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Infliximab in pediatric inflammatory bowel disease rapidly decreases fecal calprotectin levels  [cached]
Anssi H?m?l?inen,Taina Sipponen,Kaija-Leena Kolho
World Journal of Gastroenterology , 2011, DOI: 10.3748/wjg.v17.i47.5166
Abstract: AIM: To study the response to infliximab in pediatric inflammatory bowel disease (IBD), as reflected in fecal calprotectin levels. METHODS: Thirty-six pediatric patients with IBD [23 Crohn’s disease (CD), 13 ulcerative colitis (UC); median age 14 years] were treated with infliximab. Fecal calprotectin was measured at baseline, and 2 and 6 wk after therapy, and compared to blood inflammatory markers. Maintenance medication was unaltered until the third infusion but glucocorticoids were tapered off if the patient was doing well. RESULTS: At introduction of infliximab, median fecal calprotectin level was 1150 μg/g (range 54-6032 μg/g). By week 2, the fecal calprotectin level had declined to a median 261 μg/g (P < 0.001). In 37% of the patients, fecal calprotectin was normal (< 100 μg/g) at 2 wk. By week 6, there was no additional improvement in the fecal calprotectin level (median 345 μg/g). In 22% of the patients, fecal calprotectin levels increased by week 6 to pretreatment levels or above, suggesting no response (or a loss of early response). Thus, in CD, the proportion of non-responsive patients by week 6 seemed lower, because only 9% showed no improvement in their fecal calprotectin level when compared to the respective figure of 46% of the UC patients (P < 0.05). CONCLUSION: When treated with infliximab, fecal calprotectin levels reflecting intestinal inflammation normalized rapidly in one third of pediatric patients suggesting complete mucosal healing.
The role of fecal calprotectin in investigating inflammatory bowel diseases
Erbayrak, Mustafa;Turkay, Cansel;Eraslan, Elife;Cetinkaya, Hulya;Kasapoglu, Benan;Bektas, Mehmet;
Clinics , 2009, DOI: 10.1590/S1807-59322009000500009
Abstract: introduction: invasive and non-invasive tests can be used to evaluate the activity of inflammatory bowel diseases. objective: the aim of the present study was to investigate the role of fecal calprotectin in evaluating inflammatory bowel disease activity and the correlation of fecal calprotectin with the erythrocyte sedimentation rate and c reactive protein values in inflammatory bowel disease. method: sixty-five patients affected with inflammatory bowel disease were enrolled. twenty outpatients diagnosed with inflammatory bowel disease comprised the control group. results: in the present study, all patients in the control group had an fecal calprotectin value lower than the cut-off point (50 mg/kg). conclusion: in conclusion, fecal calprotectin was found to be strongly associated with colorectal inflammation indicating organic disease. fecal calprotectin is a simple and non-invasive method for assessing excretion of macrophages into the gut lumen. fecal calprotectin values can be used to evaluate the response to treatment, to screen asymptomatic patients, and to predict inflammatory bowel disease relapses.
Inflammatory bowel disease activity assessed by fecal calprotectin and lactoferrin: correlation with laboratory parameters, clinical, endoscopic and histological indexes
Andrea Vieira, Chia Fang, Ernani Rolim, Wilmar Klug, Flávio Steinwurz, Lucio Rossini, Paulo Candelária
BMC Research Notes , 2009, DOI: 10.1186/1756-0500-2-221
Abstract: A total of 78 patients presenting inflammatory bowel disease were evaluated. Blood tests, the Crohn's Disease Activity Index (CDAI), Mayo Disease Activity Index (MDAI), and Crohn's Disease Endoscopic Index of Severity (CDEIS) were used for the clinical and endoscopic evaluation. Two tests were performed on the fecal samples, to check the levels of calprotectin and lactoferrin. The performance of these fecal markers for detection of inflammation with reference to endoscopic and histological inflammatory activity was assessed and calculated sensitivity, specificity, accuracy.A total of 52 patient's samples whose histological evaluations showed inflammation, 49 were lactoferrin-positive, and 40 were calprotectin-positive (p = 0.000). Lactoferrin and calprotectin findings correlated with C-reactive protein in both the CD and UC groups (p = 0.006; p = 0.000), with CDAI values (p = 0.043; 0.010), CDEIS values in DC cases (p = 0,000; 0.000), and with MDAI values in UC cases (p = 0.000).Fecal lactoferrin and calprotectin are highly sensitive and specific markers for detecting intestinal inflammation. Levels of fecal calprotectin have a proportional correlation to the degree of inflammation of the intestinal mucosa.Inflammatory Bowel Disease (IBD) includes Crohn's Disease (CD) and Ulcerative Colitis (UC). These are chronic idiopathic conditions, marked by recurrent episodes of inflammation of the gastrointestinal tract, interspersed with periods of remission. In order to determine the degree of inflammatory activity, it is of the utmost importance to monitor patient's clinical evolution and adjust their therapy [1].Various indexes are used to evaluate the activity of the disease, which differ from each other in terms of being more subjective (clinical), more objective (endoscopic-histological) or a combination of the two. However, despite the different indexes available, there is not yet any consensus in the literature as to which is the most valid. Laboratory parameters suc
Fecal Calprotectin Excretion in Preterm Infants during the Neonatal Period  [PDF]
Carole Rougé,Marie-José Butel,Hugues Piloquet,Laurent Ferraris,Arnaud Legrand,Michel Vodovar,Marcel Voyer,Marie-France de la Cochetière,Dominique Darmaun,Jean-Christophe Rozé
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0011083
Abstract: Fecal calprotectin has been proposed as a non-invasive marker of intestinal inflammation in inflammatory bowel disease in adults and children. Fecal calprotectin levels have been reported to be much higher in both healthy full-term and preterm infants than in children and adults.
A new tool to describe inflammatory bowel disease activity?
Ma?gorzata Kosiara,Leszek Paradowski
Polish Gastroenterology , 2009,
Abstract: Introduction: Rachmilewitz?s scale and Crohn?s Disease Activity Index (CDAI) are used to describe the activity level of ulcerative colitis and Crohn?s disease, respectively. However, these scales are not faultless, especially the CDAI. We are therefore looking for a better method to describe the activity of these diseases. Some studies reveled higher concentrations of fecal calprotectin in patients with active inflammatory bowel disease. Aim of the study: The aim of the study was to determine the usefulness of fecal calprotectin in describing the activity of ulcerative colitis and Crohn?s disease. Materials and methods: The study was carried out on a group of 60 patients with inflammatory bowel disease (ulcerative colitis or Crohn?s disease). Correlation between fecal calprotectin level and activity level of the diseases was assessed by Spearman?s rank correlation coefficient. Results: The concentration of fecal calprotectin correlated with the Rachmilewitz scale, but not with Crohn?s Activity Disease Index. Conclusions: Fecal calprotectin seems to be an objective parameter of inflammatory bowel disease activity level. This simple test can be helpful in determining the activity level of inflammatory bowel disease.
Utility of faecal calprotectin analysis in adult inflammatory bowel disease  [cached]
Lyn A Smith,Daniel R Gaya
World Journal of Gastroenterology , 2012, DOI: 10.3748/wjg.v18.i46.6782
Abstract: The inflammatory bowel diseases (IBD), Crohn’s disease and ulcerative colitis, are chronic relapsing, remitting disorders. Diagnosis, along with assessment of disease activity and prognosis present challenges to managing clinicians. Faecal biomarkers, such as faecal calprotectin, are a non-invasive method which can be used to aid these decisions. Calprotectin is a calcium and zinc binding protein found in the cytosol of human neutrophils and macrophages. It is released extracellularly in times of cell stress or damage and can be detected within faeces and thus can be used as a sensitive marker of intestinal inflammation. Faecal calprotectin has been shown to be useful in the diagnosis of IBD, correlates with mucosal disease activity and can help to predict response to treatment or relapse. With growing evidence supporting its use, over the last decade this faecal biomarker has significantly changed the way IBD is managed.
Diagnostic Value of Fecal Calprotectin and Serum MMP-9 in Diagnosing Disease Activity of Ulcerative Colitis  [PDF]
Ali Ghweil, Ashraf Khodeary, Shereen Philip Aziz
Open Journal of Gastroenterology (OJGas) , 2018, DOI: 10.4236/ojgas.2018.86026
Abstract: Background and Study Aim: Ulcerative colitis (UC) is a chronic, idiopathic inflammatory bowel disease characterized by remission of disease activity. Searching for laboratory markers which are simple, sensitive, specific and noninvasive is fundamental to assess the extent of inflammation, activity of the disease, evolution and prognosis which can be used to assess response to treatment and the possibility of relapse. Our aim of the work was to investigate the diagnostic role of fecal calprotectin and serum MMP-9 in determining the activity of ulcerative colitis. Patients and Methods: 71 patients were included in the study and fecal calprotectin, serum MMP-9, ESR and CRP were measured in these patients to determine the disease activity of ulcerative colitis. Results: Fecal calprotectin concentration in the patients with active UC was significantly higher than that in inactive disease and in controls (387.21 ± 44.07 μg/g vs 103.62 ± 119.67 μg/g, 12.44 ± 3.65 μg/g, p = 0.000). Serum MMP-9 was found to be higher in patients with active UC than in patients with inactive disease (11.02 ± 5.29 vs 4.01 ± 1.72 ng/ml, p = 0.000). A significant difference was also found in the patients with active UC of mild, moderate and severe degrees. Also, strong positive correlation was found between fecal calprotectin and serum MMP-9 and the severity of the disease. The area under the curve of the receiver operating characteristics (AUCROC) was 0.949 and 0.941 for fecal calprotectin and serum MMP-9 respectively. Conclusion: Fecal calprotectin and serum MMP-9 can be used to differentiate between active and inactive forms of UC.
Usefulness of Faecal Calprotectin Measurement in Children with Various Types of Inflammatory Bowel Disease
Marzena Komraus,Halina Wos,Sabina Wiecek,Maciej Kajor,Urszula Grzybowska-Chlebowczyk
Mediators of Inflammation , 2012, DOI: 10.1155/2012/608249
Abstract: Introduction. The aim of the study was to assess the usefulness of the FC measurement in children with various types of IBD and relation to the disease activity. Patients and Methods. 91 patients (49 boys: 53.85% and 42 girls: 46.15%, mean age: 13.38 years, range 6–18 years) were included in the analysis. Patients were divided into the groups: B1—24 children with CD, B2—16 patients with UC, and a group comprising 31 children with other types of colitis; the control group (K) comprised 20 healthy children. FC was assayed by ELISA method, using Phical test (Calpro). Results. The mean faecal calprotectin concentrations were higher in children with CD and UC as compared to healthy controls, patients with eosinophilic, lymphocytic, and nonspecific colitis. A positive correlation was observed between FC concentrations and the disease activity (the PCDAI scale, the Truelove-Witts Scale, and the endoscopic Rachmilewitz Index). Conclusion. It seems that the FC concentrations can be a useful, safe, and noninvasive test in children suspected for IBD, since FC concentration is higher in children with CD and UC than in patients with other inflammatory diseases.
Noninvasive methods in evaluation of inflammatory bowel disease: where do we stand now? An update
Turkay, Cansel;Kasapoglu, Benan;
Clinics , 2010, DOI: 10.1590/S1807-59322010000200015
Abstract: the inflammatory bowel diseases, consisting of crohn's disease, ulcerative colitis and indeterminate colitis, are distinguished by idiopathic and chronic inflammation of the digestive tract. the distinction between inflammatory bowel diseases and functional bowel disorders, such as irritable bowel syndrome, can be complex because they often present with similar symptoms. rapid and inexpensive noninvasive tests that are sensitive, specific and simple are needed to prevent patient discomfort, delay in diagnosis, and unnecessary costs. none of the current commercially available serological biomarker tests can be used as a stand-alone diagnostic in clinics. instead, these are used as an adjunct to endoscopy in diagnosis and prognosis of the disease.along these lines,, fecal lactoferrin and calprotectin tests seem to be one step further from other tests with larger number of studies, higher sensitivity and specificity and wider availability.
Pancreatitis-Associated Protein Does Not Predict Disease Relapse in Inflammatory Bowel Disease Patients  [PDF]
Tiago Nunes, Maria Josefina Etchevers, Maria Jose Sandi, Susana Pinó Donnay, Teddy Grandjean, Maria Pellisé, Julián Panés, Elena Ricart, Juan Lucio Iovanna, Jean-Charles Dagorn, Mathias Chamaillard, Miquel Sans
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0084957
Abstract: Background The pancreatitis-associated protein (PAP) is increased in the serum of active inflammatory bowel disease (IBD) patients and its levels seem to be correlated with disease activity. Our aim was to evaluate the usefulness of serum and fecal PAP measurements to predict relapse in patients with inactive IBD. Materials and Methods We undertook a 12-month prospective study that included 66 Crohn's disease (CD) and 74 ulcerative colitis (UC) patients. At inclusion, patients were in clinical remission, defined by a Harvey-Bradshaw (HB) Index≤4 (CD) or a partial Mayo Score (MS)<3 (UC), along with a normal serum C reactive protein (CRP) and fecal calprotectin. Patients were followed every 3 months. Blood and stool samples were collected and a clinical evaluation was performed at each visit. Serum PAP and CRP levels as well as fecal concentrations of PAP and calprotectin were assessed. Results Active CD patients had an increased mean serum PAP at the diagnosis of the flare (104.1 ng/ml) and 3 months prior to activity (22.68 ng/ml) compared with patients in remission (13.26 ng/ml), p<0.05. No significant change in serum PAP levels in UC and fecal PAP levels in CD and UC were detected during disease activity. In CD, serum PAP was a poor diagnostic predictor of disease activity, with an AUC of 0.69. In patients in remission, fecal PAP was barely detectable in UC compared with CD patients. Conclusion Serum PAP is increased only in active CD patients, but this marker does not predict disease activity. Inactive UC patients have marked low levels of PAP in fecal samples compared with CD patients.
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