Fecal calprotectin: a quantitative marker of colonic inflammation in children with inflammatory bowel disease.
OBJECTIVE
The protein calprotectin (S100 A8/A9) is present in neutrophils, monocytes, and macrophages. Colorectal inflammation can be detected by increased excretion of fecal calprotectin (FC). The aim of this study was to evaluate FC as a quantitative marker of inflammatory activity in children with inflammatory bowel disease (IBD).


METHODS
Thirty-nine children with IBD delivered a fecal spot sample and underwent colonoscopy. The samples were examined with an enzyme-linked immunosorbent assay for FC (Calprest, Eurospital, Trieste, Italy). The concentrations were correlated to macroscopic and microscopic assessments of extent and severity of inflammation in 8 colonic segments for each patient.


RESULTS
FC correlated significantly to the macroscopic extent (Spearman rho = 0.61) and the severity (Spearman rho = 0.52) of colonic inflammation and to a macroscopic, combined extent and severity score (Spearman rho = 0.65). Significant correlations also were found to the microscopic extent (Spearman rho = 0.71) and severity (Spearman rho = 0.72) of colonic inflammation and to a microscopic, combined extent and severity score (Spearman rho = 0.75). The median FC was 392 mug/g (95% confidence interval [CI], 278-440) in children with clinical IBD symptoms (n = 23) and 32.9 mug/g (95% CI, 9.4-237) in asymptomatic IBD patients (n = 16). Of the asymptomatic children, 56% had a complete microscopic mucosal healing, and their median FC was 9.9 mug/g (95% CI, 5.9-41.9).


CONCLUSIONS
FC can be used as a surrogate marker for estimation of colonic inflammation in pediatric IBD. Normalized FC concentration seems to indicate complete mucosal healing. FC is simple to obtain and analyze; this should facilitate objective assessment and monitoring of IBD activity.
Fagerberg
Ulrika Lorentzon
UL
Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden. ulrika.fagerberg@karolinska.se
Lööf
Lars
L
Lindholm
Johan
J
Hansson
Lars-Olof
LO
Finkel
Yigael
Y
D000293:Adolescent; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D002648:Child; D003106:Colon / Q000473:pathology*; D003113:Colonoscopy; D004797:Enzyme-Linked Immunosorbent Assay; D005243:Feces / Q000737:chemistry*; D006801:Humans; D007249:Inflammation / Q000175:diagnosis* / Q000209:etiology; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000175:diagnosis*; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012720:Severity of Illness Index
D015415:Biomarkers; D039841:Leukocyte L1 Antigen Complex