Fecal Eosinophil Cationic Protein Is a Diagnostic and Predictive Biomarker in Young Adults with Inflammatory Bowel Disease

Abstract

Background and Aims: Fecal biomarkers are important non-invasive markers monitoring disease activity in inflammatory bowel disease (IBD). We compared the significance of fecal eosinophil cationic protein (fECP) and fecal calprotectin (fCal). Methods: fECP and fCal were measured in patients with Crohn’s disease (CD, n = 97), ulcerative colitis (UC, n = 53), Clostridioides difficile infection (CDI, n = 9), primary food allergy (PFA, n = 11), pollen-associated food allergy (n = 25) and non-inflammatory controls (n = 78). Results were correlated with clinical and endoscopic IBD activity scores. Results: fECP was significantly elevated in CD, UC, CDI and PFA compared to controls. fCal was significantly increased in CD, UC and CDI. fECP had lower diagnostic accuracy than fCal (area under the curve (AUC) = 0.88) in differentiating between endoscopically active and inactive patients with IBD (AUC = 0.77, ROC analysis). In contrast to fCal, fECP correlated negatively with age and levels were also elevated in clinically and endoscopically inactive patients with IBD <45 years (endoscopically inactive IBD vs controls; AUC for fECP = 0.86; AUC for fCal = 0.62). However, in those patients with low inflammatory activity (fCal <250 mg/kg), high fECP indicated the need for treatment modification or surgery (fECP <200 µg/kg = 22%; 200–600 µg/kg = 44%; >600 µg/kg = 82%) at month 48 of follow-up. Conclusions: fECP is a diagnostic and prognostic marker in young patients with IBD in remission.

AST/ALT ratio as a predictor of mortality and future exacerbations of PM/DM-ILD——a retrospective cohort study with 522 cases

“…Finally, ILDs 8 comprise a large group of diseases that generally affect the interstitium [31] and have been associated with increased levels of eosinophils in bronchoalveolar lavage fluid and serum [32,33], which work as cytokine mediators for acute and chronic inflammation, causing damage to lung tissues, myocardium, skin and gastrointestinal tract. [34][35][36][37] The positive association of EO% with the DRR in our cohort provides support for this mechanism.…”

Overexpression of corticotropin-releasing factor in intestinal mucosal eosinophils is associated with clinical severity in Diarrhea-Predominant Irritable Bowel Syndrome

“…Eosinophil PMD has been described in inflammatory conditions such as ulcerative colitis, allergic rhinitis and asthma patients 27 , by ultrastructural analysis as the loss of granular density without fusion of intergranular membranes and the increase in cytoplasmic secretory vesicles 41 . In those patients, the moderate to extensive degree of PMD 27 and the presence of extracellular and fecal eosinophil-derived cationic proteins suggest an inflammatory activation profile of eosinophils 5,[42][43][44] . In the present study, quantitative analysis demonstrated a low degree of PMD in jejunal eosinophils, being significantly higher in IBS-D respect to HC.…”

The Regulation of Intestinal Inflammation and Cancer Development by Type 2 Immune Responses

“…Similar to basophils, IBD patients exhibit a pronounced infiltration of eosinophils in the mucosa, especially in UC patients, not only in active disease but also during remission. The presence of eosinophils has even led to suggest eosinophil-derived markers, such as eosinophil-derived neurotoxin (EDN) and eosinophil cationic protein (ECP) as fecal markers in IBD, complementary to calprotectin [ 84 , 85 ]. Mechanistically, it is considered that eosinophils are effector cells that contribute to barrier dysfunction through the release of pro-inflammatory cytokines and cytotoxic factors after degranulation.…”