Calprotectina fecal: utilidad en el diagnóstico diferencial de enfermedad inflamatoria intestinal y síndrome intestino irritable en adultos / Fecal Calprotectin: utility in the differential diagnosis of inflammatory bowel disease and irritable bowel syndrome in adults

Differentiation between inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) can be complex as their symptoms are often similar and unspecific. Fecal biomarkers could be useful to select patients with suspected organic diseases for colonoscopy, with the aim to improve early diagnosis and to avoid unnecessary invasive studies. Fecal calprotectin (FC) is a protein found mainly in neutrophils that is released into the feces as a result of cell disruption and apoptosis. Currently, FC is a simple and non-invasive biomarker of intestinal inflammation. Inflammatory gastrointestinal disorders are associated with high levels of FC, as occurs in IBD. This review focuses on FC as a useful tool for differential diagnosis between IBS and IBD in adults. (AU)

Terapia de inducción acelerada con infliximab en paciente con colitis ulcerosa grave refractaria a corticoides: caso clínico / Acute severe ulcerative colitis treated with accelerated infliximab induction: case report

Acute severe ulcerative colitis (ASUC) is a potentially life-threatening condition that requires early recognition, hospitalization and adequate treatment. Currently, the use of infliximab in ulcerative colitis (UC) is recommended in the case of severe disease refractory to corticosteroids, once that superimposed bacterial or viral infections (such as cytomegalovirus or Clostridium difficile) have been excluded. However, conventional weight-based regimens of infliximab might be insufficient for patients with ASUC. Accelerated infliximab induction regimen may increase its serum concentration levels and efficacy by reducing early colectomy rates in these patients. We report a 34 year old female presenting with an ASUC. She was initially treated with hydrocortisone 300 mg/day and mesalazine enemas 4 g/day with an unfavorable clinical response. At the fifth day of therapy, an accelerated induction therapy with infliximab was started in doses of 10 mg/kg at weeks 0, 1 and 4. After the second dose, there was a favorable response with reduction of abdominal pain, stool frequency and hematochezia. She was discharged with prednisone and azathioprine. After a year of starting infliximab, the patient remains in clinical remission.

Fecal Calprotectin Level Reflects the Severity of Clostridium difficile Infection

Clostridium difficile is a significant nosocomial and community-acquired pathogen, and is the leading cause of antibiotic-induced diarrhea associated with high morbidity and mortality. Given that the treatment outcome depends on the severity of C. difficile infection (CDI), we aimed to establish an efficient method of assessing severity, and focused on the stool biomarker fecal calprotectin (FC). FC directly reflects the intestinal inflammation status of a patient, and can aid in interpreting the current guidelines, which requires the integration of indirect laboratory parameters. The distinction of 80 patients with CDI versus 71 healthy controls and 30 severe infection cases versus 50 mild cases was possible using FC as a marker. The area under the receiver operating characteristic curves were 0.821 and 0.746 with a sensitivity of 75% and 70% and specificity of 79% and 80%, for severe versus mild cases, respectively. We suggest FC as a predictive marker for assessing CDI severity, which is expected to improve the clinical management of CDI.

Fecal calprotectin levels in preterm infants with and without feeding intolerance / Níveis de calprotectina fecal em neonatos prematuros com e sem intolerância alimentar

Abstract Objectives: To assess the level of fecal calprotectin in preterm neonates with feeding intolerance, as well as to evaluate it as a marker of feeding intolerance and to determine a cut-off level of fecal calprotectin in feeding intolerance. Methods: Analytical, multicenter, case-control study, which was carried out in neonatal intensive care units in Egypt, in a period from August 1, 2014 to March 1, 2015 on 52 preterm neonates. Neonates were classified into two groups; a study group including 26 neonates who met inclusion criteria and a control group including 26 neonates for comparison. Results: Fecal calprotectin levels ranged from 3.9 µg/g to 971.8 µg/g, and there was a significant increase in fecal calprotectin in the study group when compared to the control group (334.3 ± 236.6 µg/g vs. 42.0 ± 38.2 µg/g, respectively) with moderate inverse significant correlation between fecal calprotectin and birth weight. Furthermore, there was moderate, significant correlation between fecal calprotectin and duration of breastfeeding range. On the other hand, there was no correlation between fecal calprotectin and post-natal age, gestational age, or volume of feeding. A cut-off at the 67.0 µg/g level, with 100.0% sensitivity and 76.9% specificity, was considered. Conclusion: Fecal calprotectin level increased significantly in neonates with feeding intolerance; it can be used to detect early cases with necrotizing enterocolitis in neonates, but this subject still needs more investigations on more patients.

Resumo Objetivos Avaliar o nível de calprotectina fecal em neonatos prematuros com intolerância alimentar, além de avaliá-lo como um indicador de intolerância alimentar e determinar um nível de corte da calprotectina fecal na intolerância alimentar. Métodos Estudo caso-controle analítico, feito em um multicentro de unidades de terapia intensiva neonatais no Egito, de 1° de agosto de 2014 a 1° de março de 2015, com 52 neonatos prematuros. Os neonatos foram classificados em dois grupos; um grupo de estudo incluindo 26 neonatos que atenderam aos critérios de inclusão e um grupo de controle incluindo 26 neonatos para comparação. Resultados Os níveis de calprotectina fecal variaram de 3,9 µg/g a 971,8 µg/g e houve um aumento significativo da calprotectina fecal no grupo de estudo quando comparado com o grupo de controle (334,3 ± 236,6 µg/g em comparação com 42,0 ± 38,2 µg/g, respectivamente) com correlação inversa, moderada e significativa entre a calprotectina fecal e o peso ao nascer. Adicionalmente, houve correlação moderada significativa entre a calprotectina fecal e a duração do intervalo de amamentação. Por outro lado, não houve correlação entre a calprotectina fecal e a idade pós-natal, a idade gestacional ou o volume de amamentação. Foi considerado um corte nos níveis de 67,0 µg/g; com sensibilidade de 100,0% e especificidade de 76,9%. Conclusão O nível de calprotectina fecal aumentou significativamente em neonatos com intolerância alimentar e podemos usá-lo para detectar casos precoces com enterocolite necrosante em neonatos, porém ainda são necessárias mais investigações em mais pacientes.’.

Colitis linfocítica en paciente con colitis ulcerosa: caso clínico / Lymphocytic colitis in a patient with ulcerative colitis: report of one case

The relationship between Microscopic Colitis and Inflammatory Bowel Disease is unclear. However, when both are diagnosed they seem to be part of a broader spectrum of the same disease, more than just a coincidence. We report a 55 years old woman with Ulcerative Colitis limited to the rectum with complete clinical and endoscopic response to standard treatment and adequate surveillance for 13 years, who abandoned treatment and control. After eight years, she consulted for mild-to-moderate non-bloody diarrhea lasting several months. Colonoscopy and basic laboratory did not show any alterations. Nevertheless, random biopsies had a characteristically pattern compatible with Lymphocytic Colitis. After the first week of treatment with budesonide the patient was asymptomatic and still in clinical remission, with negative fecal calprotectin at 6 months’ follow-up.

Semiquantitative fecal calprotectin test in postinfectious and non-postinfectious irritable bowel syndrome: cross-sectional study / Teste calprotectina fecal semiquantitativa na síndrome do intestino irritável pós-infecciosa e não pós-infecciosa: estudo transversal

CONTEXT AND OBJECTIVE:The presence of a certain degree of inflammation in the gut wall is now accepted in irritable bowel syndrome (IBS). Fecal calprotectin is considered to be a reliable test for detecting intestinal inflammation. Our aim was to assess the presence of inflammation in postinfectious IBS (PI-IBS), compared with non-postinfectious IBS (NPI-IBS). A secondary objective was to determine the usefulness of a rapid fecal calprotectin test in inflammatory bowel diseases (IBD).DESIGN AND SETTING:This was a cross-sectional study. Patients with IBS and IBD at a single tertiary gastroenterology center were prospectively included in this study.METHODS:116 patients with Rome III IBS score (76 females; 48 ± 12 years) were investigated; 24 patients (15 females) had PI-IBS. Intestinal inflammation was assessed using the semiquantitative fecal calprotectin test. The results were expressed as T1, T2 or T3 according to the severity of inflammation (< 15 μg/g; 15-60 μg/g; > 60 μg/g). Using the same test, we evaluated 20 patients with IBD (12 males; 47 ± 13 years).RESULTS:None of the patients with IBS had a T2 or T3 positive test. Among PI-IBS patients, 33% had a T1 positive test. Among NPI-IBS patients, 9.8% had a T1 positive test, which was significantly different to PI-IBS. The calprotectin test was positive in all IBD patients: 80% with T3, 10% with T2 and 10% with T1.CONCLUSIONS:Using a semiquantitative test for fecal calprotectin, positive tests were more frequent in PI-IBS patients than in NPI-IBS patients.

CONTEXTO E OBJETIVO:A presença de certo grau de inflamação na parede do intestino é agora aceita na síndrome do intestino irritável (SII). A calprotectina fecal é considerada teste confiável para detectar inflamação intestinal. Nosso objetivo foi avaliar a presença de inflamação na SII pós-infecciosa (SII-PI), em comparação com a SII não pós-infecciosa (SII-NPI). Um objetivo secundário foi determinar a utilidade de um teste rápido fecal da calprotectina em doenças inflamatórias intestinais (DII).TIPO DE ESTUDO E LOCAL:Este foi um estudo transversal. Pacientes com SII e DII em um único centro terciário de gastroenterologia foram prospectivamente incluídos neste estudo.MÉTODOS:116 pacientes com escore Roma III de SII (76 mulheres, 48 ± 12 anos) foram investigados; 24 pacientes (15 mulheres) tinham SII-PI. Inflamação intestinal foi avaliada pelo teste semi-quantitativo de calprotectina fecal. Os resultados foram expressos como T1, T2 ou T3 de acordo com a gravidade da inflamação (< 15 μg/g; 15-60 mg/g; > 60 mg/g). Usando o mesmo teste, foram avaliados 20 pacientes com DII (12 homens, 47 ± 13 anos).RESULTADOS:Nenhum dos pacientes com SII teve um teste positivo T2 ou T3. Na PI-IBS, 33% tiveram um teste positivo T1. Entre os pacientes SII-NPI, teste T1 positivo estava presente em 9,8%, taxa significativamente diferente quando comparada com SII-PI. O teste de calprotectina foi positivo em todos os pacientes com DII: 80% com T3, 10% com T2 e 10% com T1.CONCLUSÕES:Usando teste semi-quantitativo para calprotectina fecal, relatamos positividade em pacientes SII-PI com mais frequência que em pacientes SII-NPI.

FECAL CALPROTECTIN: levels for the ethiological diagnosis in Brazilian patients with gastrointestinal symptoms / Calprotectina fecal: níveis para o diagnóstico etiológico em pacientes brasileiros com sintomas gastrointestinais

Background Determination of fecal calprotectin can provide an important guidance for the physician, also in primary care, in the differential diagnosis of gastrointestinal disorders, meanly between inflammatory bowel diseases and irritable bowel syndrome. Objectives The aims of the present study were to prospectively investigate, in Brazilian adults with gastrointestinal complaints, the value of fecal calprotectin as a biomarker for the differential diagnosis between functional and organic disorders and to correlate the concentrations with the activity of inflammatory bowel diseases. Methods The study included consecutive patients who had gastrointestinal complaints in which the measurement levels of fecal calprotectin were recommended. Fecal calprotectin was measured using a Bühlmann (Basel, Switzerland) ELISA kit Results A total of 279 patients were included in the study, with median age of 39 years (range, 18 to 78 years). After clinical and laboratorial evaluation and considering the final diagnosis, patients were allocated into the following groups: a) Irritable Bowel Syndrome: 154 patients (102 female and 52 male subjects). b) Inflammatory Bowel Diseases group: 112 patients; 73 with Crohn’s disease; 38 female and 35 male patients; 52.1% (38/73) presented active disease, and 47.9% (35/73) had disease in remission and 39 patients with ulcerative colitis;19 female and 20 male patients; 48.7% (19/39) classified with active disease and 49.3% (20/39) with disease in remission. A significant difference (P<0.001) was observed between the median value of fecal calprotectin in Irritable Bowel Syndrome group that was 50.5 µg/g (IQR=16 - 294 µg/g); 405 µg/g (IQR=29 - 1980 µg/g) in Crohn’s disease patients and 457 µg/g (IQR=25 - 1430 µg/g) in ulcerative colitis patients. No difference was observed between the values found in the patients with Crohn’s disease and ulcerative colitis. Levels of fecal calprotectin were significantly ...

Contexto A calprotectina fecal é um biomarcador que pode fornecer informações importantes para o médico, inclusive no atendimento primário, no diagnóstico diferencial de distúrbios gastrointestinais, principalmente as doenças inflamatórias intestinais e a síndrome do intestino irritável. Objetivos Investigar prospectivamente, em adultos brasileiros com queixas gastrointestinais, o valor da calprotectina fecal como biomarcador para o diagnóstico diferencial de distúrbios funcionais e orgânicos e correlacionar as concentrações com a atividade de doenças inflamatórias intestinais. Método O estudo incluiu pacientes consecutivos que apresentavam queixas gastrointestinais e que a dosagem da calprotectina fecal foi recomendada. A dosagem da calprotectina fecal foi obtida utilizando-se o kit ELISA Buhlmann, (Basel, Suiça). Resultados Um total de 279 foram incluídos no estudo, com idade média de 39 anos (variando entre 18 a 78 anos). Após avaliação clínica e laboratorial, e considerando o diagnóstico final, os pacientes foram alocados nos seguintes grupos: a) Grupo Síndrome do Intestino Irritável: 154 pacientes (102 do sexo feminino e 52 indivíduos do sexo masculino). b) grupo Doenças Inflamatórias Intestinais: 112 pacientes; 73 com doença de Crohn; 38 do sexo feminino e 35 pacientes do sexo masculino; 52,1% (38/73) apresentavam doença ativa, e 47,9% (35/73) tiveram a doença em remissão e 39 pacientes com retocolite ulcerativa; 19 do sexo feminino e 20 pacientes do sexo masculino; 48,7% (19/39) classificadas com a doença ativa e 49,3% (20/39) com a doença em remissão. Foi observada uma diferença significativa (P<0,001) entre o valor médio de calprotectina fecal no grupo Síndrome do Intestino Irritável que foi de 50,5 µg/g (16 a 294 µg/g); 405 µg/g (29 a 1980 µg/g), em pacientes com doença de Crohn e 457 µg/g (25 a1430 µg/g), em pacientes com retocolite ulcerativa. Não foram observadas diferenças entre os valores encontrados nos pacientes com ...

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 ...

Diagnostic value of fecal calprotectin in patient with ulcerative colitis

Ulcerative colitis [UC] is characterized by recurrent episodes of inflammation limited to the mucosal layer of the colon. Calprotectin is a zinc and calcium binding protein derived from neutrophils and monocytes. It is easily detectable in tissue samples, body fluids, and stools, which makes it a potentially valuable marker of inflammation. The aim of the current study is to evaluate the value of fecal calprotectin [FC] as a marker of disease activity in patients with UC. Seventy three eligible subjects underwent ileocolonoscopy and multiple biopsies were obtained from different parts of the colon and terminal ileum. All patients underwent blood and stool sampling as well as an interview to assess the disease severity utilizing ulcerative colitis activity index [UCAI], subjectively. The diagnostic value of the FC in comparison with Mayo disease activity index as the gold standard technique, was then evaluated. Mean FC level increased linearly according to Mayo disease activity index [r=0.44, p<0.001] and was significantly different between levels of Mayo disease activity index [p=0.003]. In multivariate analysis, Mayo disease activity index, positive CRP and ESR were associated with FC level. FC level > 21.4 ng/ml was able to discriminate between active and inactive phases of UC according to Mayo disease activity index>2 with 72.3% sensitivity and 73.1% specificity. The combination of FC > 21.4 ng/ml and UCAI score of 7 had a 46.8% sensitivity and 88% specificity to diagnose Mayo disease activity index >2. Furthermore, FC level <21.4 ng/ml in combination with UCAI score of <3 showed a highly considerable specificity of 98% to discriminate the remission phase of UC [Mayo disease activity index <2], although with a low sensitivity [31%]. FC appears to be a non-invasive biomarker with moderate accuracy to discriminate the active phase of inflammatory bowel disease [IBD]. The value of FC especially in combination with UCAI is highly considerable to rule out the Mayo disease activity index >2

Utilidad de la calprotectina fecal en la patología intestinal: experiencia inicial / Fecal calprotectin and the utility in intestinal pathology: initial experience

Background: Intestinal pathology has a wide spectrum of symptoms, when these are unspecific endoscopic study is generally required in order to differentiate organic and functional disease. Fecal calprotectin (FC) is a reliable and non-invasive tool that can be used to infer damage in the intestinal mucosa, especially in Inflammatory Bowel Disease (IBD). Objective: To evaluate our initial experience measuring FC and its usefulness in medical practice. Materials and Methods: Using information of patients with FC indicated for unspecific gastrointestinal (GI) symptoms between January 2011 and March 2012. Patients were classified in: group 1 (G1 with IBD) and group 2 (without organic GI disease). Three groups were established according to FC results: negative (< 15 ug/g), intermediate (15-60 ug/g) and positive (> 60 ug/g). Concordance between results and physicians’ behavior was established. Results: In the period mentioned above a total of 64 patients (24 G1-40 G2) were selected. In G1, FC levels were negative, intermediate and positive in 8, 3 and 13 patients, respectively, being concordant in a 100, 100 and 84.6 percent, respectively. Only four patients needed a colonoscopy to adjust treatment. Mainly, there was a favorable clinical response. In G2, results on FC were negative in 19, intermediate in 8 and positive in 13 patients, in which concordance was established with the presence of organic intestinal pathology with a 94.7 percent, 87.5 percent and 92.3 percent, respectively. Conclusions: This study confirms that in our population, there is a good correlation between FC results and physicians behavior, especially in patients with IBD.

Introducción: En pacientes con síntomas gastrointestinales (GI) inespecíficos, es difícil diferenciar entre patología orgánica y funcional, requiriendo muchas veces de estudios endoscópicos asociados. La calprotectina fecal (CF) ha demostrado ser un marcador confiable y menos invasivo en la evaluación de la inflamación de la mucosa intestinal, especialmente en enfermedad inflamatoria intestinal (EII). Objetivo: Evaluar la experiencia inicial en la medición de CF y su utilidad en la práctica clínica. Material y Métodos: Utilizando datos de pacientes sometidos a medición de CF secundario a síntomas GI inespecíficos, entre enero de 2011 y marzo de 2012. Se clasificó en: grupo 1 (G1 pacientes con diagnóstico de EII) y grupo 2 (G2 sin morbilidad GI). Se midió CF y según el resultado se establecieron tres grupos: negativo (< 15 ug/g), intermedio (15-60 ug/g), y positivo (> 60 ug/g). Se buscó concordancia entre CF y conducta médica. Resultados: Se seleccionaron 64 pacientes (24 G1 y 40 G2). En G1, los niveles de CF negativa, intermedia y positiva, fueron 8, 3 y 13 respectivamente. La conducta médica fue concordante en 100, 100 y 84,6 por ciento. Sólo 4 pacientes requirieron de colonoscopia para modificar tratamiento. La mayoría tuvo respuesta clínica favorable. En G2, los resultados fueron 19 negativos, 8 intermedios y 13 positivos, donde según hallazgo de patología orgánica hubo 94,7 por ciento, 87,5 por ciento y 92,3 por ciento, de concordancia con el resultado de CF respectivamente. Conclusión: Este estudio confirma que en nuestra población existe buena correlación entre el resultado de CF y la conducta médica, sobre todo en pacientes con EII.

The Usefulness of Fecal Calprotectin in Differentiating between Functional and Organic Bowel Diseases: Application in Pediatric Constipation Patients / 대한소화기학회지

No abstract available.

Role of Fecal Calprotectin in Differentiating between Hirschsprung's Disease and Functional Constipation / 대한소화기학회지

BACKGROUND/AIMS: Calprotectin is a 36.5 kD calcium and zinc binding protein in the S100 protein family. Fecal calprotectin levels are elevated in patients with inflammatory bowel disease and some other gastrointestinal disorders such as colorectal carcinoma. We decided to evaluate the fecal calprotectin level to see if it was able to distinguish between functional and organic causes of constipation. METHODS: Seventy-six children aged 1 to 120 months that all underwent deep rectal mucosa biopsies at Children Medical Center from November 2010 till September 2011 were recruited. Nineteen cases were diagnosed as Hirschsprung's disease and 57 of the patients had nerve ganglion cells in their biopsies. Calprotectin concentration was analyzed by the ELISA method. RESULTS: Although there was a significant difference between the median of the two groups (p=0.036), the median was not above the predetermined cutoff value of 50 microg/g. CONCLUSIONS: We propose that fecal calprotectin, using the above cutoff value, has limited value in differentiating functional constipation from Hirschsprung's disease.

The role of fecal calprotectin in investigating inflammatory bowel diseases

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.

Fecal calprotectin, novel index for assessing the pathophysiological mechanisms of inflammatory bowel disease in rats treated by glutathione

In this study, the role of fecal calprotectin [FC] as a recent non-invasive diagnostic aid of inflammatory bowel disease [IBD] was evaluated and the effect of glutathione as a preventive and therapeutic factor in acetic acid induced colitis has been studied. Forty albino rats were divided into four groups; group I: acetic acid induced colitis group. Group II: before the induction of colitis, rats were given a preventive dose of glutathione [200 mg/kg, i.p]. Group III: after colitis induction rats were treated with glutathione for one week [50 mg/kg,i.p.]. Group IV: control group. At the end of experimental period, rats were sacrificed and fecal caiprotectin was assessed in the different groups, the level of antioxidant system in the intestine was evaluated and the severity of inflammation was histopathologically scored. Colitis induction was associated with significant increase in the colonic level of FC, which was significantly reduced with glutathione prevention. Glutathione level was decreased significantly in the intestine after colitis induction, however, it was significantly high in the prevention 'group. There was significant reduction in the antioxidant enzyme system after colitis induction. However, glutathione prevention was associated with higher antioxidant enzymes compared to treatment. Various histopathological changes as inflammation, ulceration and dysplasia were detected after colitis induction, group III, however, showed no ulceration and mild inflammation. Fecal caiprotectin can be used as a non-invasive and early marker for IBD. Glutathione prevention appeared to be beneficial for the acute stage of IBD than glutathione treatment. Moreover, intestinal antioxidant enzymes were correlated negatively with FC level