Lactoferrin in whole gut lavage fluid as a marker for disease activity in inflammatory bowel disease: comparison with other neutrophil-derived proteins.
OBJECTIVE
We investigated which neutrophil-derived proteins in whole gut lavage fluid (WGLF) most accurately reflect disease activity in inflammatory bowel disease.


METHODS
WGLF was obtained from patients undergoing whole gut lavage as a bowel preparation for colonoscopy. Twenty-seven patients with ulcerative colitis (UC), 23 patients with Crohn's disease (CD), and 35 control subjects were examined. The concentrations of lactoferrin, polymorphonuclear neutrophil elastase (PMN-E), myeloperoxidase, and lysozyme in WGLF were measured by ELISA. For the assessment of stability, WGLF samples were stored at 37 degrees C for various periods.


RESULTS
In UC, the concentrations of lactoferrin, myeloperoxidase, and lysozyme in WGLF had good correlations with colonoscopic grading. Zero, 12, five, and 10 of 28 samples from active UC patients showed normal concentrations of lactoferrin, PMN-E, myeloperoxidase, and lysozyme, respectively. In CD, the concentrations of lactoferrin and myeloperoxidase had good correlations with the Crohn's disease activity index. Thirteen and seven of 36 samples from inactive CD patients (Crohn's disease activity index < or = 150) showed high concentrations of lactoferrin and myeloperoxidase, respectively. Most of them (11/13, 6/7) were found to have ulceration by colonoscopy or small bowel x-ray. The ratio of the lactoferrin concentration in the WGLF supernatant to that in total WGLF was highest among these proteins in all disease groups and control subjects. Lactoferrin and myeloperoxidase showed good stability in WGLF, whereas PMN-E and lysozyme did not.


CONCLUSIONS
Lactoferrin is the most suitable of these proteins for use as a neutrophil-derived WGLF marker of intestinal inflammation.
Kayazawa
Masanobu
M
Second Department of Internal Medicine, Osaka Medical College, Takatsuki, Japan.
Saitoh
Osamu
O
Kojima
Keishi
K
Nakagawa
Ken
K
Tanaka
Seigou
S
Tabata
Kazue
K
Matsuse
Ryoichi
R
Uchida
Kazuo
K
Hoshimoto
Masahiro
M
Hirata
Ichiro
I
Katsu
Ken-ichi
K
D000328:Adult; D015415:Biomarkers / Q000032:analysis; D003113:Colonoscopy; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000473:pathology*; D007781:Lactoferrin / Q000032:analysis*; D019272:Leukocyte Elastase / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D009113:Muramidase / Q000032:analysis*; D009504:Neutrophils; D010533:Peritoneal Lavage; D009195:Peroxidase / Q000032:analysis*; D011379:Prognosis; D012016:Reference Values; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
D015415:Biomarkers; D009195:Peroxidase; D009113:Muramidase; D007781:Lactoferrin; D019272:Leukocyte Elastase