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Clinical Usefulness of Serum Autotaxin for Early Prediction of Relapse in Male Patients with Type 1 Autoimmune Pancreatitis

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Abstract

Background

Serum IgG4 level is a useful diagnostic marker for autoimmune pancreatitis (AIP), but it is difficult to use to predict relapse.

Aims

We investigated whether serum autotaxin (ATX) level is predictive of AIP relapse after steroid therapy.

Methods

Fifty-six patients with type 1 AIP were investigated. We measured serum ATX at the time of diagnosis. We selected 24 males for whom serum samples during steroid therapy had been obtained and measured serum ATX at steroid therapy for induction of remission and at maintenance therapy. In the relapse group, we also measured ATX at the time of relapse.

Results

ATX was significantly higher in female patients than in male patients. In order to clarify changes in ATX during steroid therapy, we focused on 24 male patients. We found that ATX decreased significantly during steroid therapy for induction of remission and at the time of maintenance therapy. In half of all patients who relapsed during maintenance therapy, ATX was significantly elevated at the time of relapse compared with that of induction therapy (P = 0.039). When we compared ATX at the time of maintenance therapy between patients with relapse and without, we observed significantly higher ATX in the former (P = 0.024). We found that the combination of ATX and elastase-1 could predict relapse with high accuracy (95%).

Conclusions

Preliminary evidence suggests that serum ATX might serve as a candidate biomarker to predict relapse of AIP as well as to monitor the effect of steroid therapy.

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Acknowledgments

The authors thank the patients who agreed to participate in this study. We also thank the team members at Hiroshima University Hospital for clinical sample collection. We thank Rie Akiyama, Junko Sakamiya, Yumi Shimomura and Miyuki Matsushita for technical assistance; Chizuru Hiraguchi, Akemi Sada, Chikako Kanehara and Emi Nishio for clerical assistance; and other members of the Hiroshima University and RIKEN Center for Integrative Medical Sciences for assistance with various aspects of this study.

Funding

The authors have no grant support for this manuscript.

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Authors and Affiliations

  1. Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Ayami Fukiage, Hatsue Fujino, Daiki Miki, Yasutaka Ishii, Masahiro Serikawa, Masataka Tsuge, Michio Imamura, Hiroshi Aikata, C. Nelson Hayes & Kazuaki Chayama

  2. Research Center for Hepatology and Gastroenterology, Hiroshima University, Hiroshima, Japan

    Daiki Miki, Masataka Tsuge, Michio Imamura, Hiroshi Aikata, C. Nelson Hayes & Kazuaki Chayama

  3. RIKEN Center for Integrative Medical Sciences, Yokohama, Japan

    C. Nelson Hayes & Kazuaki Chayama

Authors
  1. Ayami Fukiage
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  2. Hatsue Fujino
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  3. Daiki Miki
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  4. Yasutaka Ishii
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  7. Michio Imamura
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  8. Hiroshi Aikata
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  10. Kazuaki Chayama
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Contributions

KC conceived the study; AF, HF, DM, YI, MS and KC designed the study; AF, HF, YI, MS and KC managed and prepared serum samples; AF, HF, DM, YI, MS, MT, MI, HA and CNH performed data analysis; AF, HF, DM, CNH and KC wrote the manuscript; AF, HF, DM and KC summarized the whole results. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kazuaki Chayama.

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Fukiage, A., Fujino, H., Miki, D. et al. Clinical Usefulness of Serum Autotaxin for Early Prediction of Relapse in Male Patients with Type 1 Autoimmune Pancreatitis. Dig Dis Sci 66, 1268–1275 (2021). https://doi.org/10.1007/s10620-020-06338-8

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  • DOI: https://doi.org/10.1007/s10620-020-06338-8

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