Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 22 November 2017

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Monitoring intestinal inflammation using fecal calprotectin

Calprotectin could be suitable as a marker for assessing and monitoring disease activity in inflammatory bowel disease, as well as in screening for carcinoma and bowel disease in the general population, finds a study in the European Journal of Gastroenterology and Hepatology.

News image

fiogf49gjkf04

Calprotectin is a neutrophil granulocyte-derived protein that has been found in increased levels in plasma, cerebrospinal fluid, synovial fluid, saliva and urine following infection, inflammation and malignant disease in relevant organs, following activation of monocytes and neutrophil granulocytes.

The protein is also excreted in feces, in which it remains very stable, and so fecal calprotectin concentrations may provide an easy test for assessing infection, disease or inflammatory activity in the alimentary tract.

Calprotectin is known to be an inhibitor of zinc-dependent enzymes that, by competing for zinc, can kill microbes and induce apoptosis in both normal and malignant cells.

Zinc-dependent metalloproteinases are needed for activation of cytokines like tumor necrosis factor alpha and for invasive growth of tumors and so it is thought that calprotectin may therefore participate in the regulation of inflammatory processes and inhibit cancer cell proliferation.

However, it is possible that elevated concentrations of this protein may also induce cell and tissue damage.

It is known that there is accumulation of neutrophils at sites of active inflammatory bowel disease (IBD), leading to the possibility that cytotoxic levels of calprotectin may be reached locally and that this protein may also play an active role in IBD, in addition to being a useful fecal marker.

Therefore, researchers from the departments of Gastroenterology and Clinical Biochemistry at the North Manchester General Hospital in Manchester, England, have assessed the potential of measuring calprotectin in feces as a method of screening for alimentary inflammation and neoplasia.

Consented patients attending for routine endoscopy were requested to provide feces.

Of the initial 30 patients enrolled, 17 provided feces before and 1 week after endoscopy.

A further 116 patients with planned endoscopy provided feces prior to undergoing endoscopy.

The group comprised 43 patients with upper gastrointestinal lesions, 7 patients with IBD, a further 7 patients with irritable bowel disease, 31 patients with colonic disorders, and 28 normal people.

A final 18 patients with known inflammatory bowel disease (7 patients), gastric carcinoma (1 patient), colorectal cancer (8 patients) and colorectal adenoma (2 patients) also had stool samples analyzed.

Fecal calprotectin:
Elevated in inflammation and cancer
European Journal of Gastroenterology & Hepatology

Feces were analyzed using enzyme-linked immunosorbent assay (ELISA) techniques.

Following such analysis, no definite differences between pre- and post-endoscopy calprotectin were found.

Analyses of samples from subsequent patients were therefore carried out on pre-endoscopy feces only, as this was considered preferable.

Upper-gastrointestinal disorders showed little difference in calprotectin levels: Barrett's esophagus (median 6.8 mg/l), gastric ulcer (median 6.5 mg/l) or gastritis/duodenitis (median 5.2 mg/l).

However, these were all higher than the median calprotectin level of normal subjects (4.5 mg/l).

The esophageal and gastric carcinoma median was elevated significantly at 30 mg/l, while inflammatory bowel disease was also associated with marked elevation (Crohn's disease, 31.2 mg/l; ulcerative colitis, 116.2 mg/l).

Colorectal polyps (median 3.7 mg/l) and adenoma (median 3.8 mg/l) showed no elevated levels in contrast to colorectal carcinoma (median 53.4 mg/l).

The elevated calprotectin in IBD and colorectal carcinoma combined gave a sensitivity of 81.8% and a specificity of 73.2%.

"Calprotectin levels are elevated in inflammation and cancer but are not helpful in differentiating between these disorders," commented Dr Christopher B. Summerton, one of the study authors, adding, "In our series, calprotectin was not elevated in colonic polyps or adenomata."

"However," he continued, "Calprotectin could be helpful as a screening method in a general gastroenterology population for inflammatory bowel disease and those with carcinoma, as well as assessing and monitoring disease activity in inflammatory bowel disease."

Eur J Gastroenterol Hepatol 2002; 14(8): 841-845
06 August 2002

Go to top of page Email this page Email this page to a colleague

 22 November 2017 
Surgical treatment delays influence survival in colon cancer
 22 November 2017 
Golimumab in Crohn's disease
 22 November 2017 
Challenges of US-trained gastroenterologists when abroad
 21 November 2017 
Prepregnancy obesity and maternal mortality
 21 November 2017 
Preoperative optimization in IBD patients
 21 November 2017 
Cholangiopathy in critically ill patients
 20 November 2017 
Barriers to hepatitis C treatment
 20 November 2017 
Socioeconomic characteristics in diverticular disease
 20 November 2017 
Endoscopic indices of disease activity for Crohn’s
 17 November 2017 
Food elimination diets for treatment of adults with eosinophilic esophagitis
 17 November 2017 
PPI use and cognitive function in women
 17 November 2017 
Predicting microscopic colitis
 16 November 2017 
NAFLD-hepatocellular carcinoma and survival after orthotopic liver transplant
 16 November 2017 
Prepregnancy obesity and severe maternal morbidity
 16 November 2017 
Celiac disease screening in adult first-degree relatives
 15 November 2017 
Breastfeeding and the risk of IBD
 15 November 2017 
Predicting recurrence after curative rectal cancer surgery
 15 November 2017 
Medication nonadherence and health care costs
 14 November 2017 
Eosinophilic gastroenteritis and colitis
 14 November 2017 
HBV/HCV coinfection and cirrhosis
 14 November 2017 
Sexual dysfunction after rectal cancer surgery
 13 November 2017 
Genetic polymorphisms, fatty acids and ulcerative colitis
 13 November 2017 
Flares after immunomodulator withdrawal in Crohn's
 13 November 2017 
GI bleeding in patients taking non–vitamin K antagonist oral anticoagulants
 10 November 2017 
Thiopurines vs TNF and lymphoma risk in IBD
 10 November 2017 
Drug monitoring of anti-tumour necrosis factor therapy in IBD
 10 November 2017 
Treatment decisions for older patients with colorectal cancer
 09 November 2017 
Quality standards in upper gastrointestinal endoscopy
 09 November 2017 
Irradiated rectal cancer and chemoradiotherapy
 09 November 2017 
Environmental factors and IBD
 08 November 2017 
Prophylaxis of spontaneous bacterial peritonitis
 08 November 2017 
Optimal management of postoperative Crohn's disease
 07 November 2017 
Community Screening for Helicobacter pylori
 07 November 2017 
Early readmission in IBD patients
 07 November 2017 
Mesocolic excision for colon cancer
 06 November 2017 
Food elimination diet for children with eosinophilic esophagitis
 06 November 2017 
Biologic agents and obesity in children with IBD
 06 November 2017 
Liver cancer burden despite extensive use of antiviral agents
 03 November 2017 
Statins and mortality in chronic viral hepatitis
 03 November 2017 
Propofol for outpatient colonoscopy
 03 November 2017 
Asthma and IBD development
 02 November 2017 
Diverticulitis and emergency department burden
 02 November 2017 
Rural residence and risk of IBD
 02 November 2017 
Sexual functioning in Hep C
 01 November 2017 
Heartburn relief in adolescents with GERD
 01 November 2017 
Autoimmune pancreatitis in children
 31 October 2017 
Follow-up of positive results on fecal blood tests
 31 October 2017 
Surveillance in ulcerative colitis and Crohn’s disease
 30 October 2017 
Local recurrence after curative rectal cancer surgery
 30 October 2017 
Low-flow ascites pump in refractory cirrhosis
 30 October 2017 
Medical therapy of patients with pediatric-onset IBD
 27 October 2017 
NAFLD in advanced fibrosis in the USA
 27 October 2017 
Early readmission in cirrhosis after bacterial infections
 26 October 2017 
Predicting response to anti-TNF therapy in Crohn's
 26 October 2017 
Conversion to open laparotomy in rectal cancer
 25 October 2017 
Conversion of colonoscopy to sigmoidoscopy
 25 October 2017 
Fecal microbiota transplantation
 25 October 2017 
Rifaximin and survival in hepatic encephalopathy
 24 October 2017 
Eosinophilic esophagitis with swallowed topical corticosteroids
 24 October 2017 
Meta-analysis in nutritiona research

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2017 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us