Fecal markers of inflammation used as surrogate markers for treatment outcome in relapsing inflammatory bowel disease

Wagner, Michael; Peterson, Christer; Ridefelt, Peter; Sangfelt, Per; Carlson, Marie

doi:10.3748/wjg.14.5584

Cited by 127 publications

(103 citation statements)

References 36 publications

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“…1), in patients with UC, the highest fecal calprotectin concentration was observed when an extensive involvement of the large intestine was present and the smallest when only the rectum was involved (1504.9 mg/kg vs. 653.7 mg/kg). A similar correlation was described by Wagner [18] while other authors emphasized a link of fecal calprotectin content and local inflammation activity but not with its extent. In the case of CD, the highest fecal calprotectin concentration was observed when the disease involved the large intestine (1312.4 mg/kg) or both the small and large intestine (1145.9 mg/kg) and the smallest when only the small intestine was involved (559.1 mg/kg), which has also been confirmed by other authors [13,27] (Fig.…”

Section: Discussionsupporting

confidence: 61%

“…Nevertheless, although fecal calprotectin is not specific it is exceptionally useful in assessment of inflammatory bowel disease. This examination is worth of recommendation especially in children in whom intestinal neoplasm is extremely rare and its non-invasiveness and painlessness causes that it is a promising diagnostic tool, which can supplement the standard methods [7,15,18,27,[30][31][32].…”

Section: Discussionmentioning

confidence: 99%

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Fecal Calprotectin as an Activity Marker of Inflammatory Bowel Disease in Children

Krzesiek¹

2015

Adv Clin Exp Med

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Background. Children constitute 20% of patients with inflammatory bowel diseases (IBD). Still there is a search for a perfect marker for this group of patients which would help in the diagnosis of the disease, in determinating its activity and in monitoring the treatment. Objectives. Evaluate the usefulness of the application of calprotectin measurement in stool samples from children with IBD, as a marker of the severity of inflammation. Material and Methods. We analysed 156 patients: 58 with ulcerative colitis (UC), 67 with Crohn's disease (CD), and 31 from the control group. In all patients the concentration of calprotectin in the sample of feces, markers of inflammation and hemoglobin were measured. Results. Concentration of calprotectin in feces of patients with IBD was above the normal range in all patients with moderate and severe disease and in the majority with mild disease or in remission, but it was normal in all patients from the control group. Conclusions. Elevated concentration of fecal calprotectin (FC) was observed in the majority of patients with IBD, but in none from the control group. The number of patients with elevated FC concentration increased together with the disease activity. FC concentration was higher in patients with severe and moderate disease activity. FC concentration in patients with IBD was associated with the increase of inflammatory markers and decreased haemoglobin. Percentage of laboratory abnormalities in children with Crohn's disease and perianal changes was higher. FC concentration can be a noninvasive marker of disease activity in IBD (Adv Clin Exp Med 2015, 24, 5, 815-822).

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Fecal Calprotectin as an Activity Marker of Inflammatory Bowel Disease in Children

Krzesiek¹

2015

Adv Clin Exp Med

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“…Th ere were 27 patients with UC and 11 with CD and 97% had elevated calprotectin levels (defi ned as 94.7 μ g/g). Aft er treatment, a normalized calprotectin level predicted a complete response in 100% of patients, whereas elevated calprotectin predicted incomplete response in 30% ( 60 ). In this study, no patient received biologic therapy.…”

Section: Infl Ammatory Markersmentioning

confidence: 88%

Using Markers in IBD to Predict Disease and Treatment Outcomes: Rationale and a Review of Current Status

Lichtenstein¹,

McGovern²

2016

Am J Gastroenterol Suppl

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Biomarkers, radiology fi ndings, and endoscopic studies, together with clinical assessment of patients with infl ammatory bowel disease, can be used to help determine prognosis, assess disease activity, and increasingly to inform treatment decision-making. This article reviews the current "state of the science" regarding the multitude of different tests that can be performed and how these can be used in the clinic to guide management. Initially, when patients present with symptoms suggestive of infl ammatory bowel disease (IBD), standard endoscopic studies and radiographic studies should be performed and the use of combinations of serologic and fecal markers may additionally be incorporated into patient assessment. Once the patient has a formal diagnosis, prognosis should be assessed and serologic evaluation may be used, but in conjunction with endoscopic and radiographic studies. Within the context of evaluating clinical predictors of disease (e.g., disease location, nutritional status, routine blood tests), early mucosal healing has been linked to better outcomes, and failure to heal the mucosa has been associated with poorer outcomes. Evaluation of response to therapy can be approximated with the use of biomarkers (e.g., C-reactive protein, fecal calprotectin, lactoferrin), and therapeutic drug monitoring has enabled us to assess levels of drug metabolites, drug levels, and antidrug antibodies to guide the ongoing management. Although there is not yet universal adoption of biomarkers to determine treatment choices (e.g., the use of anti-tumor necrosis factor therapy), biomarkers have enabled us to "fi ne tune" treatment of some patients with IBD. Establishing mechanisms of communicating these risks/benefi ts to patients will be a considerable challenge and remains a priority area of research.

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“…Además, tres pacientes tuvieron una reactivación de la CU sin factores determinantes para el cambio. En nuestro caso la paciente lleva 6 meses de seguimiento sin recaída de su CU, lo que se ha objetivado según evolución clínica y control con calprotectina fecal [11][12][13] . Otra similitud con esta serie de casos es que todos los pacientes se encontraban en remisión de la CU.…”

Section: Discussionunclassified

Colitis linfocítica en paciente con colitis ulcerosa: Caso clínico

et al. 2016

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The relationship between Microscopic Colitis and Inflammatory BowelL a diarrea crónica es una patología frecuente que puede afectar a más de 5% de la población general 1 . Entre las causas de diarrea crónica, 10 a 20% corresponde a la colitis microscópica (CM) la cual es más frecuente en mujeres entre la quinta y sexta década de la vida y cuya prevalencia alcanza en algunos estudios los 219 casos por 100.000 habitantes 2,3 . Clínicamente, la CM se caracteriza por la presencia de deposiciones líquidas sin sangre y grados variables de asociación con dolor abdominal, baja de peso y urgencia fecal. Por lo general su curso es crónico con remisión y recaídas espontáneas, no tiene mayor riesgo de cáncer de colon y en la mayoría de los pacientes su curso es benigno en cuanto a necesidad de hospitalización o cirugía 4 . Además, se caracteriza por tener un estudio endoscópico normal (aunque existen pacientes en que se describen mínimas alteraciones como: eritema, edema de la mucosa, alteraciones de vasculatura de la submucosa y erosiones) y exámenes radiológicos sin alteraciones, siendo los hallazgos en la biopsia el mayor elemento diagnóstico. Dentro de la CM se pueden diferenciar dos patrones histológicos característicos; la colitis colagenosa (CC) donde se describe una banda colagenosa subepitelial engrosada (> 10-20 um) asociada a aumento de linfocitos intraepiteliales > 7 por cada 100 células epiteliales y la colitis linfocítica (CL) cuando se objetivan >20 linfocitos intraepiteliales por cada 100 células epiteliales sin aumento de la banda de colágeno subepitelial 3,5,6 .En la literatura, se han publicado casos de pacientes que teniendo el diagnóstico de Colitis Ulcerosa (CU) o Enfermedad de Crohn (EC) han presentado una CM o al revés. La relación entre ambas entidades es poco clara, pero pareciera ser que la CM es más bien un extremo (más benigno) dentro del espectro de la Enfermedad Inflamatoria Intestinal (EII) y no que su presencia se deba exclusivamente a la casualidad. Nuestro objetivo es presentar un caso de una paciente que presentó inicialmente una CU y posteriormente debuto con una CL.

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Fecal markers of inflammation used as surrogate markers for treatment outcome in relapsing inflammatory bowel disease

Abstract: A normalised FC level has the potential to be used as a surrogate marker for successful treatment outcome in IBD patients. However, patients with persistent elevation of FC levels need further evaluation. FC and MPO provide superior discrimination than EPX in IBD treatment outcome.

Cited by 127 publications

References 36 publications

Fecal Calprotectin as an Activity Marker of Inflammatory Bowel Disease in Children

Fecal Calprotectin as an Activity Marker of Inflammatory Bowel Disease in Children

Using Markers in IBD to Predict Disease and Treatment Outcomes: Rationale and a Review of Current Status

Colitis linfocítica en paciente con colitis ulcerosa: Caso clínico

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