Fecal lactoferrin and calprotectin after ileocolonic resection for Crohn's disease.
OBJECTIVE
This study was designed to assess the role of fecal lactoferrin and calprotectin as markers of intestinal inflammation in patients with Crohn's disease who have undergone ileocolonic resection.


METHODS
Sixty-three patients who had undergone ileocolonic resection for Crohn's disease with a median follow-up of 40.5 (range, 5-102) months were enrolled. Clinical examination and blood test were performed, and fecal lactoferrin and calprotectin levels were dosed. The predictors for fecal lactoferrin and calprotectin levels that resulted to be significant at the univariate analyses were included in two multiple regression analysis models.


RESULTS
The mean lactoferrin level was 21 +/- 3.9 microg/g and the mean calprotectin fecal level was 247 +/- 22.7 ng/ml. C-reactive protein levels (P < 0.01), calprotectin levels (P < 0.01), and the presence of clinical recurrence (P = 0.04) resulted to be independent predictors of lactoferrin levels. Only lactoferrin levels resulted to be an independent predictor for calprotectin fecal levels (P < 0.01).


CONCLUSIONS
Crohn's disease patients maintain high fecal levels of lactoferrin and calprotectin at long-term follow-up after resection of the diseased bowel even in case of clinical remission. The significant correlation between the two fecal markers may be the expression of the ongoing intestinal inflammation. Only lactoferrin significantly correlated with C-reactive protein and showed a reliable threshold value for systemic inflammation. Lactoferrin fecal levels may be a reliable indicator for intestinal inflammation influencing the systemic inflammatory status. The third predictor of lactoferrin fecal level was the presence of episodes of clinical recurrence during the postoperative follow-up.
Scarpa
Marco
M
Clinica Chirurgica I, Dipartimento di Scienze Chirurgiche e Gastroenterologiche, University of Padova, Padova, Italy. marcoscarpa73@yahoo.it
D'Incà
Renata
R
Basso
Daniela
D
Ruffolo
Cesare
C
Polese
Lino
L
Bertin
Eugenia
E
Luise
Alessia
A
Frego
Mauro
M
Plebani
Mario
M
Sturniolo
Giacomo C
GC
D'Amico
Davide F
DF
Angriman
Imerio
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D002097:C-Reactive Protein / Q000032:analysis; D003106:Colon / Q000601:surgery; D003424:Crohn Disease / Q000378:metabolism* / Q000601:surgery; D003430:Cross-Sectional Studies; D005243:Feces / Q000737:chemistry*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000601:surgery; D007501:Iron / Q000097:blood; D007781:Lactoferrin / Q000032:analysis*; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D012709:Serum Albumin / Q000032:analysis
D015415:Biomarkers; D039841:Leukocyte L1 Antigen Complex; D012709:Serum Albumin; D002097:C-Reactive Protein; D007501:Iron; D007781:Lactoferrin