A longitudinal study of fecal calprotectin and the development of inflammatory bowel disease in ankylosing spondylitis

Klingberg, Eva; Strid, Hans; Ståhl, Arne; Deminger, Anna; Carlsten, Hans; Öhman, Lena; Forsblad‐d’Elia, Helena

doi:10.1186/s13075-017-1223-2

Cited by 77 publications

(59 citation statements)

References 31 publications

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“…Two factors predictive of CD in association with SpA were higher disease activity, as reflected by the BASDAI, and increased FCP when not taking NSAID. Our findings are thus in keeping with other studies 44,50 . Anti-TNF therapy has been shown to induce and maintain remission of CD, while at the same time treating severe active SpA 51 , suggesting that it should be the preferred drug for the treatment of active and severe SpA associated with active or quiescent CD.…”

Section: Kopylov Et Al: the Space Capsule Studysupporting

confidence: 83%

“…A recent longitudinal study also reported that an elevated FCP was the strongest predictor of the development of CD in AS 44 . As in our study, all the IBD cases uncovered were CD rather than UC.…”

Section: Kopylov Et Al: the Space Capsule Studymentioning

confidence: 99%

“…However, mild small bowel lesions can be detected frequently in healthy controls or in NSAID users 26 . In patients with SpA, continuation of NSAID has been associated with elevated FCP levels 44 . Although patients were instructed to discontinue NSAID for at least 4 weeks, some concealed use cannot be excluded.…”

Section: Kopylov Et Al: the Space Capsule Studymentioning

confidence: 99%

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Detection of Crohn Disease in Patients with Spondyloarthropathy: The SpACE Capsule Study

Kopylov

Starr²,

Watts³

et al. 2018

J Rheumatol

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Objective.Inflammatory bowel disease (IBD) is generally reported to be associated with spondylarthropathies (SpA) in 5%–15% of cases. Systematic colonoscopic assessment by protocol demonstrated mucosal inflammation characteristic of Crohn disease (CD) in up to one-third of patients with SpA. Video capsule endoscopy (CE) is a superior diagnostic tool to detect small bowel mucosal disease. Our study compared the accuracy of CE to standard colonoscopy for detection of inflammatory bowel lesions in patients with SpA, and to describe predictors of small bowel inflammation (SBI) in this cohort.Methods.Prospective cross-sectional study of adult patients followed for SpA. Patients were evaluated by CE and standard colonoscopy with biopsies. SBI was quantified using the Lewis Score. Additional screening tests included fecal calprotectin (FCP), C-reactive protein (CRP), and a diagnostic panel of serologic, inflammatory and genetic tests (SGI).Results.There were 64 patients recruited (53% female, mean age 42 ± 13 yrs). Chronic gastrointestinal (GI) symptoms were present in 57%. CE revealed significant SBI in 27/64 (42.2%), compared to 7/64 (10.9%) by standard colonoscopy (p = 0.035). Elevated FCP was associated with small bowel CD (OR 4.5, 95% CI 1.01–19.9; p = 0.042). No correlation was observed with presence of GI symptoms, CRP, or SGI results. Finding CD led to a change in management in 65.2% of cases.Conclusion.CE uncovered SBI consistent with CD in 42.2% of patients with SpA, with a significant incremental yield over colonoscopy of 31%. FCP levels were significantly correlated with CE results, while GI symptoms and SGI results were poor predictors of SBI.

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Section: Kopylov Et Al: the Space Capsule Studysupporting

confidence: 83%

Section: Kopylov Et Al: the Space Capsule Studymentioning

confidence: 99%

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Detection of Crohn Disease in Patients with Spondyloarthropathy: The SpACE Capsule Study

Kopylov

Starr²,

Watts³

et al. 2018

J Rheumatol

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“…In SpA patients it was reported to be associated with age, acute phase reactants, disease duration, and clinical activity but not with gastrointestinal symptoms [24]. Recently, however, elevated faecal CALP has been proposed as a biomarker of SpA patients with concomitant bowel inflammation and the main predictor of IBD development [25][26][27]. Unfortunately, in the present study, despite up-regulation of faecal CALP in SpA patients compared to the healthy controls, we failed to find such association.…”

Section: Faecal Calprotectin Esrcontrasting

confidence: 82%

Spondyloarthritis patients with and without intestinal symptoms – searching for discriminating biomarkers

Kontny

Dmowska-Chalaba

2019

cejoi

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Spondyloarthritis (SpA) is often complicated with subclinical gut inflammation. This study was aimed at searching for biomarkers discriminating SpA patients with and without intestinal symptoms. A group of 29 SpA patients and 33 healthy volunteers (control) were included in the study. Based on clinical evaluation, the patient cohort was subdivided into two groups: 1) SpA accompanied by various intestinal symptoms suggesting gut inflammation (group 2, n = 14) and 2) without such complications (group 1, n = 15). Serum concentrations of interleukins (IL) (IL-10, IL-17A/F, , tumour necrosis factor (TNF), bone-homeostasis-related factors (osteoprotegerin -OPG and Dickkopf-1 -DKK-1), and the concentrations of selected gut inflammation-associated factors (intestinal fatty acid binding protein -iFABP, claudin 3 -CLDN3 and calprotectin) in samples of sera and/or urine or stool, respectively, were measured by specific ELISA. Serum concentrations of tested factors were similar in SpA patients and control. Faecal calprotectin level was higher in patients but did not discriminate between group 1 and 2. Compared to group 1, group 2 was characterized by elevated erythrocyte sedimentation rate (ESR), higher serum CLDN3 and DKK-1 levels. In SpA patients, serum DKK-1 concentrations correlated with systemic inflammation markers (R = 0.6, p < 0.01), while serum CLDN3 was found to be an independent risk factor (OR = 4.5, p = 0.021) for the occurrence of intestinal symptoms. We conclude that in SpA patients, up-regulated circulating levels of CLDN3 seem to be related to intestinal complication, while the quantity of circulating DKK-1 reflects the intensity of systemic inflammation.

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“…FC cutoff values were reported in the range of 150‐ 250 µg/g . Percent bias at FC cutoff values of 50 and 200 μg/g between both methods was simultaneously estimated using three regression models; these differences were all less than the acceptable standard (10%). The agreement study demonstrated that 99.10% (110/111) of the individuals were classified into the same group between both methods ( kappa = .99, P < .001).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a fluorescent immunochromatography test for fecal calprotectin

Zhao

Dong

et al. 2019

Clinical Laboratory Analysis

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Background Fecal calprotectin (FC) is widely used to discriminate between patients with inflammatory diseases such as inflammatory bowel disease (IBD) and functional diseases such as irritable bowel syndrome (IBS). ELISA is a time‐consuming method for the measurement of FC, whereas a fluorescent immunochromatography test can obtain results in around 30 minutes and thus enables a rapid response to clinical decision. Methods Two methods, the Proglead® calprotectin (FC Proglead) and the BÜHLMANN fCAL® ELISA (FC BÜHLMANN), were used to quantitatively examine FC in 111 stool samples. The comparison and bias estimation of both assays were assessed using CLSI EP09c protocol. Results The two methods were highly correlated (rho = .96). Deming regression was employed to calculate the regression equation, with a slope of 1.01 and an intercept of −4.98 μg/g. The estimated median bias (FC Proglead − FC BÜHLMANN) was −4.19 μg/g with the 95% limits of agreement (−55.59 to 47.21 μg/g), and the estimated median percent bias was −8.71% with the 95% limits of agreement (−50.31% to 32.90%). There was 4.50% (5/111) of values outside the 95% limits of agreement. Percent biases at the FC cutoff values of 50 and 200 μg/g between both methods evaluated by Deming regression were 8.96% and 1.49%, respectively. The biases were all less than the acceptable standard (10%). And, 99.10% of FC results were in agreement between both methods (kappa = .99, P < .001). Conclusions FC Proglead may be used as a suitable alternative to FC BÜHLMANN for the disease activity assessment for patients with IBD, considering its convenience and shorter turnaround time.

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A longitudinal study of fecal calprotectin and the development of inflammatory bowel disease in ankylosing spondylitis

Cited by 77 publications

References 31 publications

Detection of Crohn Disease in Patients with Spondyloarthropathy: The SpACE Capsule Study

Detection of Crohn Disease in Patients with Spondyloarthropathy: The SpACE Capsule Study

Spondyloarthritis patients with and without intestinal symptoms – searching for discriminating biomarkers

Evaluation of a fluorescent immunochromatography test for fecal calprotectin

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