title: Calprotectin is a stronger predictive marker of relapse in ulcerative colitis than in Crohn's disease.
abstract: OBJECTIVE
  The clinical course of inflammatory bowel disease is characterised by a succession of relapses and remissions. The aim of our study was to assess whether the predictive value of faecal calprotectin-a non-invasive marker of intestinal inflammation-for clinical relapse is different in ulcerative colitis (UC) and Crohn's disease (CD).
  
  
  METHODS
  Seventy nine consecutive patients with a diagnosis of clinically quiescent inflammatory bowel disease (38 CD and 41 UC) were followed for 12 months, undergoing regular clinical evaluations and blood tests. A single stool sample was collected at the beginning of the study from each patient and the calprotectin concentration was assessed by a commercially available enzyme linked immunoassay.
  
  
  RESULTS
  In CD, median calprotectin values were 220.1 mug/g (95% confidence interval (CI) 21.7-418.5) in those patients who relapsed during follow up, and 220.5 mug/g (95% CI 53-388) in non-relapsing patients (p=0.395). In UC, median calprotectin values were 220.6 mug/g (95% CI 86-355.2) and 67 microg/g (95% CI 15-119) in relapsing and non-relapsing patients, respectively (p<0.0001). The multivariate Cox (proportional hazard) regression model, after adjustment for possible confounding variables, showed a twofold and 14-fold increase in the relapse risk, respectively, in those patients with CD and UC in clinical remission who had a faecal calprotectin concentration higher than 150 microg/g.
  
  
  CONCLUSIONS
  Faecal calprotectin proved to be an even stronger predictor of clinical relapse in UC than in CD, which makes the test a promising non-invasive tool for monitoring and optimising therapy.
authors.affiliation: Department of Internal Medicine, Section of Gastroenterology, University of Pisa, Pisa, Italy. fcosta@int.med.unipi.it
authors.forename: F
authors.initials: F
authors.lastname: Costa
authors.forename: M G
authors.initials: MG
authors.lastname: Mumolo
authors.forename: L
authors.initials: L
authors.lastname: Ceccarelli
authors.forename: M
authors.initials: M
authors.lastname: Bellini
authors.forename: M R
authors.initials: MR
authors.lastname: Romano
authors.forename: C
authors.initials: C
authors.lastname: Sterpi
authors.forename: A
authors.initials: A
authors.lastname: Ricchiuti
authors.forename: S
authors.initials: S
authors.lastname: Marchi
authors.forename: M
authors.initials: M
authors.lastname: Bottai
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000378:metabolism; D003424:Crohn Disease / Q000175:diagnosis* / Q000378:metabolism; D004812:Epidemiologic Methods; D005243:Feces / Q000737:chemistry; D005260:Female; D006801:Humans; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012074:Remission Induction
chemical_list: D015415:Biomarkers; D039841:Leukocyte L1 Antigen Complex