High Faecal Calprotectin Levels in Healthy, Exclusively Breast-Fed Infants

Abstract

Background: Faecal calprotectin has been proposed as a sensitive marker for gastrointestinal inflammation in children and adults. High levels have been reported in healthy newborns and during the first months of life; the effect of the kind of feeding on the calprotectin concentration in stools is controversial. Objective: To evaluate faecal calprotectin values in healthy, exclusively breast-fed (BF) or formula-fed (FF) infants. Methods: Stool samples were obtained from 74 healthy infants (39 exclusively BF and 35 exclusively FF) with a median age of 51 days (range 13–90). Exclusion criteria were acute infections and treatment with anti-inflammatory drugs. Stool samples were stored at –20°C until they were analysed, and the faecal calprotectin concentration was detected using a commercial quantitative enzyme-linked immunoassay (Calprest; Eurospital SpA, Trieste, Italy). Results: The median faecal calprotectin concentration was significantly higher in BF infants (555.00 µg/g, range 122.5–2,000.0 µg/g) than in FF ones (206.60 µg/g, range 31.2–797.6 µg/g) (p < 0.001). We observed a significantly higher median stool frequency in BF infants than in FF ones (p < 0.001), but multiple regression analysis (independent variables: kind of feeding and stool frequency; dependent variable: calprotectin) showed a significant coefficient for the kind of feeding, but not for stool frequency (p = 0.937). Conclusions: Our findings show that the kind of feeding influences the faecal calprotectin concentration, with higher values in healthy exclusively BF infants than in FF ones. Our study does not allow us to clearly identify the reason for our finding; this could be due to hormones (such as ghrelin and leptin), cytokines and other immunostimulating and growth factors (such as epidermal growth factor and granulocyte colony-stimulating factor) in human milk, which contribute to the development of the gastrointestinal immune system. Further investigations are needed to better clarify the mechanism underlying the relationship between feeding and faecal calprotectin levels in young infants.

Cardiovascular risk markers until 12 mo of age in infants fed a formula supplemented with bovine milk fat globule membranes

“…In this study, we observed no differences in hsCRP between the EF and SF groups. The breast-fed infants had significantly higher fecal calprotectin levels at baseline compared with the formula-fed infants, in line with previous findings (41). The high concentration of fecal calprotectin in young infants has been suggested to be due to increased intestinal permeability and transepithelial migration of neutrophils at this age, possibly related to the development of the intestinal microbiota (42).…”

Fecal Expression of Human β-Defensin-2 following Birth

“…HBD2 should be dedicated to the protection of mucosal surfaces by preventing invasion of mucosa by intestinal microbes and promoting adaptive immune response. In contrast, a high calprotectin concentration reflects increased leukocyte migration through the gut mucosa as part of the intestinal hyperpermeability and mucosal immune stimulation of the gut-associated lymphoid tissue [27] .…”

Calprotectin in Serially Collected Meconium Portions as a Biomarker for Intrauterine Fetal Environment

“…Multiple biological functions of calprotectin have been shown in vitro and in vivo, such as involvement in the modulation of inflammatory processes and in the regulation of apoptosis, and a strong antimicrobial activity [2,4,10,11,13] . The immature intestinal mucosa of the fetus may allow a transepithelial migration of neutrophil granulocytes or macrophages into the gut lumen, resulting in higher calprotectin concentrations which might participate in the defense mechanisms in neonates.…”

“…It is a cheap and noninvasive biomarker of intestinal inflammation and permeability, allowing the assessment of disease activity and monitoring of the response to treatment, highly valued by gastroenterologists for its specificity and sensitivity [1,2,[10][11][12] .…”