Faecal calprotectin in inflammatory bowel diseases: Review

##plugins.themes.academic_pro.article.sidebar##

Published May 6, 2011
Download
pdf
Vol. 89 No. 5 (2011): Issue May 2011

##plugins.themes.academic_pro.article.main##

Lamia Kallel
Monia Fekih
Jalel Boubaker
Azza Filali

Abstract

Background: The clinical course of inflammatory bowel disease (IBD) is characterised by a succession of relapses and remissions. A regular and a long term monitoring of such patients is required.
Faecal markers, especially calprotectin’s use, seem to be useful in these patients.
Faecal calprotectin is a reliable maker of intestinal inflammation in IBD. Its level is assessed by a simple and a non invasive test.
Aim: We proposed to review main indications and study results of faecal calprotectin test use in IBD patients.
Methods: Review of literature.
Results: Faecal calprotectin assessment isn’t an IBD specific test.
Selective use is required to have a good benefit-cost ratio. Prediction of relapses in asymptomatic patients as well as post operative reccurence seems to be the main indications for its use.
Conclusion :Mucosal healing assessment after anti-TNF treatment can also be an interesting indication although it isn’t well evaluated.

Keywords:

Crohn's disease, ulcerative coltis, calprotectin, faecal markers, inflammation, disease activity, relapse, recurrence

##plugins.themes.academic_pro.article.details##

References

  1. Poullis A, Foster R, Northfield TC, Mendall MA. Faecal markers in the assessment of activity in inflammatory bowel disease. Aliment Pharmacol Ther 2002; 16:675-81.
  2. Saverymuttu SH, Peters AM, Crofton ME, et al. 111 Indium autologous granulocytes in the detection of inflammatory bowel disease. Gut 1985; 26:955-60.
  3. Bjerke K, Halstensen TS, Jahnsen F, Pulford K, Brandtzaeg P. Distribution of macrophages and granulocytes expressing L1 protein calprotectin in human Peyer's patches compared with normal ileal lamina propria and mesenteric lymph nodes. Gut 1993; 34:1357-63.
  4. Bunn SK, Bisset WM, Main MJ, Golden BE. Fecal calprotectin as a measure of disease activity in childhood inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2001; 32:171-7.
  5. Røseth AG, Fagerhol MK, Aadland E, Schjønsby H. Assessment of the neutrophil dominating protein calprotectin in feces. A methodologic study. Scand J Gastroenterol 1992; 27:793-8.
  6. Voganatsi A, Panyutich A, Miyasaki KT, Murthy RK. Mechanism of extracellular release of human neutrophil calprotectin complex. J Leukoc Biol 2001; 70:130-4.
  7. Summerton CB, Longlands MG, Wiener K, Shreeve DR. Faecal calprotectin: a marker of inflammation throughout the intestinal tract. Eur J Gastroenterol Hepatol 2002; 14:841-5.
  8. Røseth AG, Schmidt PN, Fagerhol MK. Correlation between faecal excretion of indium-111-labelled granulocytes and calprotectin, a granulocyte marker protein, in patients with inflammatory bowel disease. Scand J Gastroenterol 1999; 34:50-4.
  9. Teahon K, Smethurst P, Levi AJ, Menzies IS, Bjarnason I. Intestinal permeability in patients with Crohn's disease and their first degree relatives. Gut 1992; 33:320-3.
  10. Konikoff MR, Denson LA. Role of fecal calprotectin as a biomarker of intestinal inflammation in inflammatory bowel disease. Inflamm Bowel Dis 2006; 12:524-34.
  11. Von Roon AC, Karamountzos L, Purkayastha S, et al. Diagnostic precision of fecal calprotectin for inflammatory bowel disease and colorectal malignancy. Am J Gastroenterol 2007; 102:803-13.
  12. Husebye E, Tøn H, Johne B. Biological variability of fecal calprotectin in patients referred for colonoscopy without colonic inflammation or neoplasm. Am J Gastroenterol 2001; 96:2683-7.
  13. Fagerberg UL, Lööf L, Merzoug RD, Hansson LO, Finkel Y. Fecal calprotectin levels in healthy children studied with an improved assay. J Pediatr Gastroenterol Nutr 2003; 37:468-72.
  14. Tibble JA, Sigthorsson G, Foster R et al. Use of surrogate markers of inflammation and Rome criteria to distinguish organic from nonorganic intestinal disease. Gastroenterology Gastroenterology 2002; 123:450-60.
  15. Costa F, Mumolo MG, Ceccarelli L et al. Calprotectin is a stronger predictive marker of relapse in ulcerative colitis than in Crohn's disease. Gut 2005; 54:364-8.
  16. Pardi DS, Sandborn WJ. Predicting relapse in patients with inflammatory bowel disease: what is the role of biomarkers? Gut 2005; 54:321-2.
  17. Lemann M, Mary JY. Calprotectin and IBD. Gut 2005; 54:1349-50.
  18. Orlando A, Modesto I, Castiglione F, et al. The role of calprotectin in predicting endoscopic post-surgical recurrence in asymptomatic Crohn's disease: a comparison with ultrasound. Eur Rev Med Pharmacol Sci 2006; 10:17-22.
  19. Scarpa M, D'Incà R, Basso D, et al. Fecal lactoferrin and calprotectin after ileocolonic resection for Crohn's disease. Dis Colon Rectum 2007;50:861-9.
  20. Kolho KL, Raivio T, Lindahl H, Savilahti E. Fecal calprotectin remains high during glucocorticoid therapy in children with inflammatory bowel disease. Scand J Gastroenterol 2006; 41:720-5.
  21. Aadland E, Fagerhol MK. Faecal calprotectin: a marker of inflammation throughout the intestinal tract. Eur J Gastroenterol Hepatol 2002; 14:823-5.
  22. Røseth AG, Aadland E, Grzyb K. Normalization of faecal calprotectin: a predictor of mucosal healing in patients with inflammatory bowel disease. Scand J Gastroenterol 2004; 39:1017-20.
  23. D'Incà R, Dal Pont E, Di Leo V, et al. Calprotectin and lactoferrin in the assessment of intestinal inflammation and organic disease. Int J Colorectal Dis 2007; 22:429-37.
  24. Gaya DR, Lyon TD, Duncan A, et al. Faecal calprotectin in the assessment of Crohn's disease activity. QJM 2005; 98:435-41.
  25. Langhorst J, Elsenbruch S, Mueller T et al. Comparison of 4 neutrophil-derived proteins in feces as indicators of disease activity in ulcerative colitis. Inflamm Bowel Dis 2005; 11:1085-91.
  26. Costa F, Mumolo MG, Bellini M, et al. Role of faecal calprotectin as non-invasive marker of intestinal inflammation. Dig Liver Dis 2003; 35:642-7.
  27. Casellas F, Borruel N, Antolín M, et al. Fecal excretion of deoxyribonucleic acid in long-term follow-up of patients with inactive ulcerative colitis. Inflamm Bowel Dis 2007; 13:386-90.
  28. Thomas P, Rihani H, Røseth A, et al. Assessment of ileal pouch inflammation by single-stool calprotectin assay. Dis Colon Rectum. 2000; 43:214-20.