Advantages of Fecal Lactoferrin Measurement during Granulocyte and Monocyte Adsorptive Apheresis Therapy in Ulcerative Colitis

Abstract

Background: Fecal lactoferrin has been introduced as a useful tool for the diagnosis and monitoring of inflammatory bowel disease (IBD). The aim of this study was to assess if fecal lactoferrin can be employed to predict or estimate the effect of granulocyte and monocyte adsorptive apheresis (GMA) in ulcerative colitis (UC). Methods: This was a prospective study involving 21 patients with UC. Patients with moderately-to-severely active UC who were scheduled to undergo GMA were recruited. Changes in fecal lactoferrin concentration were compared between the GMA-responder and -nonresponder groups. Results: In the GMA-responder group, fecal lactoferrin significantly increased 1 week after the introduction of GMA and then significantly decreased after GMA sessions. Fecal lactoferrin concentrations were significantly higher in the GMA-responder group than in the GMA-nonresponder group at 1 and 2 weeks after the introduction of GMA. Multivariate logistic regression analysis revealed that fecal lactoferrin concentration 1 week after the introduction of GMA was the most contributing factor for the effectiveness of GMA in patients with UC. Conclusions: In the GMA-responder group, fecal lactoferrin concentration significantly increased 1 week after the introduction of GMA. Fecal lactoferrin may be beneficial for predicting clinical response of GMA in patients with UC at an early stage of GMA treatment.

Fecal lactoferrin early predicts long‐term outcomes in ulcerative colitis: A post‐hoc analysis of the UNIFI and PURSUIT trials

“…As a result, a significant prognostic value of FL for long‐term endoscopic, clinical, and histologic outcomes has been observed. Similarly, a previous study suggested that week‐one FL could predict the clinical response of granulocyte and monocyte adsorptive apheresis in patients with moderate to severe UC 14 . Another prospective study enrolled 80 quiescent UC patients who took mesalamine as maintenance therapy.…”

“…Some studies have shown sufficient diagnostic and predictive accuracy of neutrophilic infiltration 11–13 . In this process, some remarkable biomarkers like FL derived from neutrophils could be released into the intestinal tract, thus detectable in the feces and serving as reliable markers of intestinal inflammation 14 . Considering that the decrease in FL concentration during the induction stage may reflect effective control of intestinal inflammation, we hypothesized that FL during induction might be a potential candidate for predicting long‐term prognosis‐related outcomes.…”

“…Similarly, a previous study suggested that week‐one FL could predict the clinical response of granulocyte and monocyte adsorptive apheresis in patients with moderate to severe UC. 14 Another prospective study enrolled 80 quiescent UC patients who took mesalamine as maintenance therapy. It revealed that a cut‐off value of FL of 140 μg/g could predict relapse within 1 year with 67% sensitivity and 68% specificity.…”

Multifunctional Iron Bound Lactoferrin and Nanomedicinal Approaches to Enhance Its Bioactive Functions

“…Apart from being an immunomodulatory protein presence of lactoferrin in feces has recently been introduced as a useful tool for the diagnosis and monitoring of inflammatory bowel disease (IBD). It was revealed that fecal lactoferrin could be used to investigate or quantify the effect of granulocyte and monocyte adsorptive apheresis (GMA) in ulcerative colitis (UC) [136]. Hence, lactoferrin has multiple benefits as an immunotherapeutic and can also play a role in immunodiagnostics.…”