Age-related faecal calprotectin, lactoferrin and tumour M2-PK concentrations in healthy volunteers

Abstract

Editorial comment: Readers should be aware that the content of this research paper has changed substantially from the version that was originally published on-line on 9 September 2009. A reappraisal of the data has resulted in substantial changes to the originally quoted reference ranges. One author of the originally posted article has disassociated herself from this final version of the paper. AbstractObjective: Measurement of the faecal markers calprotectin, lactoferrin and tumour M2-PK has been reported to be useful in the diagnosis and management of a range of gastrointestinal disorders in both children and adults. The aim of this study was to investigate the requirement for age-related reference ranges. Methods: Faecal samples were obtained from 132 healthy subjects and analysis of calprotectin, lactoferrin and tumour M2-PK performed using commercially available enzyme-linked immunosorbent assay. Results: In the healthy subjects median concentrations were as follows: for calprotectin -2-9 y, 34 mg/g, 10-59 y, 22 mg/g and 60 y, 27 mg/g; for lactoferrin -2 -9 y, 2.2 mg/g, 10 y, 0.5 mg/g; and for tumour M2-PK all subjects ,1 U/mL. Significant differences between age groups for different markers resulted in the following age-related reference ranges: calprotectin -2 -9 y, ,166 mg/g, 10-59 y, ,51 mg/g, 60 y, ,112 mg/g; lactoferrin -2 -9 y, ,29 mg/g, 10 y ,4.6 mg/g. Conclusion:In healthy individuals, we found there to be variation in the faecal inflammatory markers calprotectin and lactoferrin with age. For both calprotectin and lactoferrin children aged 2-9 y had significantly higher concentrations than subjects aged 10 y. For calprotectin but not lactoferrin, adults 60 years had a higher concentration than those aged 10-59 y. There was no change with age in the metabolomic marker faecal tumour M2-PK in healthy subjects. The knowledge of age-related reference ranges in healthy subjects is important to fully interpret changes in gastrointestinal disease.

Diagnostic Accuracy of Point-of-Care Fecal Calprotectin and Immunochemical Occult Blood Tests for Diagnosis of Organic Bowel Disease in Primary Care: The Cost-Effectiveness of a Decision Rule for Abdominal Complaints in Primary Care (CEDAR) Study

“…Sensitivity estimates of calprotectin did improve when a single outcome was evaluated in our study [ Patients with diverticulosis frequently had increased calprotectin concentrations in our study, possibly due to occult mild diverticulitis, contributing to the lower specificity. High concentrations of calprotectin have also been reported in healthy individuals and may be related to various individual variables including age, diet, and medication use (e.g., nonsteroidal antiinflammatory drugs) (15,31,32 ).…”

“…Also, adaptation of calprotectin concentration cutoff concentrations for certain subgroups of patients, such as those who are older, on a certain diet, or on particular medications, could be of value (15,31,32 ).…”

Colonic Immunopathogenesis of Clostridium difficile Infections

“…Further studies, such as studies with larger patient populations from different locations, are needed to confirm these findings to further evaluate the global role of IL-23 in the immunopathogenesis of CDI. The average concentrations of lactoferrin and calprotectin in healthy adults have been found to range from 1.45 to 4.6 g/ml (24,25) and to be Յ10 g/ml (26), respectively. These are consistent with the concentrations obtained in our study: 6.8 Ϯ 0.85 g/ml for lactoferrin and 10.2 Ϯ 0.92 g/ml for calprotectin.…”

Between-assay variability of faecal calprotectin enzyme-linked immunosorbent assay kits

“…22 -24 Age-related reference ranges for calprotectin have also been proposed. 37 F-Cp is also considered useful in the management of IBD as it is a reliable predictor of relapse, particularly in ulcerative colitis (UC), 38,39 and a marker of mucosal healing in response to therapy. 40,41 Calprotectin is resistant to both in vitro and in vivo degradation, is uniformly distributed in faeces and is stable for up to seven days at room temperature, 42,43 allowing stool samples to be posted to the laboratory for f-Cp analysis.…”