Fecal lactoferrin for diagnosis of symptomatic patients with ileal pouch-anal anastomosis

Parsi, Mansour A.; Shen, Bo; Achkar, Jean Paul; Remzi, Feza; Goldblum, John R.; Boone, James H.; Lin, Dahai; Connor, Jason T.; Fazio, Victor W.; Lashner, Bret A.

doi:10.1053/j.gastro.2004.02.012

Cited by 101 publications

(58 citation statements)

References 31 publications

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“…The presence of Lf in the cytoplasm of colorectal cancer and adenoma cells has also been reported [18,19] . The high Lf level in the feces of patients with intestinal inflammation is believed to originate from the neutrophils which have infiltrated the intestinal mucosa [20][21][22] . The reason for elevation of fecal Lf level in patients with colorectal cancer has not yet been fully determined.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of fecal lactoferrin and hemoglobin in diagnosis of colorectal diseases

Hirata

Hoshimoto²,

Saito³

et al. 2007

WJG

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AIM:To evaluate prospectively usefulness of fecal lactoferrin (Lf ) and fecal hemoglobin (Hb) in the diagnosis of colorectal diseases. METHODS:Fecal Lf and Hb were measured using ELISA in 872 patients before they underwent colorectal endoscopy. RESULTS:Lf was positive in 18 (50%) of 36 patients with colorectal cancer, 25 (15.9%) of 157 with colorectal polyps, 29 (46.8%) of 62 with ulcerative colitis, and 25 (62.5%) of 40 (62.5%) with Crohn's disease. The Hbpositive rates were 50%, 12.1%, 41.9% and 32.5%, respectively. Of the 318 patients free of abnormalities by colorectal endoscopy, Lf was positive in 29 (9.1%) and Hb was positive in 15 (4.7%). Among patients with Crohn's disease, the Lf-positive rate was significantly higher than the Hb-positive rate. If either high Lf or Hb levels were considered positive, the positive rates rose to 61.1%, 51.6%, and 67.5% in the colorectal cancer group, ulcerative colitis group, and Crohn's disease group, respectively. If both high Lf and Hb levels were rated positive, the positive predictive values (PPV) were 21% for colorectal cancer, 33% for ulcerative colitis, and 17% for Crohn's disease, and PPV of high Hb level alone was 18%, 25% and 13%, respectively. CONCLUSION:Fecal Lf and Hb were found useful in the detection of colorectal diseases, and the combination of the two measurements appears to increase the sensitivity and efficacy of diagnosis.

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Section: Discussionmentioning

confidence: 99%

Usefulness of fecal lactoferrin and hemoglobin in diagnosis of colorectal diseases

Hirata

Hoshimoto²,

Saito³

et al. 2007

WJG

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“…FL levels are significantly higher in both clinically active UC, CD, and pouchitis than in controls or in inactive disease [45,72,74,75,76]. Correlations of FL with IBD endoscopic and histological activity have been detected [49,56,57,77] and concentrations in endoscopically moderate or severely active CD are significantly higher than in mild disease [34,48,56,78].…”

Section: Lactoferrinmentioning

confidence: 99%

Diagnostics and Prognostics of Inflammatory Bowel Disease with Fecal Neutrophil-Derived Biomarkers Calprotectin and Lactoferrin

Sipponen

2013

Dig Dis

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Crohn's disease (CD), ulcerative colitis (UC), and colitis unclassified, collectively defined as inflammatory bowel disease (IBD), are the consequence of chronic inflammatory reactions in the gastrointestinal tissue. Endoscopy with biopsies is the mainstay in the diagnosis of this inflammation and is also important in the assessment of disease activity and monitoring of treatment. Furthermore, mucosal healing is increasingly becoming a therapeutic target for treatment of IBD and the golden standard of assessing it is endoscopy. However, due to the costs, invasiveness, and to limited endoscopic capacity, the need is strong for reliable surrogate markers of intestinal inflammation. Bowel contents, being in close contact with intestinal mucosa, can take up molecules that are measurable from stool samples and thus can serve as markers of inflammation. The fecal neutrophil-derived biomarkers, especially calprotectin and lactoferrin, have several features of an ideal test for detecting intestinal inflammation: they are noninvasive, simple, and low in cost. The utility of these biomarkers in distinguishing IBD from noninflammatory conditions such as irritable bowel syndrome is well documented. They correlate closely with endoscopic activity both in CD and UC. They allow serial monitoring of disease activity and of treatment success, and can even serve in predicting clinical relapse in unsymptomatic patients or sustained remission after induction with TNF-α-blocking agents. In this review an overview will be given to the role of fecal neutrophil-derived biomarkers calprotectin and lactoferrin in diagnostics and prognostics of IBD.

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“…Identification of rapid, noninvasive means of diagnosing symptomatic patients with IPAA would be helpful. 77 Parsi et al 77 studied 60 subjects with IPAA for IBD and measurements of fecal lactoferrin, and underwent pouch en-doscopy with biopsy. Fecal lactoferrin could distinguish patients with irritable pouch syndrome from those with pouchitis, cuffitis, or CD with a sensitivity of 100% and specificity of 85%.…”

Section: Is Fecal Lactoferrin Determination Of Any Use In Ibd Patientmentioning

confidence: 99%

“…Therefore, the authors concluded that this fecal marker can serve as a sensitive and noninvasive initial screening test in an algorithm for evaluation of symptomatic patients with IPAA: if fecal lactoferrin levels are low, irritable pouch syndrome can be diagnosed; on the contrary, if fecal lactoferrin levels are high, pouch endoscopy with biopsy is warranted to distinguish among different causes of inflammation. 77 The next logical step would be to test whether this strategy is cost-effective. Currently, a frequently recommended initial approach to these symptomatic patients includes a therapeutic empirical trial of antibiotics such as metronidazole or ciprofloxacin.…”

Section: Is Fecal Lactoferrin Determination Of Any Use In Ibd Patientmentioning

confidence: 99%

Questions and answers on the role of fecal lactoferrin as a biological marker in inflammatory bowel disease

Gisbert

McNicholl

Gomollón

2009

Inflammatory Bowel Diseases

114

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Among the available fecal biomarkers for the diagnosis and monitoring of inflammatory bowel disease (IBD), only calprotectin and lactoferrin have translated into useful clinical tools. Lactoferrin can be detected using simple and cheap techniques and it has excellent stability in feces over a long period of time. Fecal lactoferrin has a good diagnostic precision for separating organic and functional intestinal disease. However, a negative fecal lactoferrin test should be interpreted merely as the absence of significant neutrophilic intestinal inflammation. The mean sensitivity and specificity of the fecal lactoferrin determination for the diagnosis of IBD is 80% and 82%, respectively. Some studies have suggested a lower accuracy of lactoferrin when compared with calprotectin for the diagnosis of IBD, indicating that more studies on this topic are necessary. A parallel between fecal lactoferrin levels and IBD activity estimated with clinical, endoscopic, and histological parameters has been confirmed. However, this correlation seems to be lower in Crohn's disease than in ulcerative colitis, mainly when Crohn's disease patients with purely ileal disease are considered. Fecal lactoferrin determination may be useful in predicting impending clinical relapse in IBD patients. Fecal lactoferrin may be a helpful noninvasive diagnostic tool for monitoring therapeutic efficacy, mainly on mucosal healing, as a decreasing concentration of lactoferrin can be interpreted as a marker of therapeutic response. Finally, in patients with Crohn's disease who have undergone ileocolonic resection, those with higher lactoferrin fecal levels might be more prone to postsurgical recurrence.

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Fecal lactoferrin for diagnosis of symptomatic patients with ileal pouch-anal anastomosis

Cited by 101 publications

References 31 publications

Usefulness of fecal lactoferrin and hemoglobin in diagnosis of colorectal diseases

Usefulness of fecal lactoferrin and hemoglobin in diagnosis of colorectal diseases

Diagnostics and Prognostics of Inflammatory Bowel Disease with Fecal Neutrophil-Derived Biomarkers Calprotectin and Lactoferrin

Questions and answers on the role of fecal lactoferrin as a biological marker in inflammatory bowel disease

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