Fecal leukocyte proteins in inflammatory bowel disease and irritable bowel syndrome.
The aim of this prospective study was to compare five different leukocyte proteins in feces of patients with chronic inflammatory bowel disease (IBD), irritable bowel syndrome (IBS) and healthy persons who underwent prophylactic colonoscopy.


METHODS
The leukocyte proteins calprotectin, lactoferrin, lysozyme, myeloperoxidase, and PMN-elastase were determined with immunoassays in fecal samples of three consecutive feces (e.g. three days) in 40 healthy persons, 39 patients with chronic IBD (of these 21 with Crohn's disease and 18 with ulcerative colitis), and 40 patients with IBS.


RESULTS
ROC curves calculated for healthy persons and patients with IBD yielded the following areas under the curves (AUCs): PMN-elastase 0.916, calprotectin 0.872, myeloperoxidase 0.750, lysozyme 0.726, and lactoferrin 0.693. The AUCs of PMN-elastase and calprotectin were not significantly different (p = 0.327), whereas PMN-elastase or calprotectin vs. the other proteins were significantly different (p < 0.001). PMN-elastase and calprotectin correlated with the endoscopically classified severity of inflammation. All fecal leukocyte markers in IBS were found in the range of the healthy persons. Data on storage stability of leukocyte proteins in fecal supernatants are given.


CONCLUSIONS
Fecal PMN-elastase and calprotectin support the differentiation of chronic IBD from IBS and correlate with the severity of inflammation.
Silberer
Hannah
H
University of Heidelberg, Germany.
Küppers
Bruno
B
Mickisch
Oliver
O
Baniewicz
Wojtek
W
Drescher
Maren
M
Traber
Lydia
L
Kempf
Alexander
A
Schmidt-Gayk
Heinrich
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005243:Feces / Q000737:chemistry* / Q000166:cytology; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis*; D043183:Irritable Bowel Syndrome / Q000175:diagnosis*; D007781:Lactoferrin / Q000032:analysis; D019272:Leukocyte Elastase / Q000032:analysis*; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis*; D007962:Leukocytes / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009113:Muramidase / Q000032:analysis; D009195:Peroxidase / Q000032:analysis; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve
D039841:Leukocyte L1 Antigen Complex; D009195:Peroxidase; D009113:Muramidase; D007781:Lactoferrin; D019272:Leukocyte Elastase