Evaluation of disease activity in IBD at the time of diagnosis by the use of clinical, biochemical, and fecal markers

Ricanek, Petr; Brackmann, Stephan; Perminow, Gøri; Lyckander, Lars Gustav; Sponheim, Jon; Holme, Øyvind; Høie, Ole; Rydning, Andreas; Vatn, Morten H.

doi:10.3109/00365521.2011.584897

Cited by 104 publications

(75 citation statements)

References 31 publications

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“…Presumably, FC levels increase rapid ly both in proctosigmoiditis and extensive coli tis, because the main sources of this protein are granulocytes and lymphocytes, which massive ly infiltrate the bowel wall during ac tive inflam mation. These findings partially confirm the re sults of Ricanek et al, 10 who reported no differ ence in FC levels between left sided UC and pan colitis, while showing them to be significantly lower in proctitis.…”

supporting

confidence: 90%

Does the rapid fecal calprotectin test equally predict mucosal inflammation in both ulcerative colitis (UC) and Crohn’s disease (CD)? A prospective analysis of an IBD cohort

Moniuszko¹,

Głuszek²,

Rydzewska³

2017

Polish Archives of Internal Medicine

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supporting

confidence: 90%

Does the rapid fecal calprotectin test equally predict mucosal inflammation in both ulcerative colitis (UC) and Crohn’s disease (CD)? A prospective analysis of an IBD cohort

Moniuszko¹,

Głuszek²,

Rydzewska³

2017

Polish Archives of Internal Medicine

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“…Recently, there has been increasing evidence that the level of fecal calprotectin (FCAL) is very sensitive and specifi c for the presence of intestinal infl ammation in both CD and UC ( 16,17 ). FCAL is released from the breakdown of neutrophils in the intestines, and is not elevated in the absence of gut infl ammation.…”

Section: Introductionmentioning

confidence: 99%

The Relationship Among Perceived Stress, Symptoms, and Inflammation in Persons With Inflammatory Bowel Disease

Targownik

Sexton

Bernstein

et al. 2015

American Journal of Gastroenterology

134

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Symptomatic disease activity was unrelated to intestinal inflammation in CD and only weakly associated in UC. Although there was a strong relationship between perceived stress and gastrointestinal symptoms, perceived stress was unrelated to concurrent intestinal inflammation. Longitudinal investigation is required to determine the directionality of the relationship between perceived stress, inflammation, and symptoms in IBD.

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“…In ulcerative colitis, FC has been shown to be lower in proctitis compared to those with extensive and left-sided disease. Ricanek et al [57] showed than median FC concentration was higher in patients with extensive and left sided disease distribution compared with proctitis (740 vs. 86 μg/g, p < 0.001). The cutoff for active proctitis is therefore likely to be lower than that for left-sided and pan colitis but more studies are needed.…”

Section: Fecal Biomarkers Ibd: Special Situationsmentioning

confidence: 99%

Calprotectin or Lactoferrin: Do They Help

Wright¹

2016

Dig Dis

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Background: The diagnosis and monitoring of inflammatory bowel disease (IBD) has traditionally relied on clinical assessment, serum markers of inflammation and endoscopic examination. Fecal biomarkers such as calprotectin (FC) and lactoferrin (FL) are predominantly derived from neutrophils, are easily detectable in the feces and are now established as valuable markers of intestinal inflammation. In recent years, a ‘treat to target' concept has emerged for the management of IBD. Adequate control of inflammation in IBD at a biochemical level is quickly becoming an important target in IBD management. Key Messages: Fecal biomarkers have been shown to be significantly and consistently increased in both adult and pediatric patients with IBD versus those without IBD. Fecal biomarkers are therefore useful in determining those patients with gastrointestinal symptoms who are likely to benefit from colonoscopy versus those in whom colonoscopy is likely to be normal. Fecal biomarkers correlate significantly with endoscopic disease in both Crohn's disease and ulcerative colitis. Suggested cutoffs for FC for endoscopically active disease in IBD range from 50 to 280 μg/g. Fecal biomarkers reflect the success of treatment intensification and can help predict clinical relapse. Both FC and FL are accurate in the detection of postoperative endoscopic recurrence of Crohn's disease, and FC may be clinically useful in predicting those patients with acute severe ulcerative colitis who may progress to colectomy. There are limitations to these fecal tests including a false positive rate and intra-individual variability. Conclusions: This review focuses on the role of fecal biomarkers in the diagnosis, monitoring and management of IBD and how best to interpret results. We will discuss the emerging role of these biomarkers in the IBD management landscape including FC-guided drug dosing and the development of home-based testing and e-health applications. Fecal biomarker results must always be interpreted in a clinical context. Endoscopic assessment remains the gold standard for diagnosis and monitoring of IBD.

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Evaluation of disease activity in IBD at the time of diagnosis by the use of clinical, biochemical, and fecal markers

Abstract: In UC, both biochemical and fecal markers are related to disease activity and extent of disease, whereas in CD, the fecal calprotectin concentration is a reliable marker of mucosal affection, but not for systemic disease activity.

Cited by 104 publications

References 31 publications

Does the rapid fecal calprotectin test equally predict mucosal inflammation in both ulcerative colitis (UC) and Crohn’s disease (CD)? A prospective analysis of an IBD cohort

Does the rapid fecal calprotectin test equally predict mucosal inflammation in both ulcerative colitis (UC) and Crohn’s disease (CD)? A prospective analysis of an IBD cohort

The Relationship Among Perceived Stress, Symptoms, and Inflammation in Persons With Inflammatory Bowel Disease

Calprotectin or Lactoferrin: Do They Help

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