The Role of Calprotectin in Pediatric Disease

Abstract

Calprotectin (CP) is a calcium- and zinc-binding protein of the S100 family expressed mainly by neutrophils with important extracellular activity. The aim of the current review is to summarize the latest findings concerning the role of CP in a diverse range of inflammatory and noninflammatory conditions among children. Increasing evidence suggests the implication of CP in the diagnosis, followup, assessment of relapses, and response to treatment in pediatric pathological conditions, such as inflammatory bowel disease, necrotizing enterocolitis, celiac disease, intestinal cystic fibrosis, acute appendicitis, juvenile idiopathic arthritis, Kawasaki disease, polymyositis-dermatomyositis, glomerulonephritis, IgA nephropathy, malaria, HIV infection, hyperzincemia and hypercalprotectinemia, and cancer. Further studies are required to provide insights into the actual role of CP in these pathological processes in pediatrics.

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

“…Clinical practice supports the potential presence of bacteria in fetal meconium and colonization by bacteria which may start before birth as part of the adaptation of the fetal gut to life outside the uterus. This microbial colonization process promotes short-and long-term benefits and different factors that modify the microbial composition [13,14,[16][17][18][19] . The influence of some additional factors which may regulate calprotectin levels in the developing intestine of the fetus is postulated.…”

Fecal Calprotectin: Diagnostic Accuracy of the Immunochromatographic CalFast Assay in a Pediatric Population

“…Alternatively, in order to exclude false positives when a low calprotectin cutoff is used (13), we suggest to repeat testing in children with borderline results before referral. (22), although calprotectin is elevated in other conditions with gut inflammation as well (23). The fecal concentration of this protein is regularly elevated in subjects with active IBD and its measurement may be also a useful tool for monitoring the response to clinical treatments (7,10,11).…”

“…The fecal concentration of this protein is regularly elevated in subjects with active IBD and its measurement may be also a useful tool for monitoring the response to clinical treatments (7,10,11). The meta-analyses of diagnostic accuracy studies based on six fecal calprotectin studies for screening of adults with suspected IBD, in a recent review by van Rheenen et al, found out a pooled sensitivity and specificity of 93% (95% CI 85-97%) and 96% (79-99%), respectively (23). The reliability of the test was found to be lower in the studies on pediatric patients with a pooled sensitivity and specificity of 92% (84-96%) and 76% (62-86%) respectively, for seven studies on children and teenagers (24).…”

“…Calprotectin is the most commonly prescribed test for the differentiation between gastrointestinal functional disorders and inflammatory conditions such as UC and CD , although calprotectin is elevated in other conditions with gut inflammation as well . The fecal concentration of this protein is regularly elevated in subjects with active IBD and its measurement may be also a useful tool for monitoring the response to clinical treatments .…”

Implications of hepatic dysfunction in Kawasaki disease: Time‐related changes in aspartate aminotransferase, alanine aminotransferase, total bilirubin, and C‐reactive protein levels

“…The most convenient currently available test that is relatively noninvasive and can be used repeatedly is fecal examination to detect inflammatory substances such as calprotectin and lactoferrin …”