title: Faecal calprotectin and lactoferrin are reliable surrogate markers of endoscopic response during Crohn's disease treatment.
abstract: OBJECTIVE
  Serial monitoring data for faecal calprotectin and lactoferrin during Crohn's disease (CD) therapy are scarce. The aim of this research was to study the behaviour of faecal biomarkers during CD therapy.
  
  
  METHODS
  Adult CD patients (n = 19) needing therapy enhancement were prospectively recruited. The simple endoscopic score for Crohn's disease (SES-CD) was administered before and 4-6 months after therapy. At baseline and at 2-3 and 4-6 months, patients provided faecal samples for measurements of calprotectin and lactoferrin.
  
  
  RESULTS
  Of 19 patients, seven were endoscopic responders, three were partial responders and nine were non-responders. During therapy, both faecal-biomarker concentrations decreased significantly in responders: median calprotectin from 1282 microg/g (range 156-2277 microg/g) to 73 microg/g (range 7-2222; P = 0.005) and lactoferrin from 233 microg/g (range 2.8-802 microg/g) to 0.0 microg/g (range 0.0-420 microg/g; P = 0.005), and these changes correlated significantly with changes in the SES-CD. In non-responders, changes in faecal biomarkers were non-significant: calprotectin decreased from 1017 microg/g (range 53-3928 microg/g) to 223 microg/g (range 35-15330 microg/g; P = 0.594) and lactoferrin from 22.5 microg/g (range 2.1-629 microg/g) to 13.0 microg/g (range 3.5-1259 microg/g; P = 0.515).
  
  
  CONCLUSIONS
  The faecal neutrophil-derived proteins calprotectin and lactoferrin are reliable surrogate markers of mucosal improvement. Endoscopic responders achieved normalization of faecal biomarkers, whereas in the majority of endoscopic non-responders these markers remained abnormal.
authors.affiliation: Department of Medicine, Division of Gastroenterology, Helsinki University Central Hospital, Helsinki, Finland. taina.sipponen@kolumbus.fi
authors.forename: Taina
authors.initials: T
authors.lastname: Sipponen
authors.forename: Clas-Göran A F
authors.initials: CG
authors.lastname: Björkesten
authors.forename: Martti
authors.initials: M
authors.lastname: Färkkilä
authors.forename: Hannu
authors.initials: H
authors.lastname: Nuutinen
authors.forename: Erkki
authors.initials: E
authors.lastname: Savilahti
authors.forename: Kaija-Leena
authors.initials: KL
authors.lastname: Kolho
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D003113:Colonoscopy; D003424:Crohn Disease / Q000473:pathology*; D005243:Feces / Q000737:chemistry*; D005260:Female; D006801:Humans; D007781:Lactoferrin / Q000032:analysis*; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D039841:Leukocyte L1 Antigen Complex; D007781:Lactoferrin