Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1
5-Year Impact Factor – 2.2
Scopus CiteScore – 3.4 (CiteScore Tracker 3.4)
Index Copernicus  – 161.11; MEiN – 140 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2010, vol. 19, nr 2, March-April, p. 251–255

Publication type: review article

Language: English

Fecal Markers in Inflammatory Bowel Disease

Markery zapalenia w kale w nieswoistych zapaleniach jelit

Katarzyna Neubauer1,, Robert Dudkowiak2,

1 Department of Gastroenterology and Hepatology, Wroclaw Medical University, Poland

2 Division of Dietetics, Department of Gastroenterology and Hepatology, Wroclaw Medical University, Poland

Abstract

A noninvasive, sensitive, and specific diagnostic tool to support differential diagnosis in patients with suspicion of inflammatory bowel disease (IBD), confirm an IBD, differentiate ulcerative colitis and Crohn’s disease, establish a prognosis of disease course, and evaluate response to therapy is still missing. Fecal markers constitute a promising alternative to currently available tests. The usefulness of fecal calprotectin and lactoferrin in clinical practice has been confirmed. These tests can serve to predict relapse in IBD and rule out IBD in undiagnosed symptomatic patients. Fecal calprotectin can support the differential diagnosis between IBS and IBD and distinguish disease flare from other causes of symptoms. This paper reviews the role of fecal markers associated with inflammation in inflammatory bowel disease.

Streszczenie

Wciąż poszukuje się nieinwazyjnego, czułego i swoistego narzędzia diagnostycznego, które mogłoby być stosowane w diagnostyce różnicowej u pacjentów z podejrzeniem nieswoistych zapaleń jelit (n.z.j.), w potwierdzaniu tego rozpoznania, różnicowaniu wrzodziejącego zapalenia jelita grubego i choroby Leśniowskiego-Crohna oraz prognozowaniu przebiegu choroby i ocenie odpowiedzi na leczenie. Obiecującą alternatywą dla obecnie dostępnych badań wydają się badania w kale substancji związanych z procesem zapalnym. Dotychczas potwierdzono przydatność w praktyce klinicznej badania kalprotektyny i laktoferyny w kale. Badanie to może służyć do przewidywania nawrotów choroby, wykluczania n.z.j. lub różnicowania między zaostrzeniem a objawami wywołanymi przez inne przyczyny. Artykuł omawia znaczenie badania stężenia różnych markerów zapalenia w kale w nieswoistych zapaleniach jelit.

Key words

inflammatory bowel disease, fecal markers, calprotectin, lactoferrin, S100A12

Słowa kluczowe

nieswoiste zapalenia jelit, markery w kale, kalprotektyna, laktoferyna, S100A12

References (29)

  1. Vermeire S, Van Assche G, Rutgeerts P: Laboratory markers in IBD: useful, magic, or unnecessary toys? Gut 2006, 55, 426–431.
  2. Pineton de Chambrun G, Peyrin-Biroulet L, Lémann M, Colombel JF: Clinical implications of mucosal healing for the management of IBD. Nat Rev Gastroenterol Hepatol 2010, 7, 15–29.
  3. Freezaazman HJ: Limitations in assessment of mucosal healing in inflammatory bowel disease. World J Gastroenterol 2010, 16, 15–20.
  4. Peterson CG, Eklund E, Taha Y, Raab Y, Carlson M: A new method for the quantification of neutrophil and eosinophil cationic proteins in feces: establishment of normal levels and clinical application in patients with inflammatory bowel disease. Am J Gastroenterol 2002, 97, 1755–1762.
  5. Foell D, Frosch M, Sorg C, Roth J: Phagocyte-specific calcium-binding S100 proteins as clinical laboratory markers in inflammation. Clin Chim Acta 2004, 344, 77–51.
  6. Foell D, Wittkowski H, Roth J: Monitoring disease activity by stool analyses: from occult blood to molecular markers of intestinal inflammation and damage. Gut 2009, 58, 859–868.
  7. Campeotto F, Butel MJ, Kalach N, Derrieux S, Aubert-Jacquin C, Barbot L, Francoual C, Dupont C, Kapel N: High faecal calprotectin concentrations in newborn infants. Arch Dis Child Fetal Neonatal Ed 2004, 89, 353–355.
  8. Foell D, Kucharzik T, Kraft M, Vogl T, Sorg C, Domschke W, Roth J: Neutrophil derived human S100A12 (EN-RAGE) is strongly expressed during chronic active inflammatory bowel disease. Gut 2003, 52, 847–853.
  9. Hayakawa T, Jin CX, Ko SB, Kitagawa M, Ishiguro H: Lactoferrin in gastrointestinal disease. Intern Med 2009, 48, 1251–1254.
  10. Gisbert JP, McNicholl AG, Gomollon F: Questions and answers on the role of fecal lactoferrin as a biological marker in inflammatory bowel disease. Inflamm Bowel Dis 2009, 15, 1746–1754.
  11. Sutherland AD, Geary RB, Frizelle FA: Review of fecal biomarkers in inflammatory bowel disease. Dis Colon Rectum 2008, 51, 1283–1291.
  12. Vieira A, Fang CB, Rolim EG, Klug WA, Steinwurz F, Rossini LG, Candelária PA: Inflammatory bowel disease activity assessed by fecal calprotectin and lactoferrin: correlation with laboratory parameters, clinical, endoscopic and histological indexes. BMC Res Notes 2009, 29, 2–221.
  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, 1851–1858.
  14. Schoepfer AM, Beglinger C, Straumann A, Trummler M, Vavricka SR, Bruegger LE, Seibold F: Fecal calprotectin correlates more closely with the Simple Endoscopic Score for Crohn’s disease (SES-CD) than CRP, blood leukocytes, and the CDAI. Am J Gastroenterol 2010, 105, 162–169.
  15. Lamb CA, Mohiuddin MK, Gicquel J, Neely D, Bergin FG, Hanson JM, Mansfield JC: Faecal calprotectin or lactoferrin can identify postoperative recurrence in Crohn’s disease. Br J Surg 2009, 96, 663–674.
  16. Kosiara M, Paradowski L: A new tool to describe inflammatory bowel disease activity? Gastroenterol Pol 2009, 16, 436–439.
  17. Wagner M, Peterson C GB, Ridefelt P, Sangfelt P, Carlson M: Fecal markers of inflammation used as surrogate markers for treatment outcome in relapsing inflammatory bowel disease. World J Gastroenterol 2008, 36, 5584–5589.
  18. Sipponen T, Björkesten CG, Färkkilä M, Nuutinen H, Savilahti E, Kolho KL: Faecal calprotectin and lactoferrin are reliable surrogate markers of endoscopic response during Crohn’s disease treatment. Scand J Gastroenterol 2010, 45, 325–331.
  19. Langhorst J, Elsenbruch S, Mueller T, Rueffer A, Spahn G, Michalsen A, Dobos GJ: Comparison of 4 Neutrophilderived Proteins in Feces as Indicators of Disease Activity in Ulcerative Colitis. Inflamm Bowel Dis 2005, 11, 1085–1091.
  20. Langhorst J, Elsenbruch S, Koelzer J, Rueffer A, Michalsen A, Dobos GJ: Noninvasive Markers in the Assessment of Intestinal Inflammation in Inflammatory Bowel Diseases: Performance of Fecal Lactoferrin, Calprotectin, and PMN-Elastase, CRP, and Clinical Indices. Am J Gastroenterol 2008, 103, 162–169.
  21. Dai J, Liu W-Z, Zhao Y-P, Hu Y-B, Ge Z-Z: Relationship between fecal lactoferrin and inflammatory bowel disease. Scand J Gastroenterol 2007, 42, 1440–1444.
  22. Sugi K, Saitoh O, Hirata I, Katsu K: Fecal lactoferrin as a marker for disease activity in inflammatory bowel disease: comparison with other neutrophil-derived proteins. Am J Gastroenterol 1996, 91, 927–934.
  23. Walker TR, Land ML, Kartashov A, Saslowsky TM, Lyerly DM, Boone JH, Rufo PA: Fecal Lactoferrin Is a Sensitive and Specific Marker of Disease Activity in Children and Young Adults With Inflammatory Bowel Disease. J Pediatr Gastroenterol Nutr 2007, 44, 414–422.
  24. Konikoff MR, Denson LA: Role of Fecal Calprotectin as a Biomarker of Intestinal Inflammation in Inflammatory Bowel Disease. Inflamm Bowel Dis 2006, 12, 524–534.
  25. De Jong NS, Leach ST, Day AS: Fecal S100A12: A Novel Noninvasive Marker in Children with Crohn`s Disease. Inflamm Bowel Dis 2006, 12, 566–572.
  26. Sidler MA, Leach ST, Day AS: Fecal S100A12 and Fecal Calprotectin as Noninvasive Markers for Inflammatory Bowel Disease in Children. Inflamm Bowel Dis 2008, 14, 359–366.
  27. Kaiser T, Langhorst J, Wittkowski H, Becker K, Friedrich AW, Rueffer A, Dobos GJ, Roth J, Foell D: Faecal S100A12 as a non-invasive marker distinguishing inflammatory bowel disease from irritable bowel syndrome. Gut 2007, 56, 1706–1713.
  28. Van Assche G, Dignass A, Panes J, Beaugerie L, Karagiannis J, Allez M, Ochsenkühn T, Orchard T, Rogler G, Louis E, Kupcinskas L, Mantzaris G, Travis SPL, Stange EF: for the European Crohn’s and Colitis Organisation (ECCO). The second European evidence-based consensus on the diagnosis and management of Crohn’s disease: Definitions and diagnosis. J Crohn’s Colitis 2010, 4, 7–27.
  29. Stange EF, Travis SPL, Vermeire S, Beglinger C, Kupcinskas L, Geboes K, Barakauskiene A, Villanacci V, Von Herbay A, Warren BF, Gasche C, Tilg H, Schreiber SW, Scholmerich J, Reinisch W: for the European Crohn’s and Colitis Organisation (ECCO). European evidence based consensus on the diagnosis and management of Crohn’s disease: definitions and diagnosis. Gut 2006, 55, 1–15.
© Wroclaw Medical University