Faecal S100A12 as a non-invasive marker distinguishing inflammatory bowel disease from irritable bowel syndrome.
OBJECTIVE
S100A12 is a pro-inflammatory protein that is secreted by granulocytes. S100A12 serum levels increase during inflammatory bowel disease (IBD). We performed the first study analysing faecal S100A12 in adults with signs of intestinal inflammation.


METHODS
Faecal S100A12 was determined by ELISA in faecal specimens of 171 consecutive patients and 24 healthy controls. Patients either suffered from infectious gastroenteritis confirmed by stool analysis (65 bacterial, 23 viral) or underwent endoscopic and histological investigation (32 with Crohn's disease, 27 with ulcerative colitis, and 24 with irritable bowel syndrome; IBS). Intestinal S100A12 expression was analysed in biopsies obtained from all patients. Faecal calprotectin was used as an additional non-invasive surrogate marker.


RESULTS
Faecal S100A12 was significantly higher in patients with active IBD (2.45 +/- 1.15 mg/kg) compared with healthy controls (0.006 +/- 0.03 mg/kg; p<0.001) or patients with IBS (0.05 +/- 0.11 mg/kg; p<0.001). Faecal S100A12 distinguished active IBD from healthy controls with a sensitivity of 86% and a specificity of 100%. We also found excellent sensitivity of 86% and specificity of 96% for distinguishing IBD from IBS. Faecal S100A12 was also elevated in bacterial enteritis but not in viral gastroenteritis. Faecal S100A12 correlated better with intestinal inflammation than faecal calprotectin or other biomarkers.


CONCLUSIONS
Faecal S100A12 is a novel non-invasive marker distinguishing IBD from IBS or healthy individuals with a high sensitivity and specificity. Furthermore, S100A12 reflects inflammatory activity of chronic IBD. As a marker for neutrophil activation, faecal S100A12 may significantly improve our arsenal of non-invasive biomarkers of intestinal inflammation.
Department of Pediatrics, University of Muenster, Albert-Schweitzer-Str. 33, D-48149 Muenster, Germany.
T
T
Kaiser
J
J
Langhorst
H
H
Wittkowski
K
K
Becker
A W
AW
Friedrich
A
A
Rueffer
G J
GJ
Dobos
J
J
Roth
D
D
Foell
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000175:diagnosis; D015415:Biomarkers / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000175:diagnosis; D003424:Crohn Disease / Q000175:diagnosis; D003937:Diagnosis, Differential; D005243:Feces / Q000737:chemistry*; D005260:Female; D005759:Gastroenteritis / Q000175:diagnosis; D006801:Humans; D007223:Infant; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis*; D043183:Irritable Bowel Syndrome / Q000175:diagnosis*; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D009418:S100 Proteins / Q000032:analysis*; D000067616:S100A12 Protein; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014777:Virus Diseases / Q000175:diagnosis
D015415:Biomarkers; D039841:Leukocyte L1 Antigen Complex; D009418:S100 Proteins; D000067616:S100A12 Protein; C090441:S100A12 protein, human