Fecal calprotectin level correlated with both endoscopic severity and disease extent in ulcerative colitis

Abstract

BackgroundThe relationship between fecal calprotectin (FC) and disease extent in ulcerative colitis (UC) has not been fully elucidated. The aim of this study was to clarify the correlation of FC with disease extent and severity in UC patients.MethodsUC patients scheduled to undergo an ileocolonoscopy were enrolled and fecal samples for FC measurement were collected prior to the procedure. A Mayo endoscopic subscore (MES) was determined for each of 5 colonic segments. To evaluate the association of FC with extent of affected mucosa as well as disease severity, we assessed the correlation of FC level with the sum of MES (S-MES) for the 5 colonic segments as compared to the maximum score of MES (M-MES).ResultsFC measurements in conjunction with findings from 136 complete colonoscopies in 102 UC patients were evaluated. FC level showed a stronger correlation with S-MES (correlation coefficient r = 0.86, p < 0.001) as compared to M-MES (r = 0.79, p < 0.001). In patients with an M-MES of 1, 2, and 3, FC level showed a significant correlation with S-MES (r = 0.67, p < 0.001; r = 0.70, p < 0.001; r = 0.47, p = 0.04, respectively). Our findings indicate that FC level is elevated in patients with greater areas of affected mucosa even in those with the same M-MES value.ConclusionsFC level was shown to be correlated with the extent of affected mucosa as well as severity in UC patients, thus it is useful for precise assessment of mucosal inflammation.

Fecal calprotectin in inflammatory bowel diseases: update and perspectives

“…Raised calprotectin in stools correlated with all the major endoscopic evaluation scores -SES-CD [23], UCEIS [52], and Mayo Endoscopic Subscore (MES) [53].…”

Capabilities of fecal calprotectin and blood biomarkers as surrogate endoscopic markers according to ulcerative colitis disease type

“…Calprotectin, a complex of the proteins S100A8 and A100A9, represents most of the cytosolic proteins found in granulocytes, which are released into colonic lumina from inflamed mucosa during inflammation. (15) Recent studies have shown that the level of fecal calprotectin (FC) is significantly correlated with disease severity as well as extent of affected mucosa in UC patients, (16) and is considered to be superior to blood biomarkers such as CRP and WBC. (17,18) Thus, measurement of FC level as a surrogate marker that reflects colonic inflammation associated with UC is recommended as a part of clinical examinations of patients.…”

Role of fecal calprotectin as a biomarker of intestinal inflammation in ulcerative colitis: a prospective study

“…Ulcerative colitis (UC) is a chronic disorder characterized by mucosal inflammation at the level of the colon and rectum, with a typically relapsing and remitting course [1]. Endoscopic mucosal healing represents the main therapeu-tic target, leading to sustained clinical remission and reduced hospitalization rates and need for surgery [2].…”

“…Colonoscopy in patients with active UC may be associated with serious complications such as perforation and bleeding, especially in the case of severe lesions. Therefore, noninvasive methods are required to estimate the severity and the extension of the disease [1].…”