A gut vascular barrier damage-based scoring system predicts postoperative outcomes in Crohn’s disease

BACKGROUND: The gut vascular barrier (GVB) is essential for maintaining intestinal homeostasis. However, its role in patients undergoing surgery for Crohn's disease (CD) remains unclear. Thus, our study aimed to explore the association between GVB and disease severity and postoperative outcomes in CD patients, as well as to develop a scoring system to predict postoperative prognosis. METHODS: Endothelial plasmalemma vesicle-associated protein (PV-1) is a typical biomarker of GVB dysfunction. The expression of PV-1 was measured in intestinal mucosa of patients with Crohn's disease (CD) and controls scheduled for surgery. The correlation between PV-1 expression and clinical data was analyzed. Moreover, a scoring system based on PV-1 was developed to predict the postoperative outcomes. RESULTS: GVB damage was detected in CD patients. Levels of intestinal PV-1 expression were markedly higher in inflamed parts of CD patients than in non-inflamed parts and in control patients (both P < 0.05). Levels of PV-1 were positively correlated with preoperative disease activity indexes and postoperative clinical outcomes. Importantly, a new scoring system based on PV-1 was established to predict an adverse total postoperative prognosis or a longer length of stay, and it showed better discrimination (Areas under the receiver operating characteristic curves (AUCs) = 0.808, 0.902, P < 0.001). CONCLUSION: GVB damage was found in CD patients and was associated with the severity of disease and postoperative outcomes. A scoring system based on GVB damage is promising in predicting poor postoperative outcomes.