Chromogranin A as a Novel Biomarker of Irritable Bowel Syndrome in Adults: A Systematic Review and Meta-Analysis

Abstract

Background: Irritable bowel syndrome (IBS) is a chronic condition characterized by recurring abdominal discomfort and irregular bowel movements. Currently, IBS diagnosis lacks specific radiological, biochemical, or endoscopic markers. Chromogranin A (CgA), a gastrointestinal protein, shows variation between IBS patients and healthy controls. This study aims to evaluate differences in CgA concentrations between these groups.

Methods: This review was conducted in 2023 using the PRISMA 2020 guidelines. All observational research were retrieved from MEDLINE, EBSCO-Host, ScienceDirect, and ProQuest electronic databases using a predefined search strategy. Study quality was assessed using the Newcastle-Ottawa Scale (NOS) and meta-analysis was conducted using Review Manager (RevMan) 5.4.

Results: Nine out of fourteen studies eligible for meta-analysis, revealing significantly higher CgA cell density (p=0.0001) in all IBS patients compared to controls. This difference persisted across colon regions (left: p=0.04, right: p=0.0009) and duodenum (p<0.00001). Notably, subgroup analysis found no significant disparity in CgA cell density between diarrhea and constipation- predominant IBS within duodenum or colon.

Conclusion: CgA cell density showed trends toward IBS compared to control groups, with significant concentration differences were found in the duodenum, left, and right colon. Therefore, current findings might offer a histopathological approach to confirm the IBS diagnosis.