the mucosal healing state (P = 0.019 and P = 0.009). The correlation between changes in PGE-MUM and the endoscopic score was stronger than that for CRP (r = 0.518, P < 0.001 vs. r = 0.444, P < 0.001, respectively). PGE-MUM reflected changes in endoscopic scores more accurately than CRP.

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Significant Increase in Prostaglandin E-Main Urinary Metabolite by Laxative Administration: Comparison with Ulcerative Colitis

Digestion ◽

10.1159/000007758 ◽

2000 ◽

Vol 61 (3) ◽

pp. 201-206 ◽

Cited By ~ 11

Author(s):

Mutsunori Fujiwara ◽

Isao Okayasu ◽

Masae Oritsu ◽

Junko Komatsu ◽

Michiyasu Yoshitsugu ◽

...

Keyword(s):

Ulcerative Colitis ◽

Urinary Metabolite ◽

Prostaglandin E

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Prostaglandin E-Major Urinary Metabolite (PGE-MUM) as a Tumor Marker for Lung Adenocarcinoma

Cancers ◽

10.3390/cancers11060768 ◽

2019 ◽

Vol 11 (6) ◽

pp. 768 ◽

Cited By ~ 1

Author(s):

Hironori Kawamoto ◽

Hiromichi Hara ◽

Jun Araya ◽

Akihiro Ichikawa ◽

Yu Fujita ◽

...

Keyword(s):

Lung Adenocarcinoma ◽

Cancer Progression ◽

Stage Iv ◽

Staging System ◽

Tnm Staging ◽

Tumor Burden ◽

Urinary Metabolite ◽

Prostaglandin E ◽

Major Urinary Metabolite ◽

Embryonic Antigen

Background: Prostaglandin E2 (PGE2) is metabolized to prostaglandin E-major urinary metabolite (PGE-MUM). Enhanced cyclooxygenase-2 (COX-2) expression demonstrated in lung adenocarcinoma indicates increased PGE-MUM levels in patients with lung adenocarcinoma. Objectives: We aimed to elucidate the clinical usefulness of measuring PGE-MUM as an indicator of tumor burden in patients with lung adenocarcinoma. Methods: PGE-MUM was measured by a radioimmunoassay in control healthy volunteers (n = 124) and patients with lung adenocarcinoma (n = 54). Associations between PGE-MUM levels and clinical characteristics of the patients (including lung cancer stage and TNM factors (T: Tumor, N: Node, M: Metastasis) were examined. Results: PGE-MUM levels were significantly elevated in patients with lung adenocarcinoma. A PGE-MUM level of 14.9 μg/g∙Cr showed 70.4% sensitivity and 67.7% specificity for the diagnosis of lung adenocarcinoma. PGE-MUM levels tended to be positively correlated with cancer progression as determined by the TNM staging system. Advanced stage (stage III, stage IV, and recurrence) was significantly associated with high PGE-MUM levels by logistic regression analysis. No apparent correlation was demonstrated between PGE-MUM and carcinoma embryonic antigen (CEA) levels. Conclusions: PGE-MUM can be a promising biomarker reflecting the systemic tumor burden of lung adenocarcinoma.

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Decreased systemic formation of prostaglandin E and prostacyclin, and unchanged thromboxane formation, in alcoholics during withdrawal as estimated from metabolites in urine

Clinical Science ◽

10.1042/cs0730277 ◽

1987 ◽

Vol 73 (3) ◽

pp. 277-283 ◽

Cited By ~ 7

Author(s):

Ulrich Förstermann ◽

Thomas J. Feuerstein

Keyword(s):

Hydrolysis Product ◽

Thromboxane A2 ◽

Normal Subjects ◽

Thromboxane B2 ◽

Urinary Metabolite ◽

Prostaglandin E ◽

Dioic Acid ◽

Control Subjects ◽

Major Urinary Metabolite ◽

Prostaglandins E1 And E2

1. The rates of secretion into the circulation of prostaglandin E, prostacyclin, and thromboxane A2 were estimated in male alcoholics on the third day of withdrawal and in control subjects by measuring appropriate metabolites in urine. 2. Urinary levels of tetranor-5,11-diketo-7α-hydroxyprostane-1,16-dioic acid (the major urinary metabolite of prostaglandins E1 and E2), of 2,3-dinor-6-ketoprostaglandin F1α (the major urinary metabolite of prostacyclin) and of 6-keto-prostaglandin F1α (the stable hydrolysis product of prostacyclin) were significantly different from the normal subjects in the alcoholic group. In contrast, 2,3-dinor-thromboxane B2 (the major urinary metabolite of thromboxane A2) and thromboxane B2 (the stable hydrolysis product of thromboxane A2) were not significantly different between the groups. 3. These data suggest that the ratio of the vasodilator prostanoids prostaglandin E and prostacyclin and the vasoconstrictor prostanoid thromboxane A2 is lower than in normal subjects, in alcoholics during withdrawal. This may be one causal factor for the higher incidence of hypertension observed in withdrawing alcoholics compared with control subjects.

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