Fecal Lactoferrin Is a Sensitive and Specific Marker of Disease Activity in Children and Young Adults With Inflammatory Bowel Disease

Walker, T.G.; Land, Michelle L.; Kartashov, Alex; Saslowsky, Tracee M.; Lyerly, David M.; Boone, James H.; Rufo, Paul A.

doi:10.1097/mpg.0b013e3180308d8e

Cited by 121 publications

(94 citation statements)

References 60 publications

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“…[49][50][51][52] However, most studies found no difference in the faecal levels of calprotectin and lactoferrin between IBS patients and healthy controls. 43,44,49,50,[52][53][54][55][56][57][58][59] Only one publication reported that increased levels of faecal calprotectin were correlated with pain severity; however, this result was observed in children displaying both functional abdominal pain and IBS. 60 Key point: (i) Typically, no changes in the levels of the faecal inflammatory markers calprotectin and lactoferrin are reported in IBS patients.…”

Section: Key Pointsmentioning

confidence: 73%

Review article: associations between immune activation, intestinal permeability and the irritable bowel syndrome

Matricon

Méleine

Gelot

et al. 2012

Aliment Pharmacol Ther

187

180

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This uncommissioned review article was subject to full peer-review. SUMMARY BackgroundIrritable bowel syndrome (IBS), one of the most common gastrointestinal disorders, markedly impairing patients' quality of life. Drug development for IBS treatment has been hampered by the lack of understanding of IBS aetiology. In recent years, numerous data have emerged that suggest the involvement of immune activation in IBS, at least in a subset of patients. AimTo determine whether immune activation and intestinal permeabilisation are more frequently observed in IBS patients compared with healthy controls. MethodsThe scientific bibliography was searched using the following keywords: irritable bowel syndrome, inflammation, immune activation, permeabilisation, intestine, assay, histology and human. The retrieved studies, including blood, faecal and histological studies, were analysed to provide a comprehensive and structured overview of the available data including the type of assay, type of inflammatory marker investigated or intestinal segment studied. ResultsImmune activation was more frequently observed in IBS patients than in healthy controls. An increase in the number of mast cells and lymphocytes, an alteration in cytokine levels and intestinal permeabilisation were reported in IBS patients. No consistent changes in the numbers of B cells or enterochromaffin cells or in mucosal serotonin production were demonstrated. ConclusionsThe changes observed were modest and often heterogeneous among the studied population. Only appropriate interventions improving irritable bowel syndrome symptoms could highlight and confirm the role of immune activation in this pathophysiology.

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Section: Key Pointsmentioning

confidence: 73%

Review article: associations between immune activation, intestinal permeability and the irritable bowel syndrome

Matricon

Méleine

Gelot

et al. 2012

Aliment Pharmacol Ther

187

180

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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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“…Lactoferrin is bactericidal to enteric pathogens, modulates the intestinal immune response, and is released by neutrophils into stool in response to infection. 52 Of interest in the current study, the mean lactoferrin levels were lower in children who were malnourished and had diarrhea compared with those without malnutrition who had diarrhea. We speculate that the lactoferrin assay may be marginally less sensitive in the setting of malnutrition.…”

mentioning

confidence: 98%

Pediatric Diarrhea in Southern Ghana: Etiology and Association with Intestinal Inflammation and Malnutrition

Opintan¹,

Newman²,

Ayeh‐Kumi³

et al. 2010

The American Society of Tropical Medicine and Hygiene

104

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Abstract. Diarrhea is a major public health problem that affects the development of children. Anthropometric data were collected from 274 children with ( N = 170) and without ( N = 104) diarrhea. Stool specimens were analyzed by conventional culture, polymerase chain reaction for enteroaggregative Escherichia coli (EAEC), Shigella , Cryptosporidium , Entamoeba , and Giardia species, and by enzyme-linked immunosorbent assay for fecal lactoferrin levels. About 50% of the study population was mildly to severely malnourished. Fecal lactoferrin levels were higher in children with diarrhea ( P = 0.019). Children who had EAEC infection, with or without diarrhea, had high mean lactoferrin levels regardless of nutritional status. The EAEC and Cryptosporidium were associated with diarrhea ( P = 0.048 and 0.011, respectively), and malnourished children who had diarrhea were often co-infected with both Cryptosporidium and EAEC. In conclusion, the use of DNA-biomarkers revealed that EAEC and Cryptosporidium were common intestinal pathogens in Accra, and that elevated lactoferrin was associated with diarrhea in this group of children.

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Fecal Lactoferrin Is a Sensitive and Specific Marker of Disease Activity in Children and Young Adults With Inflammatory Bowel Disease

Cited by 121 publications

References 60 publications

Review article: associations between immune activation, intestinal permeability and the irritable bowel syndrome

Review article: associations between immune activation, intestinal permeability and the irritable bowel syndrome

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

Pediatric Diarrhea in Southern Ghana: Etiology and Association with Intestinal Inflammation and Malnutrition

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