Effect of disease duration on fecal biomarkers in ulcerative colitis: a prospective cohort study

Abstract

Background Biomarkers such as fecal calprotectin (FC) and fecal immunochemical occult blood tests (FIT) for ulcerative colitis (UC) are used in clinical practice. In this study, the effect of UC disease duration on FC was investigated and compared to that on FIT. Methods One hundred twenty-eight colonoscopic examinations and two fecal biomarkers measurements were performed. The cases of UC were divided into short- and long-term disease-duration groups or categorized into three groups with disease durations of 0–5, 6–13, and 14–38 years. We analyzed correlations between biomarker levels and endoscopic scores, including the Mayo endoscopic subscore (MES), ulcerative colitis endoscopic index of severity, and the sum of MES. Results In the analysis of short- and long-term disease durations, the three endoscopic scores and biomarker levels showed significant correlations in both long-term and short-term groups. Most of the correlation coefficients for the individual long-term group were lower than the corresponding values for all cases, while most of the correlation coefficients for the individual short-term groups were higher than the corresponding values for all cases. In the three-group analysis (disease durations of 0–5, 6–13, and 14–38 years), the two biomarkers and three endoscopic scores showed significant correlations, and most of the correlation coefficients between biomarkers and endoscopic scores tended to be lower in the long-term follow-up group. In the receiver operating characteristic analysis for predicting mucosal healing in the three groups, the area under the curve for FC and FIT concentrations in the 0–5 year disease-duration group showed particularly higher values than those for the other two groups. Conclusions Similar to FIT, FC is affected by the duration of UC, indicating that FC may be a highly useful biomarker, especially in short-term disease.

Comprehensive Profiling of the Human Fecal Proteome from IBD Patients with DIA-MS Enables Evaluation of Disease-Relevant Proteins

“…Currently, fCAL is used as a proxy for intestinal inflammation in clinical practice and in clinical studies to monitor both IBD disease activity and treatment response [15][16][17][18]. Recent studies indicate that fCAL measured at baseline and up to 14 weeks after treatment with biologics had long-term prognostic value; however, fCAL levels were affected by duration of disease, making it less reliable as an inflammatory signal indicative of flare or disease activity [19,20]. Furthermore, fCAL is also elevated in patients with NAFLD and obesity, and therefore, fCAL is not necessarily reflective of gut specific inflammation or IBD flare [21][22][23][24].…”