Observational Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 28, 2020; 26(32): 4866-4877
Published online Aug 28, 2020. doi: 10.3748/wjg.v26.i32.4866
Inactive matrix Gla protein is elevated in patients with inflammatory bowel disease
Darko Brnic, Dinko Martinovic, Piero Marin Zivkovic, Daria Tokic, Marino Vilovic, Doris Rusic, Ivana Tadin Hadjina, Christian Libers, Sandro Glumac, Daniela Supe-Domic, Ante Tonkic, Josko Bozic
Darko Brnic, Piero Marin Zivkovic, Ivana Tadin Hadjina, Department of Gastroenterology, University Hospital of Split, Split 21000, Croatia
Dinko Martinovic, Daria Tokic, Department of Emergency Medicine, Institute of Emergency Medicine of Split-Dalmatia County, Split 21000, Croatia
Marino Vilovic, Christian Libers, Josko Bozic, Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
Doris Rusic, Department of Pharmacy, University of Split School of Medicine, Split 21000, Croatia
Sandro Glumac, Department of Anesthesiology and Intensive Care, University Hospital of Split, Split 21000, Croatia
Daniela Supe-Domic, Department of Medical Laboratory Diagnostics, University Hospital of Split, Split 21000, Croatia
Ante Tonkic, Department of Internal Medicine, University of Split School of Medicine, Split 21000, Croatia
Author contributions: Brnic D, Martinovic D and Bozic J were involved in the study conceptualization, methodology design, funding acquisition and manuscript drafting and writing; Zivkovic PM, Tokic D, Vilovic M, Tadin H and Libers C were involved in the literature investigation, software statistical analysis and manuscript visualization and editing; Supe-Domic D, Rusic D and Glumac S were involved in patient sampling, laboratory analysis and manuscript editing; Tonkic A was involved in supervision and project administration.
Institutional review board statement: The study was reviewed and approved by the University Hospital of Split Institutional Review Board (Approval No. 2181-147-01/06/M.S.-17-2).
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: Data set is available from the corresponding author at email: josko.bozic@mefst.hr.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Josko Bozic, MD, PhD, Associate Professor, Department of Pathophysiology, University of Split School of Medicine, Soltanska 2, Split 21000, Croatia. josko.bozic@mefst.hr
Received: May 30, 2020
Peer-review started: May 30, 2020
First decision: June 12, 2020
Revised: July 30, 2020
Accepted: August 15, 2020
Article in press: August 15, 2020
Published online: August 28, 2020
ARTICLE HIGHLIGHTS
Research background

Several recent studies have pointed to a possible link between immunomodulatory effect of matrix Gla protein (MGP) and inflammatory bowel disease (IBD). Their results showed that MGP improved the clinical and histopathological severity of colonic inflammation, alleviated the T-cells infiltration and suppressed the production of pro-inflammatory cytokines in colon tissues.

Research motivation

While experimental studies showed the potential that MGP could bring in managing IBD, clinical studies are still lacking.

Research objectives

The aim of this study was to compare plasma levels of inactive dephosphorylated and uncarboxylated (dp-ucMGP) between patients with IBD and healthy controls. The additional goal was to investigate the association of plasma dp-ucMGP levels with the anthropometric, clinical and laboratory parameters.

Research methods

This cross-sectional study was conducted on 70 patients with IBD (30 patients with ulcerative colitis and 40 patients with Crohn’s disease) and 60 age and gender matching healthy controls. Plasma dp-ucMGP levels were analyzed from blood samples by CLIA method using IDS-iSYS InaKtif MGP (Immunodiagnostic Systems, Frankfurt, Germany) according to the manufacturer's instructions. Other parameters were analyzed according to the standard laboratory procedures.

Research results

Plasma levels of dp-ucMGP were significantly higher in patients with IBD compared to the control group (P < 0.001), and there was no significant difference between patients with Crohn’s disease and patients with ulcerative colitis (P = 0.432). Furthermore, a significant positive correlation of plasma dp-ucMGP levels was found with both fecal calprotectin levels (P < 0.001) and hsCRP levels (P < 0.001).

Research conclusions

Our clinical results support previous experimental data of MGP involvement in IBD pathophysiology through inflammation process and disease activity.

Research perspectives

The potential MGP immunomodulatory effect should be addressed with larger scale studies in the future.