title: Intestinal inflammation and impact on growth in children with cystic fibrosis.
abstract: OBJECTIVE
  The aim of the study was to evaluate and compare faecal markers of intestinal inflammation in children with cystic fibrosis (CF), and determine whether intestinal inflammation adversely affects the nutritional phenotype.
  
  
  METHODS
  Faecal samples for markers of intestinal inflammation, calprotectin, S100A12, and osteoprotegerin, were collected from children with CF, healthy controls (HCs), and Crohn disease (CD). Associations between inflammatory markers and clinical and nutritional indices were determined in subjects with CF.
  
  
  RESULTS
  Twenty-eight children with CF (mean [standard deviation (SD)] 8.4 [3.3] years old, 22 pancreatic insufficient [PI]), 47 HC, and 30 CD were recruited. Mean (SD) faecal calprotectin in CF (94.3 [100.6] mg/kg) was greater than HC (26.7 [15.4] mg/kg, P < 0.0001), but lower than CD (2133 [2781] mg/kg, P = 0.0003). Abnormal faecal calprotectin was found in subjects only with PI (17/22 (77%), P = 0.001). There was no difference in faecal mean (SD) S100A12 (0.8 [0.9] vs 1.5 [2.2] mg/kg, P = 0.14) and osteoprotegerin concentrations (72.7 [52.2] vs 62.5 [0.0] pg/mL, P = 0.2) between CF and HC. Patients with CD had significantly elevated S100A12 and osteoprotegerin compared with CF and HC. Faecal calprotectin inversely correlated with both weight (r = -0.5, P = 0.003) and height z scores (r = -0.6, P = 0.002) in CF.
  
  
  CONCLUSIONS
  The pattern of intestinal inflammation in CF is unique and distinct from inflammatory bowel disease, with elevated faecal calprotectin but normal faecal S100A12 and osteoprotegerin concentrations. The severity of intestinal inflammation, based on faecal calprotectin, significantly correlates with poor growth.
authors.affiliation: *Department of Pediatric Gastroenterology, Sydney Children's Hospital Randwick †Discipline of Pediatrics, School of Women's and Children's Health, Medicine, University of New South Wales ‡Department of Nutrition and Dietetics §Clinical Trials Centre ||Department of Pediatric Respiratory, Sydney Children's Hospital Randwick, Sydney, Australia ¶Department of Pediatrics, University of Otago, Christchurch, New Zealand.
authors.forename: Jasbir
authors.initials: J
authors.lastname: Dhaliwal
authors.forename: Steven
authors.initials: S
authors.lastname: Leach
authors.forename: Tamarah
authors.initials: T
authors.lastname: Katz
authors.forename: Lily
authors.initials: L
authors.lastname: Nahidi
authors.forename: Tamara
authors.initials: T
authors.lastname: Pang
authors.forename: J M
authors.initials: JM
authors.lastname: Lee
authors.forename: Roxanne
authors.initials: R
authors.lastname: Strachan
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Day
authors.forename: Adam
authors.initials: A
authors.lastname: Jaffe
authors.forename: Chee Y
authors.initials: CY
authors.lastname: Ooi
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D003424:Crohn Disease / Q000378:metabolism; D003550:Cystic Fibrosis / Q000378:metabolism / Q000473:pathology*; D004797:Enzyme-Linked Immunosorbent Assay; D010188:Exocrine Pancreatic Insufficiency / Q000378:metabolism; D005243:Feces / Q000737:chemistry; D005260:Female; D006128:Growth; D006130:Growth Disorders / Q000209:etiology; D006801:Humans; D007249:Inflammation / Q000378:metabolism*; D007413:Intestinal Mucosa / Q000378:metabolism*; D039841:Leukocyte L1 Antigen Complex / Q000378:metabolism*; D008297:Male; D053244:Osteoprotegerin / Q000378:metabolism*; D000067616:S100A12 Protein / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D039841:Leukocyte L1 Antigen Complex; D053244:Osteoprotegerin; D000067616:S100A12 Protein