Leucine-rich alpha-2 glycoprotein as a blood biomarker in inflammatory bowel disease: clinical implications and future perspectives

LRG shows strong correlations with mucosal and transmural inflammation across IBD phenotypes, retains sensitivity in biologic-treated patients or those with normal CRP, and predicts treatment response. Its rapid turnaround and noninvasive nature make it well suited to treat-to-target strategies. However, most evidence originates from Japan, limiting generalizability until confirmed in large, multicenter international cohorts. Broader adoption will require assay standardization, validation across diverse populations, and integration into composite indices to optimize individualized care. If validated globally, LRG could transform precision monitoring and enhance outcomes in clinical practice.