Trends of fecal calprotectin levels and associations with early life experience in preterm infants

Abstract

Background: Preterm infants are at risk for severe infections due to their immature immune systems. Factors such as early life pain/stress experiences and feeding may influence immune activation and maturation of immune systems. However, the underlying mechanism remains unclear. Fecal calprotectin (FCP) is a noninvasive surrogate biomarker of mucosal inflammation in the gastrointestinal tract and has been used in detecting intestinal inflammation in specific pediatric gastrointestinal disorders. Objective: To describe the longitudinal trajectory of FCP levels in preterm infants and investigate the contributing factors that are associated with FCP levels. Design: A longitudinal study design was used. Settings: Preterm infants were recruited from 2 neonatal intensive care units (NICU) of a children’s medical center in the North-eastern US. Methods: Preterm infants were followed during their first 4 weeks of NICU hospitalization. Stool samples were collected twice per week to quantify the FCP levels. Cumulative pain/stress experiences and feeding types were measured daily. A linear mixed-effect model was used to examine the associations between FCP levels and demographic and clinical characteristics, cumulative pain/stress, and feeding over time. Results: Forty-nine preterm infants were included in the study. Infants’ FCP levels varied largely with a mean of 268.7±261.3 µg/g and increased over time. Preterm infants experienced an average of 7.5±5.0 acute painful procedures and 15.3±20.8 hours of chronic painful procedures per day during their NICU stay. The mean percentage of mother’s own milk increased from the first week (57.1±36.5%) to the fourth week (60.7±38.9%) after birth. Elevated FCP concentration was associated with acute and cumulative (chronic) pain/stress levels, mother’s own milk, non-White race, and higher severity of illness score. Conclusions: FCP levels were elevated in preterm infants with wide interindividual and intraindividual variations. Cumulative pain/stress during the NICU hospitalization, feeding, race, and health status may influence FCP concentrations in early life that may be associated with inflammatory gut processes.

Comparison of the Effect of Two Different Handling Conditions at Slaughter in Saliva Analytes in Pigs

“…Calprotectin was significantly increased in Group B after 4 h of lairage at the slaughterhouse. Although the relationship between stress and calprotectin has not been fully studied, some studies in patients with inflammatory bowel disease have associated the presence of higher levels of stress with increased fecal calprotectin [41], and also in a study involving preterm infants from neonatal intensive care units found a relationship between cumulative pain/stress during hospitalization and fecal calprotectin concentrations [42].…”

Measurement of Calprotectin (S100A8/A9) in the Saliva of Pigs: Validation Data of A Commercially Available Automated Assay and Changes in Sepsis, Inflammation, and Stress

“…This stress is due to new situations that face the pigs at the slaughterhouse, with various stressful stimuli such as strange sounds and mixing with unfamiliar pigs [ 17 ]. Previous reports have indicated that stress can increase faecal CALP in humans, suggesting that this increase could be related to the regulation of the immune system by stress [ 18 ], while other reports have associated these increases with the activation of inflammatory processes in the gut that occurs in stressful conditions [ 19 , 20 ]. The increases found in our study in the stress due to pre-slaughter lairage were lower than those found in sepsis, however further studies with other types of stress should be performed to evaluate if in some cases the increases could be high enough to mask a septic situation.…”

Monitoring of the State of the Intestinal Epithelial Barrier in Children of the First Year of Life With Allergic Enteropathy

“…Диагностическая ценность кальпротектина у детей раннего возраста также вызывает растущий интерес. Повышенные концентрации кальпротектина в кале коррелируют с тяжестью воспалительных процессов при воспалительных заболеваниях кишечника [8,9], но могут встречаться и у здоровых новорожденных [10]. До настоящего времени существуют противоречивые данные о референсных значениях данного маркера у детей первого года жизни, не определена его роль у детей первого года с аллергической энтеропатией [11,12].…”

“…В нашем исследовании фекальный кальпротектин у детей с аллергической энтеропатией превышал показатели контрольной группы более чем в 5 раз. Это согласуется с данными проведенных ранее исследований [7,8] и подтверждает, что фекальный кальпротектин может служить достоверным маркером, позволяющим судить о выраженности воспалительного повреждения слизистой оболочки кишечника, в том числе аллергического генеза. При анализе определяемых показателей у детей с аллергической энтеропатией в различных возрастных группах мы не обнаружили статистически значимых различий, что косвенно подтверждает активное участие данного маркера именно в воспалительных изменениях кишечника и не может быть объяснено функциональной незрелостью детей данной возрастной группы.…”