Detection of inflammatory markers in stools from patients with irritable bowel syndrome and collagenous colitis.
OBJECTIVE
Irritable bowel syndrome (IBS) and collagenous colitis (CC) share chronically recurring symptoms of altered bowel habits associated with abdominal pain or discomfort. The aims of the present study were to investigate whether inflammatory markers could be detected in faeces from patients with IBS and CC, and to elucidate whether such analyses could be used as non-invasive tools to distinguish between these disorders.


METHODS
Stool samples were obtained from 18 patients with CC, 46 patients with IBS and 20 healthy controls (HC). Eosinophil protein X (EPX), myeloperoxidase (MPO), tryptase, interleukin-1 beta (IL-1beta) and tumour necrosis factor alpha (TNFalpha) were measured in supernatants from processed faeces using immunoassays.


RESULTS
EPX levels were enhanced in faeces from CC patients (median 3.8 microg/g (0.47-16.2)) compared to patients with IBS (0.44 microg/g (0.25-1.8)), p<0.001, and HC (0.46 microg/g (0.21-1.3)), p<0.001. In addition, MPO was increased in CC patients (11.7 microg/g (2.0-124)) compared to IBS patients (1.7 microg/g (0.81-5.2)), p<0.01, and HC (2.5 microg/g (1.1-6.3)), p<0.05. Tryptase was found in 9/18 patients with CC, 6/46 with IBS and 1/19 HC. IL-1beta was only enhanced in 2/11 CC patients and TNFalpha was not detected in any sample.


CONCLUSIONS
Increased levels of EPX, MPO and tryptase were observed in stools from collagenous colitis patients, whereas the levels in IBS patients did not differ from healthy controls. Our data suggest that faecal markers could be used as part of the clinical work-up to determine which patients should be biopsied and evaluated for collagenous colitis.
Lettesjö
Helene
H
Department of Gastrointestinal Research, Pharmacia Diagnostics, Uppsala, Sweden.
Hansson
Tony
T
Peterson
Christer
C
Ung
Kjell-Arne
KA
Ringström
Gisela
G
Abrahamsson
Hasse
H
Simrén
Magnus
M
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis*; D046729:Colitis, Collagenous / Q000175:diagnosis / Q000378:metabolism*; D003937:Diagnosis, Differential; D047208:Eosinophil-Derived Neurotoxin / Q000032:analysis; D005243:Feces / Q000737:chemistry*; D005260:Female; D006801:Humans; D007118:Immunoassay; D007249:Inflammation; D007375:Interleukin-1 / Q000032:analysis; D043183:Irritable Bowel Syndrome / Q000175:diagnosis / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009195:Peroxidase / Q000032:analysis; D012697:Serine Endopeptidases / Q000032:analysis; D053802:Tryptases; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D015415:Biomarkers; D007375:Interleukin-1; D014409:Tumor Necrosis Factor-alpha; D009195:Peroxidase; D047208:Eosinophil-Derived Neurotoxin; D012697:Serine Endopeptidases; D053802:Tryptases