Discriminating IBD from IBS: Comparison of the test performance of fecal markers, blood leukocytes, CRP, and IBD antibodies

Schoepfer, Alain; Trummler, Michael; Seeholzer, P; Seibold-Schmid, Beatrice; Seibold, Frank

doi:10.1002/ibd.20275

Cited by 255 publications

(231 citation statements)

References 34 publications

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“…Investigating 252 CrD patients, Seibold's group in Switzerland found a negative association of PABs with inflammatory CrD and revealed a trend towards small bowel disease and small bowel surgery. In contrast to the Hungarian study, this latter report did not find a significant correlation with penetrating disease behavior [31]. A multicenter study involving 109 CrD patients from five university hospitals in France and one in Luxemburg, failed to identify an association between PABs and clinical features of the disease except of a relationship between the presence of the autoantibodies and an early disease onset [30].…”

Section: Autoimmunity In Crohn's Diseasecontrasting

confidence: 77%

Crohn’s disease specific pancreatic antibodies: clinical and pathophysiological challenges

Roggenbuck¹,

Reinhold

Schierack

et al. 2014

Clinical Chemistry and Laboratory Medicine

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Crohn's disease (CrD) and ulcerative colitis (UC) are the main inflammatory bowel diseases (IBD). IBDspecific humoral markers of autoimmunity in the form of autoantibodies have been reported first in the late 1950s by demonstrating the occurrence of autoimmunity in UC, while humoral autoimmunity in CrD can be traced back to the 1970s. Ever since, the pathophysiological role of autoimmune responses in IBDs has remained poorly understood. Notwithstanding, autoreactive responses play a major role in inflammation leading to overt IBD. In CrD, approximately 40% of patients and < 20% of patients with UC demonstrate loss of tolerance to antigens of the exocrine pancreas. Glycoprotein 2 (GP2) has been identified as a major autoantigenic target of the so-called pancreatic antibodies. The previously unsolved contradiction of pancreatic autoreactivity and intestinal inflammation in IBD was elucidated by demonstrating the expression of GP2 at the site thereof. Intriguingly, GP2 has been reported to be a receptor on microfold cells of intestinal Peyer's patches, which are believed to represent the origin of CrD inflammation. The development of immunoassays for the detection of antibodies to GP2 has paved the way to investigate the association of such antibodies with the clinical phenotype in CrD. Given the recently discovered immunomodulating role of GP2 in innate and adaptive intestinal immunity, this association can shed further light on the pathophysiology of IBD. In this context, the association of anti-GP2 autoantibodies as novel CrD-specific markers with the clinical phenotype in CrD will be discussed in this review.

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Section: Autoimmunity In Crohn's Diseasecontrasting

confidence: 77%

Crohn’s disease specific pancreatic antibodies: clinical and pathophysiological challenges

Roggenbuck¹,

Reinhold

Schierack

et al. 2014

Clinical Chemistry and Laboratory Medicine

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“…Nevertheless, although fecal calprotectin is not specific it is exceptionally useful in assessment of inflammatory bowel disease. This examination is worth of recommendation especially in children in whom intestinal neoplasm is extremely rare and its non-invasiveness and painlessness causes that it is a promising diagnostic tool, which can supplement the standard methods [7,15,18,27,[30][31][32].…”

Section: Discussionmentioning

confidence: 99%

Fecal Calprotectin as an Activity Marker of Inflammatory Bowel Disease in Children

Krzesiek¹

2015

Adv Clin Exp Med

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Background. Children constitute 20% of patients with inflammatory bowel diseases (IBD). Still there is a search for a perfect marker for this group of patients which would help in the diagnosis of the disease, in determinating its activity and in monitoring the treatment. Objectives. Evaluate the usefulness of the application of calprotectin measurement in stool samples from children with IBD, as a marker of the severity of inflammation. Material and Methods. We analysed 156 patients: 58 with ulcerative colitis (UC), 67 with Crohn's disease (CD), and 31 from the control group. In all patients the concentration of calprotectin in the sample of feces, markers of inflammation and hemoglobin were measured. Results. Concentration of calprotectin in feces of patients with IBD was above the normal range in all patients with moderate and severe disease and in the majority with mild disease or in remission, but it was normal in all patients from the control group. Conclusions. Elevated concentration of fecal calprotectin (FC) was observed in the majority of patients with IBD, but in none from the control group. The number of patients with elevated FC concentration increased together with the disease activity. FC concentration was higher in patients with severe and moderate disease activity. FC concentration in patients with IBD was associated with the increase of inflammatory markers and decreased haemoglobin. Percentage of laboratory abnormalities in children with Crohn's disease and perianal changes was higher. FC concentration can be a noninvasive marker of disease activity in IBD (Adv Clin Exp Med 2015, 24, 5, 815-822).

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“…A study in 56 subjects found a median concentration of 0.43 mg/g (range 0.01-14.55) 11 and a more recent study (n ¼ 42) showed a median of 2.2 mg/g (range 1.8-3.3). 24 Previous studies of tumour M2-PK have included measurement in controls (Table 4). Our results suggest that separate reference ranges are required for calprotectin and lactoferrin in children aged 2-9 y and that for calprotectin a separate reference range is also required in those 60 y.…”

Section: Discussionmentioning

confidence: 99%

Age-related faecal calprotectin, lactoferrin and tumour M2-PK concentrations in healthy volunteers

et al. 2009

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Editorial comment: Readers should be aware that the content of this research paper has changed substantially from the version that was originally published on-line on 9 September 2009. A reappraisal of the data has resulted in substantial changes to the originally quoted reference ranges. One author of the originally posted article has disassociated herself from this final version of the paper. AbstractObjective: Measurement of the faecal markers calprotectin, lactoferrin and tumour M2-PK has been reported to be useful in the diagnosis and management of a range of gastrointestinal disorders in both children and adults. The aim of this study was to investigate the requirement for age-related reference ranges. Methods: Faecal samples were obtained from 132 healthy subjects and analysis of calprotectin, lactoferrin and tumour M2-PK performed using commercially available enzyme-linked immunosorbent assay. Results: In the healthy subjects median concentrations were as follows: for calprotectin -2-9 y, 34 mg/g, 10-59 y, 22 mg/g and 60 y, 27 mg/g; for lactoferrin -2 -9 y, 2.2 mg/g, 10 y, 0.5 mg/g; and for tumour M2-PK all subjects ,1 U/mL. Significant differences between age groups for different markers resulted in the following age-related reference ranges: calprotectin -2 -9 y, ,166 mg/g, 10-59 y, ,51 mg/g, 60 y, ,112 mg/g; lactoferrin -2 -9 y, ,29 mg/g, 10 y ,4.6 mg/g. Conclusion:In healthy individuals, we found there to be variation in the faecal inflammatory markers calprotectin and lactoferrin with age. For both calprotectin and lactoferrin children aged 2-9 y had significantly higher concentrations than subjects aged 10 y. For calprotectin but not lactoferrin, adults 60 years had a higher concentration than those aged 10-59 y. There was no change with age in the metabolomic marker faecal tumour M2-PK in healthy subjects. The knowledge of age-related reference ranges in healthy subjects is important to fully interpret changes in gastrointestinal disease.

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Discriminating IBD from IBS: Comparison of the test performance of fecal markers, blood leukocytes, CRP, and IBD antibodies

Abstract: The PhiCal Test and IBD-SCAN are highly accurate for discriminating IBD from IBS. There is only marginal additional diagnostic accuracy when the PhiCal Test and IBD-SCAN are combined with ASCA and pANCA. ASCA and pANCA have a high specificity for IBD.

Cited by 255 publications

References 34 publications

Crohn’s disease specific pancreatic antibodies: clinical and pathophysiological challenges

Crohn’s disease specific pancreatic antibodies: clinical and pathophysiological challenges

Fecal Calprotectin as an Activity Marker of Inflammatory Bowel Disease in Children

Age-related faecal calprotectin, lactoferrin and tumour M2-PK concentrations in healthy volunteers

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