Fecal lactoferrin as a new marker of disease activity in inflammatory bowel diseases

Background: Inflammatory bowel diseases [IBD] including ulcerative colitis [UC] and Crohn's disease [CD] are organic inflammatory diseases, caused by chronic mucosal inflammation of the gasrtointetinal tract. As the presenting manifestations of IBD and other diseases are similar, obtaining a clinical diagnosis can be difficult, and further invasive diagnostic procedures may be required in order to obtain a confirmed diagnosis. The aim of this study is to evaluate the diagnostic utility of measuring fecal concentrations of lactoferrin as a simple and noninvasive indicator of disease activity in patients IBD and to be correlated with endoscopic findings and disease activity index and acute inflammatory response including leucocytic count, high sensitive CRP, ESR

Methods: This study was carried on 40 patients with IBD; 24 patients with active IBD [16 UC patients and 8 CD patients] and 16 patients with inactive IBD [10 UC patients and 6 CD patients] versus 40 healthy controls. All patients underwent blood and stool sampling as well as an interview to assess the disease severity utilizing UC activity measured by the Truelove and Witts Severity Index and Crohn's Disease Activity Index. Measurement of FLA levels at different stages of inflammatory bowel disease activity to detect its role in assessment of disease severity

Results: This study showed that FLA levels were highest in patients with IBD in comparison with healthy group. FLA levels also correlated significantly with disease severity in patients with IBD where higher levels of FLA were found in patients with severe UC or Crohn's disease. At cutoff value 9.68 ug/ml FLA showed 100% sensitivity and specificity in identification of patients with IBD from healthy subjects

Conclusions: FLA is a sensitive and specific biochemical marker of inflammation for use in the diagnosis of suspected IBD cases, and its level correlates well with both clinical disease activity indices

Clinical Significance of Fecal Lactoferrin and Multiplex Polymerase Chain Reaction in Patients with Acute Diarrhea

BACKGROUND/AIMS: The diagnostic yield of fecal leukocyte and stool cultures is unsatisfactory in patients with acute diarrhea. This study was performed to evaluate the clinical significance of the fecal lactoferrin test and fecal multiplex polymerase chain reaction (PCR) in patients with acute diarrhea. METHODS: Clinical parameters and laboratory findings, including fecal leukocytes, fecal lactoferrin, stool cultures and stool multiplex PCR for bacteria and viruses, were evaluated prospectively for patients who were hospitalized due to acute diarrhea. RESULTS: A total of 54 patients were included (male, 23; median age, 42.5 years). Fecal leukocytes and fecal lactoferrin were positive in 33 (61.1%) and 14 (25.4%) patients, respectively. Among the 31 patients who were available for fecal pathogen evaluation, fecal multiplex PCR detected bacterial pathogens in 21 patients, whereas conventional stool cultures were positive in only one patient (67.7% vs 3.2%, p=0.000). Positive fecal lactoferrin was associated with presence of moderate to severe dehydration and detection of bacterial pathogens by multiplex PCR (21.4% vs 2.5%, p=0.049; 100% vs 56.5%, p=0.032, respectively). CONCLUSIONS: Fecal lactoferrin is a useful marker for more severe dehydration and bacterial etiology in patients with acute diarrhea. Fecal multiplex PCR can detect more causative organisms than conventional stool cultures in patients with acute diarrhea.

ASSESSMENT OF THE RESPONSE OF PATIENTS WITH CROHN'S DISEASE TO BIOLOGICAL THERAPY USING NEW NON-INVASIVE MARKERS: lactoferrin and calprotectin

Context The use of fecal markers to monitor Crohn's disease is crucial for assessing the response to treatment. Objective To assess the inflammatory activity of Crohn's disease by comparing fecal markers (calprotectin and lactoferrin), colonoscopy combined with biopsy, and the Crohn's disease activity index (CDAI), as well as serum markers, before treatment with infliximab, after the end of induction, and after the end of maintenance. Methods Seventeen patients were included who had been previously diagnosed with Crohn's disease and were using conventional treatment but required the introduction of biological therapy with infliximab. Each patient underwent a colonoscopy with biopsy, serum, and fecal (calprotectin and lactoferrin) tests to assess inflammatory activity, and CDAI assessments before treatment with infliximab, after induction (week 8), and after maintenance (week 32). Results The calprotectin levels exhibited significant reductions (P = 0.04) between the assessment before treatment with infliximab and the end of induction, which did not occur after the end of the maintenance phase. Lactoferrin remained positive throughout the three phases of the study. Regarding the histological assessment, a significant difference was found only between the assessment before treatment and after the end of maintenance (P = 0.036), and 60% of the patients exhibited histological improvements after the completion of the follow-up period. The CDAI exhibited a significant difference between the assessment before treatment with infliximab and after induction, as well as before treatment and after maintenance (P<0.01). Conclusion Calprotectin and lactoferrin are not useful for monitoring inflammatory activity in Crohn's disease patients who are subjected to biological therapy. .

Contexto O uso de marcadores fecais para a monitorização da doença de Crohn é muito importante para a avaliação da resposta ao tratamento instituído. Objetivo Avaliar a atividade inflamatória da doença de Crohn comparando os marcadores fecais (calprotectina e lactoferrina), colonoscopia com biópsias, Crohn's Disease Activity Index (CDAI) e marcadores séricos antes do uso do Infliximabe, após a fase de indução e após a fase de manutenção. Método Foram incluídos 17 pacientes com diagnóstico prévio de doença de Crohn, que faziam uso da terapia convencional, mas que necessitaram da introdução da terapia biológica: Infliximabe. Esses pacientes realizaram colonoscopias com biópsias, exames de atividade inflamatória sérica, fecal (calprotectina e lactoferrina) e análise do CDAI nas fases pré Infliximabe, pós indução (semana 8) e pós manutenção (semana 32). Resultados Houve queda significativa (P = 0,04) da calprotectina entre as fases pré Infliximabe e pós indução, o mesmo não ocorrendo após a fase de manutenção. A lactoferrina manteve-se positiva nas três fases do estudo. Na análise histológica, houve diferença significativa apenas entre as fases pré Infliximabe e pós manutenção (P = 0,036), com 60% dos pacientes apresentando melhora histológica após o período de acompanhamento. O CDAI apresentou diferença significativa entre as fases pré Infliximabe e pós indução e entre as fases pré Infliximabe e pós manutenção (P<0,01). Conclusão A calprotectina e a lactoferrina não foram capazes de monitorizar a atividade inflamatória ...

Differential expression of salivary glycoproteins in aggressive and chronic periodontitis

OBJECTIVES:The aim of this study was to compare the pattern of secretion and the expression of mucin glycoprotein-2 (MG2) and lactoferrin in individuals with or without periodontitis. MATERIAL AND METHODS: Five individuals with aggressive periodontitis (APG), 5 with generalized chronic periodontitis (CPG) and 5 without periodontitis (CG) were enrolled after informed consent. Non-stimulated and stimulated submandibular and sublingual saliva was collected and samples analyzed by Western blot probed with specific antibodies. RESULTS: Stimulated and non-stimulated salivary flow rates did not differ among groups. Western blot analysis revealed that stimulation led to: an increase in MG2 expression in all groups, and to lactoferrin expression in APG and CPG. In non-stimulated saliva, CG exhibited the highest expression of both glycoproteins. In stimulated saliva, CG exhibited the highest expression of MG2, whereas APG the highest of lactoferrin. CONCLUSIONS: The pattern of secretion of MG2 and lactoferrin in health and disease is complex. Although the present study analyzed samples from a limited number of participants, the reduced expression of MG2 and lactoferrin in APG and CPG under non-stimulated condition, the predominant circumstance of salivary secretion during the day, suggests that these salivary constituents may play a role in the etiopathogenesis of these diseases.

The stress of weaning influences serum levels of acute-phase proteins, iron-binding proteins, inflammatory cytokines, cortisol, and leukocyte subsets in Holstein calves

The purpose of our study was to investigate changes in immunological parameters induced by weaning stress (including milk restriction) in calves. Fifteen Holstein calves were subjected to weaning at 6 weeks of age. Blood samples were collected at -14, -7, -2, 1, 3, and 5 days post-weaning (DPW; 0 DPW = 42 days). Weaning caused significant (p < 0.01) increases in the neutrophil (NE):lymphocyte (LY) ratio at 5 DPW with a significant (p < 0.05) reduction of LYs. The concentration of acute-phase proteins (haptoglobin and serum amyloid A) also increased significantly (p < 0.05) at 3 and 5 DPW compared to -2 DPW. Levels of the iron-binding protein lactoferrin decreased significantly (p < 0.05) after weaning. Serum tumor necrosis factor-alpha and cortisol levels were elevated (p < 0.05) at 3 DPW, while those of serum interferon-gamma decreased (p < 0.05) at 1 and 3 DPW compared to levels observed before weaning. Weaning significantly (p < 0.05) decreased the percentage of CD25+ T cells in the peripheral blood. In conclusion, weaning stress affected the NE:LY ratio along with the levels of acute phase proteins, lactoferrin, cortisol, and inflammatory cytokines in the peripheral blood of calves. Weaning stress may induce an acute phase response possibly through the elevation of cortisol production and modulation of inflammatory cytokines.

Elevated free tear lactoferrin levels in leprosy are associated with Type 2 reactions.

PURPOSE: To determine the association of demographics, leprosy and ocular characteristics with altered levels of lactoferrin in the tears of normal subjects and leprosy patients, and to detect the presence of antibodies to lactoferrin in these tear samples. METHOD: We collected light-stimulated tears from 298 leprosy patients and an equal number of normal subjects using the glass capillary method. Free lactoferrin levels were estimated using ELISA and the presence of antibodies to lactoferrin was detected using the immuno-blotting method. Significant associations were looked for between tear lactoferrin levels and demographic characteristics, leprosy characteristics such as type of disease, duration of disease, reactions, deformity and bacterial load, and ocular complications, using chi-square and regression analysis. RESULTS: Tear lactoferrin levels with a mean (SD) of 2.55 (2.83)mg/ml in the control group were significantly different (P<0.000) from leprosy patients with a smean (SD) of 5.66 (7.21)mg/ml. Age showed an inverse correlation with tear lactoferrin levels in controls. Increased bacterial load, grade 2 leg deformity and Type 2 reactions were significantly associated (P<0.05) with increased tear lactoferrin levels. Type 2 reactions remained significantly associated (P=0.01) on multiple regression analysis. Tear lactoferrin levels were not associated with gender, serum lactoferrin levels, Type 1 reactions, face patches, treatment status, orbicularis oculi weakness, lagophthalmos, ectropion, entropion, corneal opacity, cataract and iridocyclitis. CONCLUSION: Age is inversely related to tear lactoferrin levels in normal subjects. Free lactoferrin levels in tears are significantly higher in leprosy patients compared with normal controls. Type 2 reactions in leprosy are significantly associated with elevated tear lactoferrin levels.

Simultaneous assays for Clostridium difficile and faecal lactoferrin in ulcerative colitis.

Infectious agents may be one of the important factors in initiating or perpetuating ulcerative colitis. Increasing evidence has accumulated regarding the role of Clostridium difficile (C. difficile) infection in the exacerbation of ulcerative colitis. The present work was undertaken to study the implications of C. difficile toxin (CDT) and faecal lactoferrin (FL) positivity in patients with idiopathic ulcerative colitis (IUC) in a north Indian hospital. Ninety-four faecal samples from patients of IUC were processed for CDT and FL simultaneously. Clinical details of patients, including antibiotic intake in the past 6 weeks, were recorded. Eighty-one of the 94 patients (86.2%) had diarrhoea and 48 (51.1%) had received antibiotics. There was a statistically significant (p < 0.001) increase in the prevalence of diarrhoea among individuals receiving antibiotics. Twelve of the 94 samples (12.8%) were CDT positive while 16 were FL positive. No statistical significance (p > 0.05) was seen while comparing the positivity of CDT and FL in relation to the receipt of antibiotics. A statistically significant (p < 0.001) positive correlation was present between CDT and FL assays. FL positivity in IUC may depend on the intestinal inflammation precipitated by C. difficile infection.

Estudo da lactoferrina na saliva gengival de pacientes infectados pelo HIV / Lactoferrin study in saliva and gingival fluids in HIV-infected patients

Introdução: Esta pesquisa foi realizada para investigar a concentração de LF na salivas parotídea e total e no fluído gengival, e correlacionar estes resultados a complicações bucais como candidíase bucal e doença periodontal em pacientes infectados e não-infectados pelo HIV. Métodos: Vinte e oito adultos infectados pelo HIV e dez não-infectados foram selecionados. Consentimentos livres e informados foram obtidos para todos. Os pacientes incluídos apresentavam doença periodontal definida como pelo menos um sítio com profundidade de bolsa à sondagem de ≥ 5 milímetros. Foram coletados esfregaços para exame citopatológico da mucosa bucal e placa subgengival e também fluído gengival das bolsas periodontais rasas e profundas, saliva total não-estimulada e saliva parotídea. Resultados: Indivíduos infectados pelo HIV, com ou sem AIDS, mostraram um maior percentual de fungos cultivados da mucosa bucal e subgengival quando comparados aos pacientes não-infectados. Evidência clínica de candidíase bucal estava significativamente associada à carga viral. Observou-se uma elevação não-significativa na concentração de LF na salivas total e parotídea nos pacientes infectados pelo HIV. Nos pacientes infectados com alta carga viral foi evidenciado aumento significativo de concentração de LF na saliva parotídea. Embora não significativa, a concentração de LF estava diminuída nos pacientes com AIDS. Conclusões: Nossos resultados confirmam que a concentração de LF não está diretamente relacionada à prevalência de candidíase bucal. Adicionalmente, duas importantes tendências tornaram-se evidentes: 1) a tendência de concentração elevada de LF nas salivas parotídea e total durante a progressão da doença pelo HIV-1; 2) redução na concentração de LF no fluído gengival, especialmente nos pacientes com AIDS. Estas duas tendências reforçam a necessidade de investigações futuras sobre o papel da LF na progressão da doença periodontal e doença de glândula salivar associadas com ...

Faecal lactoferrin assay as an adjunct to Clostridium difficile diarrhoea.

Inflammation is the hallmark of Clostridium difficile associated diarrhoea and lactoferrin is produced by inflammatory cells. The aim of this study was to find out whether faecal lactoferrin latex agglutination (FLLA) assay done simultaneously with Clostridium difficile toxin (CDT) assay would help in the diagnosis of C. difficile infection in paediatric patients. One hundred and fifty faecal samples were obtained from paediatric group of patients. Both FLLA and CDT assays were done in conjunction on these samples. The data were expressed by descriptive statistics. One hundred and nineteen patients received antibiotics while 31 did not receive it. Of the former group 89 (74.8%) had diarrhoea while 30 (25.2%) did not have it. No significant relationship (p=0.287) was seen between antibiotic usage and occurrence of diarrhoea. However, CDT positivity was seen to be influenced by prior antibiotic usage as 51 (42.9%) patients receiving antibiotics were CDT positive when compared to 4 (7.3%) of those who did not receive antibiotics (p=0.002). A highly statistically significant (p<0.001) relationship was seen between CDT and FLLA positivity. FLLA appears to be an useful adjunct for C. difficile associated intestinal diseases in children when both the tests are done simultaneously and when other enteropathogens causing inflammatory diarrhoeas are ruled out.

Use of lactoferrin assay in the diagnosis of different vaginal pathogens

Local cell mediated immunity is more important than systemic immunity for protection against different vaginal pathogens. The predominant inflammatory cells in vaginal pool are almost exclusively polymorphonuclear neutrophils [PMN] which were varied according to the type of vaginal pathogens, lactoferrin is an iron binding glycoprotein found in the secondary granules of PMN. In order to determine the usefulness of such marker for neutrophilic activity in different vaginal infections, we examined the vaginal discharge using antilactoferrin antibodies [lactoferrin latex agglutination test: LFLA].Against different gold standard techniques. Our results demonstrated that Trichomonas vaginalis [T.V] revealed a high lactoferrin titer which was positively correlated with the number of PMN. In addition, cases with vaginal candidiasis [V.C] was characterized by mild inflammatory process as expressed by mild lactoferrin level which was also correlated with the PMN count. However, a paradoxic finding was observed in discharge recovered from cases with bacterial vaginosis [B.V] where lactoferrin titer was not correlated with PMN count. In addition, the findings of the present work indicated that LFLA was sensitive and specific when used alone and its sensitivity was increased after coupling with other simple methods as pH determination or amin test. In conclusion, our results described the feasibility of using LFLA as a simple, extremely sensitive, reliable method in distinguishing different types of vaginal pathogens, so it could be used as a promising method for a widespread community screening to diagnose population of females at risk

Prenatal development of human major salivary glands. Histological and immunohistochemical characteristics with reference to adult and neoplastic salivary glands

No abstract available.

Repercussöes do tratamento ultra-sônico sobre os glóbulos de gordura, a autolipólise, o conteúdo de imunoglobulinas A e G, a lactoferrina e bactérias do leite humano

Com a finalidade de minimizar as perdas de gordura durante a administraçäo do leite humano, estudou-se um método de homogeneizaçäo do leite por intermédio da aplicaçäo de vibraçöes ultrasônicas. Em quatro minutos as vibraçöes foram capazes de reduzir o tamanho dos glóbulos de gordura do leite, tornando-os estáveis em soluçäo e evitando variaçöes de concentraçäo e perda de gordura durante a sua administraçäo. Quando a homogeneizaçäo foi realizada em temperaturas menores que 45-C, ocorreu ativaçäo da lipólise do leite, independentemente da presença de sal biliar e näo houve alteraçäo no conteúdo de IgA, Lactoferrina e bactérias das amostras. Homogeneizaçäo com temperaturas maiores que 55-C, inibiu a lipólise mesmo em presença de sal biliar, reduziu a quantidade de IgA, IgG e esterelizou a maioria das amostras. A simplicidade e confiabilidade do método levam a se sugerir que pesquisas clínicas passem a ser desenvolvidas, visando averiguar, na prática clínica, as vantagens ou näo da alimentaçäo do pré-termo com leite humano homogeinizado