Clinical utility of calprotectin and lactoferrin as markers of inflammation in patients with inflammatory bowel disease

Abstract

Crohn's disease and ulcerative colitis have a feature in common (i.e., chronic inflammation). Their clinical management requires repeated assessments; endoscopy with histological examination remains the gold standard for detecting and quantifying intestinal inflammation. An ideal marker should be quick and easy to obtain noninvasively, and should be inexpensive and reproducible. Several laboratory tests have been studied but, to date, a disease marker is not yet available. A combination of signs and symptoms, laboratory findings and imaging techniques is consequently still needed for assessing disease activity and prognosis. In recent years, research has drawn attention to fecal markers owing to their specificity for intestinal inflammation, ease of sample collection, availability of commercial immunoassays and convenience. Biological markers have been used to assess inflammatory bowel disease patients for the purposes of their clinical management, monitoring disease activity, predicting relapses, assessing prognosis and monitoring response to treatment.

Measuring disease activity in Crohn's disease: what is currently available to the clinician

“…Fecal biomarkers, such as the neutrophil-derived calprotectin and lactoferrin, have proved useful for managing CD patients in several settings, as previously reported in two recent reviews 89,90. Both fecal calprotectin and lactoferrin significantly correlate with endoscopic and histological scores of CD activity in ileocolonic or colonic disease, but not when the disease is confined to the ileum 91,92.…”

Fecal Calprotectin Level Reflects the Severity of Clostridium difficile Infection

“…The role of FC was examined in many other gastrointestinal diseases such as inflammatory bowel disease (IBD), acute gastroenteritis, and malignancies [14]. The use of FC in CDI diagnosis was also demonstrated in a few studies; however, this marker showed restricted utility for assessing CDI severity [1115].…”

Advances in the diagnosis and management of inflammatory bowel disease: Challenges and uncertainties

“…The use of these markers has expanded to include making initial diagnosis and differentiating between IBD and other diseases, evaluating the symptoms of active IBD to rule out flare-ups, postoperative evaluation, monitoring the response to therapy, and predicting relapse. [505152535455565758596061626364] Historically, inflammatory markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were used for these indications, but have since fallen out of favor as they are generally non-specific. [65] More recently, markers of inflammation that are specific to the GI tract, such as fecal calprotectin (FC) and stool lactoferrin (SL), have been introduced.…”