Fecal calprotectin and elastase 1 determinations in patients with pancreatic diseases: a possible link between pancreatic insufficiency and intestinal inflammation.
BACKGROUND
Fecal calprotectin determination has been demonstrated to be useful in diagnosing various inflammatory diseases of the gastrointestinal tract; however, data available for patients with pancreatic diseases are scarce. Our aim was to assess fecal calprotectin in order to evaluate the presence of intestinal inflammation in patients with pancreatic disease.


METHODS
Eligible patients with suspected pancreatic illness were enrolled, and in all of them fecal calprotectin and elastase-1, as well as serum amylase and lipase activities, were assayed using commercially available kits.


RESULTS
A total of 90 subjects (47 men, 43 women, mean age 58.6 +/- 14.9 years) were enrolled: 20 (22.2%) had chronic pancreatitis; 15 (16.7%) had pancreatic cancer; six (6.7%) had chronic nonpathological pancreatic hyperenzymemia; 16 (17.8%) had nonpancreatic diseases; and 23 (25.6%) had no detectable diseases. Diarrhea was present in 19 patients (21.1%). In univariate analyses, the presence of diarrhea and low fecal elastase-1 concentrations were significantly associated (P = 0.019 and P = 0.002, respectively) with abnormally high fecal calprotectin concentration, and the multivariate analysis demonstrated that low fecal elastase-1 concentration was the only variable independently associated with a high fecal calprotectin concentration.


CONCLUSIONS
Pancreatic insufficiency may cause intestinal inflammation, probably because of a modification of the intestinal ecology.
Pezzilli
Raffaele
R
Department of Digestive Diseases and Internal Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy.
Barassi
Alessandra
A
Morselli-Labate
Antonio M
AM
Fantini
Lorenzo
L
Tomassetti
Paola
P
Campana
Davide
D
Casadei
Riccardo
R
Finazzi
Sergio
S
d'Eril
Gianvico Melzi
GM
Corinaldesi
Roberto
R
D000681:Amylases / Q000097:blood; D015415:Biomarkers / Q000378:metabolism; D004797:Enzyme-Linked Immunosorbent Assay; D010188:Exocrine Pancreatic Insufficiency / Q000150:complications / Q000378:metabolism*; D005243:Feces / Q000737:chemistry*; D005260:Female; D005756:Gastritis / Q000209:etiology / Q000378:metabolism*; D006801:Humans; D039841:Leukocyte L1 Antigen Complex / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010196:Pancreatic Elastase / Q000378:metabolism*; D011379:Prognosis; D012307:Risk Factors
D015415:Biomarkers; D039841:Leukocyte L1 Antigen Complex; D000681:Amylases; D010196:Pancreatic Elastase