Calprotectin could be a potential biomarker for acute appendicitis

Ambe, Peter C.; Gödde, Daniel; Bönicke, Lars; Papadakis, Marios; Störkel, Stephan; Zirngibl, Hubert

doi:10.1186/s12967-016-0863-3

Cited by 20 publications

(26 citation statements)

References 18 publications

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“…Immunohistochemical activity was determined in epithelial and inflammatory cells in consideration of the amount of inflammatory cells within the lumen of the vermiform appendix. As reported previously, specimens with confirmed appendicitis stained positive, Fig 1 , while control specimens without appendicitis (from patients following right hemicolectomy) stained negative, Fig 2 [18]. …”

Section: Methodssupporting

confidence: 69%

“…In a previous paper, the qualitative expression of Cal in appendectomy specimens was examined via immunohistochemistry using specific anti-calprotectin antibodies [18]. Strong reactions were seen in specimens with proven appendicitis following histopathology, while no reaction was observed in non-inflamed vermiform appendix specimens from patients following right sided hemicolectomy.…”

Section: Discussionmentioning

confidence: 99%

“…The expression of calprotectin in the appendix specimens was assessed by immunohistochemistry using the DAKO Autostainer plus (DakoCytomation) following the manufacturer´s instructions as reported previously [18]: 3–5 μm sections of formalin-fixed, paraffin-embedded tissue was dried overnight at 37°C and deparaffinized. Antigen retrieval was performed using the Target Retrieval Solution (Citrate pH 6,1, 10x, DakoCytomation, cat.no.…”

Section: Methodsmentioning

confidence: 99%

“…This hypothesis was tested in a qualitative analysis using calprotectin specific antibodies. Strong immunostainings were recorded in specimens from patients with AA while no reaction was seen in control specimens without AA [18]. The aim of the present study was to investigate the expression of Cal in stool of patients presenting with suspected AA due to pain to the right lower quadrant.…”

Section: Introductionmentioning

confidence: 99%

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Improving the Preoperative Diagnostic Accuracy of Acute Appendicitis. Can Fecal Calprotectin Be Helpful?

et al. 2016

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BackgroundIs the patient really suffering from acute appendicitis? Right lower quadrant pain is the most common sign of acute appendicitis. However, many other bowels pathologies might mimic acute appendicitis. Due to fear of the consequences of delayed or missed diagnosis, the indication for emergency appendectomy is liberally made. This has been shown to be associated with high rates of negative appendectomy with risk of potentially serious or lethal complications. Thus there is need for a better preoperative screening of patients with suspected appendicitis.MethodsThis prospective single center single-blinded pilot study was conducted in the Department of surgery at the HELIOS Universitätsklinikum Wuppertal, Germany. Calprotectin was measured in pre-therapeutic stool samples of patients presenting in the emergency department with pain to the right lower quadrant. Fecal calprotectin (FC) values were analyzed using commercially available ELISA kits. Cut-off values for FC were studied using the receiver-operator characteristic (ROC) curve. The Area under the curve (AUC) was reported for each ROC curve.ResultsThe mean FC value was 51.4 ± 118.8 μg/g in patients with AA, 320.9 ± 416.6 μg/g in patients with infectious enteritis and 24.8 ± 27.4 μg/g in the control group. ROC curve showed a close to 80% specificity and sensitivity of FC for AA at a cut-off value of 51 μg/g, AUC = 0.7. The sensitivity of FC at this cut-off value is zero for enteritis with a specificity of 35%.ConclusionFecal calprotectin could be helpful in screening patients with pain to the right lower quadrant for the presence of acute appendicitis or infectious enteritis with the aim of facilitating clinical decision-making and reducing the rate of negative appendectomy.

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Section: Methodssupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Improving the Preoperative Diagnostic Accuracy of Acute Appendicitis. Can Fecal Calprotectin Be Helpful?

et al. 2016

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“…In addition, numerous ongoing studies investigate the relationship of the FC levels with various bowel diseases, such as acute appendicitis, Henoch‐Schönlein purpura, and colonic polyps . Several studies showed that even neonates who suffered from necrotizing enterocolitis had early elevation in FC levels .…”

Section: Discussionmentioning

confidence: 99%

Fecal calprotectin level in healthy children aged less than 4 years in South Korea

Song

Lee

Choi

et al. 2017

Clinical Laboratory Analysis

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Background Fecal calprotectin (FC) is non‐invasive inflammatory marker indicating various bowel diseases. However, the median‐specific cut‐off values and the standard deviations (SD) of the FC levels in each age group <4 years were not elucidated. Methods Healthy volunteers were enrolled from four kindergartens. A questionnaire was used to confirm that the children met the inclusion criteria, and several demographics and history of bowel symptoms were collected. The FC level was measured. Results A total of 234 healthy children aged between 6 months and 4 years were recruited. The median FC concentration of all participants was 245 μg/g (range 12–1033 μg/g, mean 68.5 μg/g, SD 123.12 μg/g). The children were divided into six age groups. The upper limit of 95% CI of median FC values was 135 μg/g in 7–12 months group, 65 μg/g in 13–18 months group, 55 μg/g in 19–24 months group, 40 μg/g in 25–30 months group, 21 μg/g in 31–36 months group, and 12 μg/g in 37–48 months group. A negative correlation trend was found between the age and the FC concentration. Conclusion This is the first study to present the FC median levels in the specific age groups <4 years in Korea. We found a FC level reduction with age, indicating a bowel maturation process and decreased intestinal permeability of the intestinal mucosa. In our study, FC levels reached the values of 50 μg/g around the age of 2 years.

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On the Way to Improve Diagnostic Marker Panel for Acute Appendicitis in Adults: the Role of Calprotectin

et al. 2021

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Calprotectin is a positive acute-phase protein participating in innate immune responses and inflammatory processes. This protein is produced mainly in neutrophils, which infiltrate inflamed tissues and then increase the level of calprotectin in plasma, urine, or body secretions. Its measurement is used in the diagnosis of many inflammatory diseases of the gastrointestinal tract. Here, we reviewed the studies evaluating the utility of calprotectin when the patient is suspected of acute appendicitis, one of the most common causes of abdominal pain. Fecal and serum calprotectin provide clinicians additional information as compared to routinely performed laboratory analyses. Moreover, among all forms of the protein, the fecal calprotectin seems to be a particularly promising biomarker due to its high resistance to degradation in the stool. In the future, innovative methods in the form of neural networks may play a valuable role in developing such panels. These findings are important because current literature showed that sensitive and specific markers of acute appendicitis are still urgently needed.

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Calprotectin could be a potential biomarker for acute appendicitis

Cited by 20 publications

References 18 publications

Improving the Preoperative Diagnostic Accuracy of Acute Appendicitis. Can Fecal Calprotectin Be Helpful?

Improving the Preoperative Diagnostic Accuracy of Acute Appendicitis. Can Fecal Calprotectin Be Helpful?

Fecal calprotectin level in healthy children aged less than 4 years in South Korea

On the Way to Improve Diagnostic Marker Panel for Acute Appendicitis in Adults: the Role of Calprotectin

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