{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T14:06:30Z","timestamp":1789221990156,"version":"build-2803163510"},"reference-count":13,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therap Adv Gastroenterol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Serum leucine-rich \u03b12-glycoprotein1 (LRG1) is a promising biomarker for mucosal inflammation in ulcerative colitis (UC). However, because systemic LRG1 expression is partly tumor necrosis factor-\u03b1 (TNF-\u03b1)-dependent, anti-TNF therapy may pharmacologically suppress its levels independently of mucosal status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate whether anti-TNF therapy is associated with false-negative serum LRG1 results, attenuates diagnostic accuracy for endoscopic activity (MES \u2267 2), and impairs diagnostic granularity to differentiate strict healing targets (MES 0 vs. 1) compared to other therapies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A retrospective, single-center diagnostic accuracy study conducted in accordance with the STARD 2015 guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 127 paired colonoscopy\u2013LRG1 evaluations (49 under anti-TNF, 78 without) from 50 patients receiving advanced therapies (April 2021\u2013March 2025). Endoscopic activity was defined as Mayo Endoscopic Subscore (MES) \u22652. Diagnostic performance was evaluated using ROC analysis; AUC differences were compared using a cluster bootstrap approach. Factors associated with false-negative LRG1 (&lt;16 \u03bcg\/mL despite MES \u22652) were identified using generalized estimating equations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, LRG1 demonstrated satisfactory discrimination (AUC 0.81), but performed significantly lower under anti-TNF than non-anti-TNF therapy (AUC 0.44 vs. 0.91; \u0394AUC=0.46). Among active evaluations, 45% (24\/53) showed false-negatives. Anti-TNF was a strong independent predictor of false-negatives (OR 9.3, 95% CI 1.68\u201351.9), while JAK inhibitor use was protective (OR 0.09, 95% CI 0.01\u20130.80, P&lt;0.03) with high accuracy (AUC 0.95 vs. 0.75, P&lt;0.01). LRG1 failed to differentiate MES 0 and MES 1 in the anti-TNF cohort (p=0.63), whereas a marginal trend was observed in the non-anti-TNF cohort (p=0.06).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Anti-TNF therapy may selectively attenuate serum LRG1 performance, potentially causing frequent false-negatives and obscuring the distinction between complete healing (MES 0) and mild residual inflammation (MES 1). Clinicians must consider the therapeutic context when interpreting LRG1 for disease monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17562848261489192","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T14:08:05Z","timestamp":1789049285000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Anti-TNF therapy attenuates the diagnostic utility of leucine-rich \u03b12-Glycoprotein 1 for endoscopic activity in ulcerative colitis"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8422-2406","authenticated-orcid":false,"given":"Akihiro","family":"Dejima","sequence":"first","affiliation":[{"name":"Kanazawa University Graduate School of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajime","family":"Takatori","sequence":"additional","affiliation":[{"name":"Kanazawa University Graduate School of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaki","family":"Miyazawa","sequence":"additional","affiliation":[{"name":"Kanazawa University Graduate School of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirofumi","family":"Okafuji","sequence":"additional","affiliation":[{"name":"Kanazawa University Graduate School of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyuki","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Kanazawa University Graduate School of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Seki","sequence":"additional","affiliation":[{"name":"Kanazawa University Graduate School of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kouki","family":"Nio","sequence":"additional","affiliation":[{"name":"Kanazawa University Graduate School of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriho","family":"Iida","sequence":"additional","affiliation":[{"name":"Kanazawa University Graduate School of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4399-1217","authenticated-orcid":false,"given":"Shinya","family":"Yamada","sequence":"additional","affiliation":[{"name":"Kanazawa University Graduate School of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuro","family":"Shimakami","sequence":"additional","affiliation":[{"name":"Kanazawa University Graduate School of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadashi","family":"Toyama","sequence":"additional","affiliation":[{"name":"University of Fukui"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taro","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Kanazawa University Graduate School of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2012-302830"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2016.01.015"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.12.031"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00054725-200409000-00026"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.22936"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjw132"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/crocol\/otac039"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h5527"},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198712243172603"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2011-300486"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2012.244"},{"key":"e_1_3_8_13_2","doi-asserted-by":"crossref","first-page":"e0257576","DOI":"10.1371\/journal.pone.0257576","article-title":"Tumor Necrosis Factor-alpha utilizes MAPK\/NF\u03baB pathways to induce cholesterol-25 hydroxylase for amplifying pro-inflammatory response via 25-hydroxycholesterol-integrin-FAK pathway","volume":"16","author":"Swechha MP","year":"2021","unstructured":"Swechha MP, Kim C, Niraj KS, et al. Tumor Necrosis Factor-alpha utilizes MAPK\/NF\u03baB pathways to induce cholesterol-25 hydroxylase for amplifying pro-inflammatory response via 25-hydroxycholesterol-integrin-FAK pathway. PloS One 2021; 16: e0257576.","journal-title":"PloS One"},{"key":"e_1_3_8_14_2","doi-asserted-by":"publisher","DOI":"10.1159\/000547007"}],"container-title":["Therapeutic Advances in Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17562848261489192","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17562848261489192","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17562848261489192","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T13:17:18Z","timestamp":1789219038000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17562848261489192"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":13,"alternative-id":["10.1177\/17562848261489192"],"URL":"https:\/\/doi.org\/10.1177\/17562848261489192","relation":{},"ISSN":["1756-2848","1756-2848"],"issn-type":[{"value":"1756-2848","type":"print"},{"value":"1756-2848","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"article-number":"17562848261489192"}}