Calprotectin and lactoferrin in the assessment of intestinal inflammation and organic disease

D’Incà, R.; Pont, E. Dal; Leo, Vincenza Di; Ferronato, A.; Fries, Walter; Vettorato, Maria Grazia; Martines, Diego; Sturniolo, Giacomo Carlo

doi:10.1007/s00384-006-0159-9

Cited by 182 publications

(89 citation statements)

References 34 publications

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“…188 Schoepfer et al 75 compared the accuracy of faecal markers, blood leucocytes, CRP and IBD antibodies in discriminating IBD from IBS and found that the overall accuracies of FC ELISA (PhiCal test -89%) and lactoferrin (IBD-SCAN -90%) were similar. In another study 190 using colonoscopy as the reference standard, the sensitivity, specificity, PPV and diagnostic efficacy were slightly higher with lactoferrin (80%, 85%, 87% and 81%, respectively) than with calprotectin (78%, 83%, 86% and 80%).…”

Section: Lactoferrinmentioning

confidence: 91%

Faecal calprotectin testing for differentiating amongst inflammatory and non-inflammatory bowel diseases: systematic review and economic evaluation

Waugh

Cummins²,

Royle³

et al. 2013

Health Technology Assessment

227

201

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Section: Lactoferrinmentioning

confidence: 91%

Faecal calprotectin testing for differentiating amongst inflammatory and non-inflammatory bowel diseases: systematic review and economic evaluation

Waugh

Cummins²,

Royle³

et al. 2013

Health Technology Assessment

227

201

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“…In other studies, sensitivity in adults has ranged from 63 to 100% and specificity from 80 to 100% in differentiating IBD from functional disorders [4,15,30,31,32,33,34,35]. Accordingly, the positive predictive value has been between 70 and 100% and the negative predictive value between 51 and 91% [15,30,31,32,33,34,35]. Comparable results have been detected in pediatric studies [15,32,36,37].…”

Section: Calprotectinmentioning

confidence: 99%

Diagnostics and Prognostics of Inflammatory Bowel Disease with Fecal Neutrophil-Derived Biomarkers Calprotectin and Lactoferrin

Sipponen

2013

Dig Dis

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Crohn's disease (CD), ulcerative colitis (UC), and colitis unclassified, collectively defined as inflammatory bowel disease (IBD), are the consequence of chronic inflammatory reactions in the gastrointestinal tissue. Endoscopy with biopsies is the mainstay in the diagnosis of this inflammation and is also important in the assessment of disease activity and monitoring of treatment. Furthermore, mucosal healing is increasingly becoming a therapeutic target for treatment of IBD and the golden standard of assessing it is endoscopy. However, due to the costs, invasiveness, and to limited endoscopic capacity, the need is strong for reliable surrogate markers of intestinal inflammation. Bowel contents, being in close contact with intestinal mucosa, can take up molecules that are measurable from stool samples and thus can serve as markers of inflammation. The fecal neutrophil-derived biomarkers, especially calprotectin and lactoferrin, have several features of an ideal test for detecting intestinal inflammation: they are noninvasive, simple, and low in cost. The utility of these biomarkers in distinguishing IBD from noninflammatory conditions such as irritable bowel syndrome is well documented. They correlate closely with endoscopic activity both in CD and UC. They allow serial monitoring of disease activity and of treatment success, and can even serve in predicting clinical relapse in unsymptomatic patients or sustained remission after induction with TNF-α-blocking agents. In this review an overview will be given to the role of fecal neutrophil-derived biomarkers calprotectin and lactoferrin in diagnostics and prognostics of IBD.

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“…During intestinal inflammation neutrophils infiltrate the mucosa and markedly increase LF levels that can be readily measured in feces or gut lavage fluid [16,17]. Studies evaluating lactoferrin in the diagnosis of IBD show that it exhibited similar performance to fecal calprotectin and correlated better than C-reactive protein with mucosal inflammation by endoscopy [18][19][20].…”

Section: Lactoferrin (Lf)mentioning

confidence: 99%

Fecal Lactoferrin, Fecal Calprotectin, Transforming growth factor-b1, and CRP in Evaluation of Disease Activity in Egyptian patients With Ulcerative colitis

2017

Int. J. Curr. Res. Med. Sci.

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Aims: to analyze the usefulness of fecal lactoferrin, fecal calprotectin, transforming growth factor-B1,Endoscopic Activity Index, Clinical Activity Index, C-reactive protein, and blood leucocytes in monitoring disease activity in Egyptian patients with ulcerative colitis. Methods: One hundred and twenty patients with ulcerative colitis were enrolled and scored according to the endoscopic part of the Rachmilewitz Index. Patients and controls: Patients and controls provided fecal and blood samples for measuring Lactoferrin, calprotectin, TGF-B1, CRP, and leucocytes. Results: The values in ulcerative colitis patients (n = 120) compared to controls (n = 30): Fecal lactoferrin: 703.6±657.6 versus7.01±3.9 µg/g, calprotectin: 867.4±561.2 versus 36.3±15.3 μg /g, TGF-B1: 386.9±246.7 versus 5.9±1.8 pg /ml, CRP:19.4±14.7 versus 3.2±0.9 mg/L, blood leucocytes: 11.6±3.8 versus 6.8±1.9 g/L ( for all P< 0.001). Endoscopic disease activity correlated significantly with lactoferrin (Spearman's rank correlation coefficient r =0.949), calprotectin (r = 0.923), TGF-B1 (r = 0.918), Clinical Activity Index (r = 0. 761), CRP (r = 0.851), and blood leucocytes (r = 0.681). Fecal lactoferrin, calprotectin and TGF-B1 levels were significantly lower in ulcerative colitis patients with inactive disease ( endoscopic score 0 -3, Lactoferrin 48.7±24.9 µg/g, calprotectin 81.5 ± 48.8 μg / g, TGF-B1 42.5 ± 36.5 pg/mL , P < 0.001 for both lactoferrin and calprotectin, but P <0.059 for TGF-B1), compared to patients with mild ( score 4 -6, lactoferrin 465.7 ± 217.4 µg/g, calprotectin 420.4 ±244.8 μg/g, TGF-B1 269.6 ± 80.3 pg/mL, P < 0.001 ), moderate ( score 7 -9, lactoferrin 678.7 ± 258.6 µg/g, calprotectin 1074.9 ± 303.5 μg/g, TGF-B1 391.5 ± 56.8 pg/mL, P < 0.001 ), and high disease ( score 10 -12 , lactoferrin 1624.5 ± 327.2 µg/g, calprotectin 1466.5.2 ± 31.5 μg/g, TGF-B1 690.9 ± 160.1 Pg/ mL, P < 0.001). The overall accuracy for detection of histopathological active disease was 96.9 % for fecal lactoferrin, 96.6 for fecal calprotectin, 94.5 % for TGF-B1, 90 % for Endoscopic Activity Index, 87 % for Clinical Activity Index, and 65 % for both blood leucocytes and CRP. Conclusion: Fecal lactoferrin, fecal calprotectin and TGF-B1 correlated significantly with endoscopic disease activity, clinical activity index, CRP, and blood leucocytes. Furthermore, lactoferrin and calprotectin were suitable markers that can differentiate endoscopically and histopathologically inactive from active disease. Also TGF-B1 was used as a useful marker to distinguish mild from moderate and high active disease. Thus, these three biomarkers may be used for monitoring ulcerative colitis activity.

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Calprotectin and lactoferrin in the assessment of intestinal inflammation and organic disease

Abstract: Fecal calprotectin and lactoferrin appear to be equally recommendable as inflammatory disease markers in patients with lower gastrointestinal symptoms. Both tests are needed to accurately discriminate activity in inflammatory bowel disease patients.

Cited by 182 publications

References 34 publications

Faecal calprotectin testing for differentiating amongst inflammatory and non-inflammatory bowel diseases: systematic review and economic evaluation

Faecal calprotectin testing for differentiating amongst inflammatory and non-inflammatory bowel diseases: systematic review and economic evaluation

Diagnostics and Prognostics of Inflammatory Bowel Disease with Fecal Neutrophil-Derived Biomarkers Calprotectin and Lactoferrin

Fecal Lactoferrin, Fecal Calprotectin, Transforming growth factor-b1, and CRP in Evaluation of Disease Activity in Egyptian patients With Ulcerative colitis

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