Fecal calprotectin correlated with endoscopic remission for Asian inflammatory bowel disease patients

Lin, Wei Chen; Wong, Jau Min; Tung, Chien Chih; Lin, Ching Pin; Chou, Jen Wei; Wang, Horng Yuan; Shieh, Ming Jium; Chang, Chin Hao; Liu, Heng Hsiu; Shu, Wei

doi:10.3748/wjg.v21.i48.13566

Cited by 40 publications

(44 citation statements)

References 32 publications

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“…Fecal calprotectin, a protein derived from neutrophils, is markedly elevated in infectious and inflammatory conditions, including IBD, and correlated well with endoscopic activity in IBD patients in a study conducted Taiwan 112113. Patients with endoscopically and histologically active UC have higher fecal calprotectin levels than those with mildly active or inactive UC, and calprotectin concentration correlates positively with advancing histological inflammation and negatively with endoscopic remission 114115. As a predictor of relapse in UC, studies have shown the sensitivity and specificity of calprotectin to be approximately 90% and 80%, respectively 116117.…”

Section: Resultsmentioning

confidence: 95%

Management of ulcerative colitis in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease

et al. 2017

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Ulcerative colitis (UC) is an inflammatory bowel disease characterized by chronic mucosal inflammation of the colon, and the prevalence and incidence of UC have been steadily increasing in Taiwan. A steering committee was established by the Taiwan Society of Inflammatory Bowel Disease to formulate statements on the diagnosis and management of UC taking into account currently available evidence and the expert opinion of the committee. Accurate diagnosis of UC requires thorough clinical, endoscopic, and histological assessment and careful exclusion of differential diagnoses, particularly infectious colitis. The goals of UC therapy are to induce and maintain remission, reduce the risk of complications, and improve quality of life. As outlined in the recommended treatment algorithm, choice of treatment is dictated by severity, extent, and course of disease. Patients should be evaluated for hepatitis B virus and tuberculosis infection prior to immunosuppressive treatment, especially with steroids and biologic agents, and should be regularly monitored for reactivation of latent infection. These consensus statements are also based on current local evidence with consideration of factors, and could be serve as concise and practical guidelines for supporting clinicians in the management of UC in Taiwan.

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Section: Resultsmentioning

confidence: 95%

Management of ulcerative colitis in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease

et al. 2017

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“…United Kingdom 5983 IBD/Healthy 100 95/91 Diagnosis Dhaliwal et al 21 United Kingdom 88 IBD/IBS 100 97/76 Distinguish IBD from IBS D'Incà et al 22 Italy 46 UC 80 78/70 Active disease Xiang et al 23 China 66 UC/Healthy 50 79/92 Active disease D'Haenset al 24 The Netherlands 126 UC/IBS 250 71/100 Active disease Schoepfer et al 16 Switzerland 228 UC/Healthy 57 91/90 Active disease Samant et al 12 India 32 UC 800 96/71 Active disease Lobatón et al 25 Spain 123 UC 250 74/90 Remission Lin et al 26 Taiwan 52 UC 191 88/75 Remission Dhaliwal et al 21 United Kingdom 88 IBD/IBS 250 90/76 Remission Costa et al 27 Italy 41 UC 150 89/82 Relapse Tibble et al 28 England 80 IBD 50 90/83 Relapse D'Inca et al 29 Italy Optimal cut-off value of fecal calprotectin: An unsolved issue?…”

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confidence: 99%

Optimal cut‐off value of fecal calprotectin for the evaluation of ulcerative colitis: An unsolved issue?

et al. 2018

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IntroductionThere is variability in the fecal calprotectin (FCP) cut‐off level for the prediction of ulcerative colitis (UC) disease activity and differentiation from irritable bowel disease (IBS‐D). The FCP cut‐off levels vary from country to country.AimsWe aimed to assess FCP as a marker of disease activity in patients with UC. We determined the optimal FCP cut‐off value for differentiating UC and IBS‐D.MethodsIn a prospective study, we enrolled 76 UC and 30 IBS‐D patients. We studied the correlation of FCP with disease activity/extent as well as its role in differentiating UC from IBS‐D. We also reviewed literature regarding the optimal FCP cut‐off level for the prediction of disease activity and differentiation from IBS‐D patients.ResultsSensitivity, specificity, positive predictive value, and negative predictive value of FCP (cut‐off level, 158 μg/g) for the prediction of complete mucosal healing (using Mayo endoscopic subscore) were 90, 85, 94.7, and 73.3%, respectively. Sensitivity, specificity, positive predictive value, and negative predictive value of FCP (cut‐off level, 425 μg/g) for the prediction of inactive disease (Mayo Score ≤ 2) were 94.3, 88.7, 86.2, and 95.4%, respectively. We also found a FCP cut‐off value of 188 μg/g for the differentiation of UC from IBS‐D.ConclusionsThe study reveals the large quantitative differences in FCP cut‐off levels in different study populations. This study demonstrates a wide variation in FCP cut‐off levels in the initial diagnosis of UC as well as in follow‐up post‐treatment. Therefore, this test requires validation of the available test kits and finding of appropriate cut‐off levels for different study populations.

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“…First, the effectiveness of serum SHAP-HA complex as a biomarker remains unclear. Other promising biomarkers, for example, calprotectin, have already been shown to be useful in screening for suspected IBD, in predicting endoscopic remission, and in predicting the risk of relapse [21,22,23]. However, even with calprotectin, an essential first step is to demonstrate a difference between healthy controls and IBD patients [24].…”

Section: Discussionmentioning

confidence: 99%

Serum-Derived Hyaluronan-Associated Protein Is a Novel Biomarker for Inflammatory Bowel Diseases

et al. 2017

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Background/Aims: We evaluated the role of serum-derived hyaluronan-associated protein (SHAP) in inflammatory bowel disease (IBD) pathogenesis and its potential as a novel IBD biomarker. Methods: We studied the SHAP expression in a mouse model of colitis and in human intestinal samples of IBD and compared serum concentrations with normal controls. Results: SHAP was expressed in the connective tissue derived from inflamed regions of the intestine. In mice, serum levels of SHAP-hyaluronic acid (SHAP-HA) were positively correlated with the histological damage of the colon (r = 0.566, p < 0.001). Serum concentration of SHAP-HA complex was significantly higher in patients with active ulcerative colitis than in those in remission, and this value was positively correlated with the erythrocyte sedimentation rate, serum level of tumor necrosis factor (TNF)-α, and endoscopic damage (r = 0.568, p < 0.001; r = 0.521, p < 0.001, and r = 0.641, p < 0.001). In patients with Crohn's disease, the serum SHAP-HA level correlated only with TNF-α (r = 0.630, p = 0.002). Conclusion: SHAP is a novel IBD biomarker that is related to disease activity in certain types of colitis, and it may affect disease pathogenesis. Future studies are needed to evaluate the therapeutic potential of this complex.

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Fecal calprotectin correlated with endoscopic remission for Asian inflammatory bowel disease patients

Abstract: fC correlated with both CDEIS and UCEIS. fC could be used as a predictor of endoscopic remission for Asian IBD patients.

Cited by 40 publications

References 32 publications

Management of ulcerative colitis in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease

Management of ulcerative colitis in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease

Optimal cut‐off value of fecal calprotectin for the evaluation of ulcerative colitis: An unsolved issue?

Serum-Derived Hyaluronan-Associated Protein Is a Novel Biomarker for Inflammatory Bowel Diseases

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