Enteric Protein Loss, Measured by Fecal Alpha-1-Anti-Trypsin (At) Clearance, in the Assessment of Crohn's Disease Activity

Griffiths, Anne M.; Soldin, S J; Hewitt, G; Hamilton, Richard

doi:10.1203/00006450-198404001-00625

Cited by 5 publications

(6 citation statements)

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“…where F is the fecal AAT concentration (mg/g), W is the daily stool weight, and p is the serum AAT concentration (mg/dL) [17]. A clearance of !27 mL/ day suggests the diagnosis of protein-losing enteropathy.…”

Section: Pharmacokinetic and Correlative Studiesmentioning

confidence: 99%

Response of Steroid-Refractory Acute GVHD to α 1 -Antitrypsin

Marcondes

Hockenbery

Lesnikova

et al. 2016

Biology of Blood and Marrow Transplantation

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α1-Antitrypsin (AAT) is a serine protease inhibitor with anti-inflammatory, antiapoptotic, and immunomodulatory properties. It has therapeutic efficacy in animal models of autoimmune diseases, inflammatory disorders, and transplantation. In a phase I/II open-label single-center study, we administered AAT (Glassia; Baxalta/Kamada, New Ziona, Israel) as salvage therapy to 12 patients with steroid-refractory acute graft-versus-host disease (GVHD). AAT was given i.v. at 2 dose levels over a 15-day course. All patients had grades III or IV GVHD with stage 4 gut involvement. After treatment, plasma AAT levels increased in both cohorts and remained within 2 to 4 mg/mL for the duration of treatment. No clinically relevant toxicities attributable to AAT were observed. GVHD manifestations improved in 8 of 12 patients, and 4 responses were complete. Six patients (50%) were alive at last follow-up (>104 to >820 days). These findings show that AAT is well tolerated and has efficacy in the treatment of steroid-refractory severe acute GVHD. Further studies are warranted.

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Section: Pharmacokinetic and Correlative Studiesmentioning

confidence: 99%

Response of Steroid-Refractory Acute GVHD to α 1 -Antitrypsin

Marcondes

Hockenbery

Lesnikova

et al. 2016

Biology of Blood and Marrow Transplantation

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“…For instance, children with active IBD may have altered levels of acute phase proteins with increased CRP, elevated ESR, and thrombocytosis 5. Fecal markers, which include stool leucocytes and α‐1‐antitrypsin, may also be helpful 6. These markers have been employed in the assessment of children suspected of having IBD and in subsequent follow‐up to document resolution of inflammation, although these markers are not always reliable in children and adolescents 5, 6.…”

mentioning

confidence: 99%

“…Fecal markers, which include stool leucocytes and α‐1‐antitrypsin, may also be helpful 6. These markers have been employed in the assessment of children suspected of having IBD and in subsequent follow‐up to document resolution of inflammation, although these markers are not always reliable in children and adolescents 5, 6. However, various novel inflammatory markers may provide better evidence of gut inflammation in children.…”

mentioning

confidence: 99%

Fecal S100A12 and fecal calprotectin as noninvasive markers for inflammatory bowel disease in children

Sidler

Leach

Day

2008

Inflammatory Bowel Diseases

135

146

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Both fecal markers were superior to the sensitivities and specificities of any standard inflammatory test. Both fecal S100A12 and calprotectin are sensitive markers of gastrointestinal inflammation, but fecal S100A12 provided exceptional specificity in distinguishing children with IBD from children without IBD. Fecal S100A12 is a simple, noninvasive test that can be used to screen and select children warranting further invasive and laborious procedures such as endoscopy for the investigation of their gastrointestinal symptoms.

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“…27 Other published data are limited with regard to quantifying the extent of malabsorption; however, that which is available suggests that significant intestinal fat malabsorption is uncommon, 28 but leakage of protein is frequent. 29 The nature of elevated stool losses and the extent to which they may raise energy demands has not been adequately addressed, and malabsorption or enteric protein loss may potentially have a very significant impact on the nutrition requirements in children with CD.…”

Section: Stool Lossesmentioning

confidence: 99%

Nutrition Issues in Pediatric Crohn's Disease

2007

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Twenty-five percent of inflammatory bowel disease (IBD) diagnoses present in childhood, with Crohn's disease (CD) being the most common type. Many children have poor nutrition status at presentation of the disease, which may worsen during the clinical course, with a significant number of children having impaired linear growth. The cause of this poor nutrition status is complex, and contributing factors include inadequate intake, malabsorption, altered energy demands, and losses through stool, particularly in colitis. The principal aim of medical management is to induce disease remission, with minimal side effects, thereby enabling normal growth and development. This must include active consideration of the nutrition needs of such children and how they may be best met. However, our understanding of the manner in which the disease process affects the energy demands of children with CD or how poor nutrition, in turn, may affect the disease course is limited. This may constrain the efficacy and effectiveness of standard therapeutic approaches to care. This review explores the many factors of relevance in the delivery of nutrition support to children with inflammatory bowel disease, and explores the role of exclusive enteral nutrition as a corticosteroid-sparing strategy to induce remission in children with active Crohn's disease.

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Enteric Protein Loss, Measured by Fecal Alpha-1-Anti-Trypsin (At) Clearance, in the Assessment of Crohn's Disease Activity

Cited by 5 publications

References 0 publications

Response of Steroid-Refractory Acute GVHD to α 1 -Antitrypsin

Response of Steroid-Refractory Acute GVHD to α 1 -Antitrypsin

Fecal S100A12 and fecal calprotectin as noninvasive markers for inflammatory bowel disease in children

Nutrition Issues in Pediatric Crohn's Disease

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