The Relation Between Fecal Calprotectin and the Rate of Clinical Activity of Ulcerative Colitis

Authors

1 Gastroenterology and Hepatology Research Center,Mashhad University of Medical Sciences,Mashhad, Iran

2 Assistant Professor, Gastroenterology and Hepatology,Mashhad University of Medical Sciences,Mashhad, Iran

3 Corresponding a

4 Assistant Professor, Gastroenterology and Hepatology, Sabzevar University of Medical Sciences, Sabzevar, Iran

5 Assistant Professor of Microbiology, Sabzevar University of Medical Sciences, Sabzevar, Iran

6 Associate Professor, Gastroenterology and Hepatology,Mashhad University of Medical Sciences,Mashhad, Iran

7 Assistant Professor, Gastroenterology, Department of InternalMedicine,Mashhad Branch, Islamic Azad University,Mashhad, I

10.5812/rijm.14533

Abstract

Abstract Background: Inflammatory bowel disease is a disorder with unknown origin in which environment, genetics, and immunity play a part. Although colonoscopy and biopsy are expensive and invasive, are used to monitoring the mucosal inflammation. Fecal calprotectin is a non-invasive test which has attracted a lot of attention. We aimed to determine the relation of fecal calprotectin and clinical activity of ulcerative colitis. Methods: This cross-sectional study took place with the confirmation of ethics committee of Mashhad University of Medical Sci- ences in 2014 - 2015. Patients with diagnosis of ulcerative colitis were included; demographic information was recorded and clinical activity of disease was evaluated. Fecal calprotectin was measured by the quantitative ELISA method and results of laboratory studies and clinical examinations were analyzed by SPSS software version 16. Level of significance was considered less than 0.05. Results: Seventy patients were studied (male = 56%, average age = 38  15). 25 patients (36.2%) were newly diagnosed. The average period of disease was 4.1 ± 5 years. 25 individuals (35.7%) had mild, 19 individuals (27.1%) had moderate, and 26 individuals (37.1%) had severe disease. Averages of fecal calprotectin in mild, moderate, and severe disease were 132  111, 119  44 and 141  78 g/ g, respectively. Averages of fecal calprotectin in mild and moderate disease (P = 0.874), in mild and severe (P = 0.925) and in moderate and severe disease (P = 0.662) were not significantly different. Conclusions: Although fecal calprotectin in severe ulcerative colitis is higher, it has no relation with disease clinical activity.

Keywords


  1. 1.Moris G. Inflammatory bowel disease: an increased risk factor for neurologic complications. World J Gastroenterol. 2014;20(5):1228–37. doi: 10.3748/wjg.v20.i5.1228. [PubMed: 24574797].

    1. Ordas I, Eckmann L, Talamini M, Baumgart DC, Sandborn WJ. Ulcerative colitis. Lancet. 2012;380(9853):1606–19. doi: 10.1016/S0140- 6736(12)60150-0. [PubMed: 22914296].
    2. Mosli MH, Feagan BG, Sandborn WJ, D’Haens G, Behling C, Kaplan K, et al. Histologic evaluation of ulcerative colitis: a systematic review of disease activity indices. Inflamm Bowel Dis. 2014;20(3):564–75. doi: 10.1097/01.MIB.0000437986.00190.71. [PubMed: 24412993].
    3. Menees SB, Powell C, Kurlander J, Goel A, Chey WD. A meta-analysis of the utility of C-reactive protein, erythrocyte sedimentation rate, fecal calprotectin, and fecal lactoferrin to exclude inflammatory bowel disease in adults with IBS. Am J Gastroenterol. 2015;110(3):444–54. doi: 10.1038/ajg.2015.6. [PubMed: 25732419].
    4. Marie I, Leroi AM, Menard JF, Levesque H, Quillard M, Ducrotte P. Fecal calprotectin in systemic sclerosis and review of the literature. Autoimmun Rev. 2015;14(6):547–54. doi: 10.1016/j.autrev.2015.01.018. [PubMed: 25661980].
    5. Burri E, Beglinger C. The use of fecal calprotectin as a biomarker in gastrointestinal disease. Expert Rev Gastroenterol Hepatol. 2014;8(2):197–210. doi: 10.1586/17474124.2014.869476. [PubMed: 24345070].
    6. Mark F, Lawrence SF, Lawrence JB. Sleisenger and Fordtran‘s Gastrointestinal and liver disease. Pathophysiology/diagnosis/management. 2. 10th ed. United States of America: Elsevier Saunders; 2016. 2040 p. 8. Mao R, Xiao YL, Gao X, Chen BL, He Y, Yang L, et al. Fecal calprotectin in predicting relapse of inflammatory bowel diseases: a metaanalysis of prospective studies. Inflamm Bowel Dis. 2012;18(10):1894–9. doi: 10.1002/ibd.22861. [PubMed: 22238138].
    7. Bennike TB, Carlsen TG, Ellingsen T, Bonderup OK, Glerup H, Bogsted M, et al. Neutrophil Extracellular Traps in Ulcerative Colitis: A Proteome Analysis of Intestinal Biopsies. Inflamm Bowel Dis. 2015;21(9):2052–67. doi: 10.1097/MIB.0000000000000460. [PubMed: 25993694].
    8. Calafat M, Cabre E, Manosa M, Lobaton T, Marin L, Domenech E. High within-day variability of fecal calprotectin levels in patients with active ulcerative colitis: what is the best timing for stool sampling?. Inflamm Bowel Dis. 2015;21(5):1072–6. doi: 10.1097/MIB.0000000000000349. [PubMed: 25793326].
    9. Ferreiro-Iglesias R, Barreiro-de Acosta M, Otero Santiago M, Lorenzo Gonzalez A, Alonso de la Pena C, Benitez Estevez AJ, et al. Fecal Calprotectin as Predictor of Relapse in Patients With Inflammatory Bowel Disease Under Maintenance Infliximab Therapy. J Clin Gastroenterol. 2016;50(2):147–51. doi: 10.1097/MCG.0000000000000312. [PubMed: 25811118].
    10. Andrisani G, Guidi L, Papa A, Armuzzi A. Anti-TNF alpha therapy in the management of extraintestinal manifestation of inflammatory bowel disease. Eur Rev Med Pharmacol Sci. 2012;16(7):890–901. [PubMed: 22953637].
    11. Li Z, Long Y, Bai M, Li J, Feng Z. Neutrophil and Eosinophil Granule Proteins as Potential Biomarkers of Assessing Disease Activity and Severity in Patients With Ulcerative Colitis. J Clin Lab Anal. 2016;30(5):776–8. doi: 10.1002/jcla.21937. [PubMed: 27076259].
    12. Sandborn WJ, Panes J, Zhang H, Yu D, Niezychowski W, Su C. Correlation Between Concentrations of Fecal Calprotectin and Outcomes of Patients With Ulcerative Colitis in a Phase 2 Trial. Gastroenterology. 2016;150(1):96–102. doi: 10.1053/j.gastro.2015.09.001. [PubMed: 26376350].
    13. Schoepfer AM, Beglinger C, Straumann A, Trummler M, Renzulli P, Seibold F. Ulcerative colitis: correlation of the Rachmilewitz endoscopic activity index with fecal calprotectin, clinical activity, C-reactive protein, and blood leukocytes. Inflamm Bowel Dis. 2009;15(12):1851–8. doi: 10.1002/ibd.20986. [PubMed: 19462421].
    14. Kristensen V, Klepp P, Cvancarova M, Roseth A, Skar V, Moum B. Prediction of endoscopic disease activity in ulcerative colitis by two different assays for fecal calprotectin. J Crohns Colitis. 2015;9(2):164–9. doi: 10.1093/ecco-jcc/jju015. [PubMed: 25518057].
    15. Kotze LM, Nisihara RM, Marion SB, Cavassani MF, Kotze PG. FECAL CALPROTECTIN: levels for the ethiological diagnosis in Brazilian patients with gastrointestinal symptoms. Arq Gastroenterol. 2015;52(1):50–4. doi: 10.1590/S0004-28032015000100011. [PubMed: 26017083]. 4 Razavi Int J Med. 2018; 6(1):e14533. Vosoughinia H et al.
    16. Xiang JY, Ouyang Q, Li GD, Xiao NP. Clinical value of fecal calprotectin in determining disease activity of ulcerative colitis. World J Gastroenterol. 2008;14(1):53–7. [PubMed: 18176961].
    17. Lobaton T, Rodriguez-Moranta F, Lopez A, Sanchez E, RodriguezAlonso L, Guardiola J. A new rapid quantitative test for fecal calprotectin predicts endoscopic activity in ulcerative colitis. Inflamm Bowel Dis. 2013;19(5):1034–42. doi: 10.1097/MIB.0b013e3182802b6e. [PubMed: 23470502].