Reviewer’s report
Title: Prostaglandin E-major urinary metabolite versus fecal immunochemical occult blood test as a
biomarker for patient with ulcerative colitis
Version: 1 Date: 01 Dec 2019
Reviewer: Isao Okayasu
Reviewer's report:
Please include all comments  for the authors in this  box rather than uploading your report as an
attachment. Please only upload as attachments annotated versions of manuscripts, graphs, supporting
materials or other aspects of your report which cannot be included in a text format.
Please overwrite this text when adding your comments to the authors.
Major comments
1.PGE-MUM reflects the inflammation status of a whole colon. Mucosal healing is important for
patients with UC to maintain remission. Accordingly, authors should show the correlation of PGE-
MUM or FIT to the sum of eMayo calculated from 6 segments (the cecum, ascending colon, transverse
colon, descending colon, sigmoid colon, and rectum) in Figs. 2, 3, 4, 5, 6. In fact, the better correlation
of PGE-MUM to the sum of eMayo than to the highest score of eMayo in pediatric patients with UC
was reported by Hagiwara et al (JPGN 2017). 
Analysis of correlation of PGE-MUM or FIT with histologic scores (histologic Matts score) may be
more attractive, if you have data. 
2.It can be also considered that eMayo 0 is defined as remission and eMayo 1 to 3 as active.
Could you check the difference of PGE-MUM or FIT between the group of eMayo 0 and the group of 1
to 3 in Fig. 6?
3.There  are  some  problems  regarding  the  significance  on  correlation  analysis  between  two
factors. I believe that r 0.5 is significant. 0.4< r <0.5 might be considered weak correlation. Would you ≧
ask a specialist of statistics to check statistical analysis?
Minor comments
1.Page 5, line 4. Ref 9 is the review article. Please use the original article (Arai Y ,  et al. J
Inflamm Bowel Dis 2014; 20: 1208) 
2.Page  7,  line  10.  Authors  wrote  that  urine  samples  were  obtained  on  the  morning  of  the
endoscopic examination. 
Didn't authors use pretreatment of endoscopy like laxative administration one day before endoscopy
which gives some influence to values of PGE-MUM? (Fujiwara M, et al. Digestion 2000; 61: 201) 
3.Description of Results is rather redundant. Please make them simple.
4.Page 12, line 41. Ref 10 is misleading.
5.Page 14, line 16, 26. PEG-MUM should be PGE-MUM
6.I recommend to authors adding numbers of cases in each group in Figs.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Yes
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Unable to assess
Are you able to assess any statistics in the manuscript or would you recommend an additional
statistical review?
If  an  additional  statistical  review  is  recommended,  please  specify  what  aspects  require  further
assessment in your comments to the editors.
I recommend additional statistical review
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
Declaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1. Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of this
manuscript, either now or in the future?
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose
financially from the publication of this manuscript, either now or in the future?
3. Do you hold or are you currently applying for any patents relating to the content of the
manuscript?
4. Have you received reimbursements, fees, funding, or salary from an organization that holds
or has applied for patents relating to the content of the manuscript?
5. Do you have any other financial competing interests?
6. Do you have any non-financial competing interests in relation to this paper?
If you can answer no to all of the above, write 'I declare that I have no competing interests' below. If
your reply is yes to any, please give details below.
I am one of members who have developed a method measuring PGE-MUM and keep its patent.
I agree to the open peer review policy of the journal. I understand that my name will be included on my
report to the authors and, if the manuscript is accepted for publication, my named report including any 
attachments I upload will be posted on the website along with the authors' responses. I agree for my 
report to be made available under an Open Access Creative Commons CC-BY license 
(http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments which I do not wish to 
be included in my named report can be included as confidential comments to the editors, which will not
be published.
I agree to the open peer review policy of the journal
Reviewer’s report
Title: Prostaglandin E-major urinary metabolite versus fecal immunochemical occult blood test as a
biomarker for patient with ulcerative colitis
Version: 1 Date: 01 Dec 2019
Reviewer: Isao Okayasu
Reviewer's report:
Please include all comments  for the authors in this  box rather than uploading your report as an
attachment. Please only upload as attachments annotated versions of manuscripts, graphs, supporting
materials or other aspects of your report which cannot be included in a text format.
Please overwrite this text when adding your comments to the authors.
Major comments
1.PGE-MUM reflects the inflammation status of a whole colon. Mucosal healing is important for
patients with UC to maintain remission. Accordingly, authors should show the correlation of PGE-
MUM or FIT to the sum of eMayo calculated from 6 segments (the cecum, ascending colon, transverse
colon, descending colon, sigmoid colon, and rectum) in Figs. 2, 3, 4, 5, 6. In fact, the better correlation
of PGE-MUM to the sum of eMayo than to the highest score of eMayo in pediatric patients with UC
was reported by Hagiwara et al (JPGN 2017). 
Analysis of correlation of PGE-MUM or FIT with histologic scores (histologic Matts score) may be
more attractive, if you have data. 
2.It can be also considered that eMayo 0 is defined as remission and eMayo 1 to 3 as active.
Could you check the difference of PGE-MUM or FIT between the group of eMayo 0 and the group of 1
to 3 in Fig. 6?
3.There  are  some  problems  regarding  the  significance  on  correlation  analysis  between  two
factors. I believe that r 0.5 is significant. 0.4< r <0.5 might be considered weak correlation. Would you ≧
ask a specialist of statistics to check statistical analysis?
Minor comments
1.Page 5, line 4. Ref 9 is the review article. Please use the original article (Arai Y ,  et al. J
Inflamm Bowel Dis 2014; 20: 1208) 
2.Page  7,  line  10.  Authors  wrote  that  urine  samples  were  obtained  on  the  morning  of  the
endoscopic examination. 
Didn't authors use pretreatment of endoscopy like laxative administration one day before endoscopy
which gives some influence to values of PGE-MUM? (Fujiwara M, et al. Digestion 2000; 61: 201) 
3.Description of Results is rather redundant. Please make them simple.
4.Page 12, line 41. Ref 10 is misleading.
5.Page 14, line 16, 26. PEG-MUM should be PGE-MUM
6.I recommend to authors adding numbers of cases in each group in Figs.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Yes
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Unable to assess
Are you able to assess any statistics in the manuscript or would you recommend an additional
statistical review?
If  an  additional  statistical  review  is  recommended,  please  specify  what  aspects  require  further
assessment in your comments to the editors.
I recommend additional statistical review
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
Declaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1. Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of this
manuscript, either now or in the future?
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose
financially from the publication of this manuscript, either now or in the future?
3. Do you hold or are you currently applying for any patents relating to the content of the
manuscript?
4. Have you received reimbursements, fees, funding, or salary from an organization that holds
or has applied for patents relating to the content of the manuscript?
5. Do you have any other financial competing interests?
6. Do you have any non-financial competing interests in relation to this paper?
If you can answer no to all of the above, write 'I declare that I have no competing interests' below. If
your reply is yes to any, please give details below.
I am one of members who have developed a method measuring PGE-MUM and keep its patent.
I agree to the open peer review policy of the journal. I understand that my name will be included on my
report to the authors and, if the manuscript is accepted for publication, my named report including any 
attachments I upload will be posted on the website along with the authors' responses. I agree for my 
report to be made available under an Open Access Creative Commons CC-BY license 
(http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments which I do not wish to 
be included in my named report can be included as confidential comments to the editors, which will not
be published.
I agree to the open peer review policy of the journal
Please review this paper.
user
Reviewer’s report
Title: Prostaglandin E-major urinary metabolite versus fecal immunochemical occult blood test as a
biomarker for patient with ulcerative colitis
Version: 1 Date: 01 Dec 2019
Reviewer: Isao Okayasu
Reviewer's report:
Please include all comments  for the authors in this  box rather than uploading your report as an
attachment. Please only upload as attachments annotated versions of manuscripts, graphs, supporting
materials or other aspects of your report which cannot be included in a text format.
Please overwrite this text when adding your comments to the authors.
Major comments
1.PGE-MUM reflects the inflammation status of a whole colon. Mucosal healing is important for
patients with UC to maintain remission. Accordingly, authors should show the correlation of PGE-
MUM or FIT to the sum of eMayo calculated from 6 segments (the cecum, ascending colon, transverse
colon, descending colon, sigmoid colon, and rectum) in Figs. 2, 3, 4, 5, 6. In fact, the better correlation
of PGE-MUM to the sum of eMayo than to the highest score of eMayo in pediatric patients with UC
was reported by Hagiwara et al (JPGN 2017). 
Analysis of correlation of PGE-MUM or FIT with histologic scores (histologic Matts score) may be
more attractive, if you have data. 
2.It can be also considered that eMayo 0 is defined as remission and eMayo 1 to 3 as active.
Could you check the difference of PGE-MUM or FIT between the group of eMayo 0 and the group of 1
to 3 in Fig. 6?
3.There  are  some  problems  regarding  the  significance  on  correlation  analysis  between  two
factors. I believe that r 0.5 is significant. 0.4< r <0.5 might be considered weak correlation. Would you ≧
ask a specialist of statistics to check statistical analysis?
Minor comments
1.Page 5, line 4. Ref 9 is the review article. Please use the original article (Arai Y ,  et al. J
Inflamm Bowel Dis 2014; 20: 1208) 
2.Page  7,  line  10.  Authors  wrote  that  urine  samples  were  obtained  on  the  morning  of  the
endoscopic examination. 
Didn't authors use pretreatment of endoscopy like laxative administration one day before endoscopy
which gives some influence to values of PGE-MUM? (Fujiwara M, et al. Digestion 2000; 61: 201) 
3.Description of Results is rather redundant. Please make them simple.
4.Page 12, line 41. Ref 10 is misleading.
5.Page 14, line 16, 26. PEG-MUM should be PGE-MUM
6.I recommend to authors adding numbers of cases in each group in Figs.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Yes
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Unable to assess
Are you able to assess any statistics in the manuscript or would you recommend an additional
statistical review?
If  an  additional  statistical  review  is  recommended,  please  specify  what  aspects  require  further
assessment in your comments to the editors.
I recommend additional statistical review
Quality of written English
Please indicate the quality of language in the manuscript:
Needs some language corrections before being published
Declaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1. Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of this
manuscript, either now or in the future?
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose
financially from the publication of this manuscript, either now or in the future?
3. Do you hold or are you currently applying for any patents relating to the content of the
manuscript?
4. Have you received reimbursements, fees, funding, or salary from an organization that holds
or has applied for patents relating to the content of the manuscript?
5. Do you have any other financial competing interests?
6. Do you have any non-financial competing interests in relation to this paper?
If you can answer no to all of the above, write 'I declare that I have no competing interests' below. If
your reply is yes to any, please give details below.
I am one of members who have developed a method measuring PGE-MUM and keep its patent.
I agree to the open peer review policy of the journal. I understand that my name will be included on my
report to the authors and, if the manuscript is accepted for publication, my named report including any 
attachments I upload will be posted on the website along with the authors' responses. I agree for my 
report to be made available under an Open Access Creative Commons CC-BY license 
(http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments which I do not wish to 
be included in my named report can be included as confidential comments to the editors, which will not
be published.
I agree to the open peer review policy of the journal
assistant