Correlation of faecal calprotectin and lactoferrin with an endoscopic score for Crohn’s disease and histological findings

Sipponen, Taina; Kärkkäinen, Päivi; Savilahti, Erkki; Kolho, Kaija‐Leena; Nuutinen, Hannu; Turunen, Ulla; Färkkilä, Martti

doi:10.1111/j.1365-2036.2008.03835.x

Cited by 285 publications

(241 citation statements)

References 40 publications

(78 reference statements)

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“…Interpretation of calprotectin values in proximal bowel disease is proven to be difficult [25,26]. Siponnen et al showed a low sensitivity for calprotectin in small bowel CD.…”

Section: Discussionmentioning

confidence: 99%

Faecal leukocyte esterase activity is an alternative biomarker in inflammatory bowel disease

Dumoulin

Biervliet

Vos

et al. 2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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Background: Leukocyte cytosolic proteins (e.g., calprotectin) are emerging biomarkers for inflammatory bowel disease. Leukocyte aryl esterase activity has been commonly used for sensitive detection of leukocytes in human body fluids such as urine. Urine test strip results are generally reported in categories. As automated strip readers allow quantitative data to be reported, sensitive quantitative detection of leukocytes in body fluids has become possible. Here, we explored the use of leukocyte esterase as a potential alternative faecal biomarker for inflammatory bowel disease. Methods: We evaluated leukocyte esterase activity in faecal extracts and compared Cobas u 411 (Roche) quantitative reflectance data with calprotectin concentration for 107 routine samples. Stability of leukocyte esterase for trypsin digestion was carried out by adding trypsin to the extract. Incubation occurred at 37 °C for 24 h or 48 h. Results: Reproducibility of the reflectance signal was good (within-run imprecision: 6.1%; between-run imprecision: 6.2%). Results were linear in the range 10

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“…Interpretation of calprotectin values in proximal bowel disease is proven to be difficult [25,26]. Siponnen et al showed a low sensitivity for calprotectin in small bowel CD.…”

Section: Discussionmentioning

confidence: 99%

Faecal leukocyte esterase activity is an alternative biomarker in inflammatory bowel disease

Dumoulin

Biervliet

Vos

et al. 2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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“…Its presence in feces is directly proportional to the migration of neutrophils to the intestinal tract (15). It is simple and inexpensive to measure using ELISA, and shows a strong direct correlation between FC values and CD activity as measured by clinical, endoscopic and even histological indices (5,16). It is highly accurate for establishing endoscopic activity and is considered to be the most accurate indirect parameter for mucosal healing (17,18).…”

Section: Introductionmentioning

confidence: 99%

Accurate cut-offs for predicting endoscopic activity and mucosal healing in Crohns disease with fecal calprotectin

Morón¹,

Manrique²,

Machancoses³

et al. 2017

Rev Esp Enferm Dig

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Background: Fecal biomarkers, especially fecal calprotectin, are useful for predicting endoscopic activity in Crohn's disease; however, the cut-off point remains unclear. The aim of this paper was to analyze whether faecal calprotectin and M2 pyruvate kinase are good tools for generating highly accurate scores for the prediction of the state of endoscopic activity and mucosal healing.Methods: The simple endoscopic score for Crohn's disease and the Crohn's disease activity index was calculated for 71 patients diagnosed with Crohn's. Fecal calprotectin and M2-PK were measured by the enzyme-linked immunosorbent assay test.Results: A fecal calprotectin cut-off concentration of ≥ 170 µg/g (sensitivity 77.6%, specificity 95.5% and likelihood ratio +17.06) predicts a high probability of endoscopic activity, and a fecal calprotectin cut-off of ≤ 71 µg/g (sensitivity 95.9%, specificity 52.3% and likelihood ratio -0.08) predicts a high probability of mucosal healing. Three clinical groups were identified according to the data obtained: endoscopic activity (calprotectin ≥ 170), mucosal healing (calprotectin ≤ 71) and uncertainty (71 > calprotectin < 170), with significant differences in endoscopic values (F = 26.407, p < 0.01). Clinical activity or remission modified the probabilities of presenting endoscopic activity (100% vs 89%) or mucosal healing (75% vs 87%) in the diagnostic scores generated. M2-PK was insufficiently accurate to determine scores.Conclusions: The highly accurate scores for fecal calprotectin provide a useful tool for interpreting the probabilities of presenting endoscopic activity or mucosal healing, and are valuable in the specific clinical context.

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“…So far, data regarding the correlation of fecal calprotectin with SES-CD are scarce, and there is especially a paucity of studies evaluating the endoscopic disease activity with calprotectin in relation to other biomarkers. 19 , 20 Knowledge about the test performance of different biomarkers to discriminate classes of inflammatory activity is important for the early detection of relapses and for tailoring the individual therapy. This appraisal is supported by recently published papers claiming that the optimal therapeutic target to modify disease course in IBD patients should not only be clinical remission, but also mucosal healing as this item has shown an association with reduced need for surgery and hospitalization in CD patients.…”

Section: Introductionmentioning

confidence: 99%

Fecal Calprotectin Correlates More Closely With the Simple Endoscopic Score for Crohn's Disease (SES-CD) than CRP, Blood Leukocytes, and the CDAI

Schoepfer

Beglinger

Straumann

et al. 2010

American Journal of Gastroenterology

492

352

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OBJECTIVES:Studies evaluating the correlation between the widely used Simple Endoscopic Score for Crohn's disease (SES-CD) and noninvasive markers are scarce. The aim of this study was to evaluate the correlation between the SES-CD and fecal calprotectin, C-reactive protein (CRP), blood leukocytes, and the Crohn's disease activity index (CDAI).METHODS:Crohn's disease patients undergoing complete ileocolonoscopy were prospectively enrolled and scored independently according to the SES-CD and the CDAI. SES-CD was defined as follows: inactive 0-3; mild 4-10; moderate 11-19; and high >/=20.RESULTS:Values in CD patients (n=140 ileocolonoscopies) compared with controls (n=43) are as follows: calprotectin, 334+/-322 vs. 18+/-5 mug/g; CRP, 26+/-29 vs. 3+/-2 mg/l; and blood leukocytes, 9.1+/-3.4 vs. 5.4+/-1.9 g/l (all P<0.001). The SES-CD correlated closest with calprotectin (Spearman's rank correlation coefficient r=0.75), followed by CRP (r=0.53), blood leukocytes (r=0.42), and the CDAI (r=0.38). Calprotectin was the only marker that could discriminate inactive endoscopic disease from mild activity (104+/-138 vs. 231+/-244 mug/g, P<0.001), mild from moderate activity (231+/-244 vs. 395+/-256 mug/g, P=0.008), and moderate from high activity (395+/-256 vs. 718+/-320 mug/g, P<0.001). The overall accuracy for the detection of endoscopically active disease was 87% for calprotectin (cutoff 70 mug/g), 66% for elevated CRP, 54% for blood leukocytosis, and 40% for the CDAI >/=150.CONCLUSIONS:Fecal calprotectin correlated closest with SES-CD, followed by CRP, blood leukocytes, and the CDAI. Furthermore, fecal calprotectin was the only marker that reliably discriminated inactive from mild, moderate, and highly active disease, which underlines its usefulness for activity monitoring.

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Correlation of faecal calprotectin and lactoferrin with an endoscopic score for Crohn’s disease and histological findings

Abstract: SUMMARY BackgroundFaecal calprotectin and lactoferrin increasingly serve as surrogate markers of disease activity in IBD. Data on the correlation of these markers with simple endoscopic score for Crohn's disease (SES-CD) and with histological findings are as yet limited.

Cited by 285 publications

References 40 publications

Faecal leukocyte esterase activity is an alternative biomarker in inflammatory bowel disease

Faecal leukocyte esterase activity is an alternative biomarker in inflammatory bowel disease

Accurate cut-offs for predicting endoscopic activity and mucosal healing in Crohns disease with fecal calprotectin

Fecal Calprotectin Correlates More Closely With the Simple Endoscopic Score for Crohn's Disease (SES-CD) than CRP, Blood Leukocytes, and the CDAI

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Correlation of faecal calprotectin and lactoferrin with an endoscopic score for Crohn’s disease and histological findings

Abstract: SUMMARY BackgroundFaecal calprotectin and lactoferrin increasingly serve as surrogate markers of disease activity in IBD. Data on the correlation of these markers with simple endoscopic score for Crohn's disease (SES-CD) and with histological findings are as yet limited.

Cited by 285 publications

References 40 publications

Faecal leukocyte esterase activity is an alternative biomarker in inflammatory bowel disease

Faecal leukocyte esterase activity is an alternative biomarker in inflammatory bowel disease

Accurate cut-offs for predicting endoscopic activity and mucosal healing in Crohns disease with fecal calprotectin

Fecal Calprotectin Correlates More Closely With the Simple Endoscopic Score for Crohn's Disease (SES-CD) than CRP, Blood Leukocytes, and the CDAI

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Accurate cut-offs for predicting endoscopic activity and mucosal healing in Crohns disease with fecal calprotectin