scholarly journals Trends in Faecal Calprotectin Levels During Pregnancy in Non-IBD Patients

2021 ◽  
Author(s):  
Jayne Doherty ◽  
Rebecca Moore ◽  
Clodagh Kivlehan ◽  
David F Byrne ◽  
Cara A Yelverton ◽  
...  
Keyword(s):  
Post Partum ◽  
Healthy Population ◽  
Healthy Individuals ◽  
Faecal Calprotectin ◽  
Patient Demographics ◽  
Calprotectin Level ◽  
Minimal Data ◽  
Inflammatory Bowel ◽  
Stool Samples ◽  
Physiological Changes In Pregnancy

Abstract Background and Aims: No optimal marker exists to assess activity of inflammatory bowel disease (IBD) during pregnancy, though faecal calprotectin (FCP) is the most commonly used test. However minimal data exists on what a normal calprotectin level is during pregnancy and post-partum in healthy individuals. Objective: Our aim is to determine normal FCP levels during pregnancy and post-partum in a healthy population. Methods: We performed a prospective analysis of FCP levels from pregnant women at 16- and 34-weeks’ gestation and 4- and 12-weeks post-partum. Patient demographics were collected. FCP concentrations were measured with a quantitative ELISA assay. Results: 98 patients were included in our study. 172 maternal stool samples were collected in total; 62 samples at 16-weeks’ gestation, 48 samples at 34-weeks’ gestation, 38 samples from 4-weeks post-partum and 24 samples from 12-weeks post-partum. Median age was 33.0 years. 41 patients had a BMI > 25 (41.8%). 16 patients were ex-smokers (16.3 %). The median FCP levels at 16-weeks’ gestation was 29.5 µg/g (range 10–476 µg/g), median level from 34-weeks’ gestation was 25.6 µg/g (range 10–259 µg/g), from 4-weeks post-partum was 23.4 µg/g (range 10–318 µg/g) and 12-weeks post-partum was 29.4 µg/g (range 10–216 µg/g). There was no significant change in median FCP levels over the course of pregnancy and post-partum (p = 0.294). Conclusion: Faecal calprotectin levels are not affected by physiological changes in pregnancy or post-partum in normal healthy individuals without IBD. This suggests FCP is a useful tool for identifying flares of colitis during pregnancy.

scholarly journals P271 Trends in faecal calprotectin levels during pregnancy and post-partum in healthy women

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S286-S286
Author(s):  
J Doherty ◽  
R Moore ◽  
C Kivlehan ◽  
P Twomey ◽  
F McAuliffe ◽  
...  
Keyword(s):  
Smoking Status ◽  
Post Partum ◽  
Statistical Significance ◽  
Clinical History ◽  
Smoking History ◽  
Healthy Individuals ◽  
Faecal Calprotectin ◽  
Detailed Clinical History ◽  
Stool Samples ◽  
Physiological Changes In Pregnancy

Abstract Background Faecal calprotectin (FCP) is one of the most widely used non-invasive tools for diagnosis and assessment of inflammatory bowel disease (IBD). Numerous factors can influence FCP levels including weight, smoking status and medications. In clinical practise FCP is commonly used to identify flares during pregnancy. For a test that is widely used minimal data exists on the determinants of normal levels and variations in concentrations during pregnancy in healthy individuals. Our aim is to determine normal FCP levels during pregnancy and post-partum and whether levels change during pregnancy and post-partum in healthy individuals. Methods We performed a prospective study analysing FCP levels from pregnant women at 16- and 34-weeks’ gestation and 4- and 12-weeks post-partum. Basic demographics were collected including age, parity, medical history, BMI and smoking status. Patients with a history of gastrointestinal disorders were excluded. FCP concentrations were measured with a quantitative ELISA assay. Results 98 patients were included in our study. 172 stool samples were collected for analysis. Sixty-two stool samples were collected at 16 weeks gestation, 48 samples from 34 weeks gestation, 38 samples from 4weeks post-partum and 24 samples from 12 weeks post-partum. The median age was 33 years (21–44). Forty-one patients had a BMI > 25 (42%). Sixteen patients were ex-smokers (16%) and one patient was actively smoking (1%). The median FCP levels from 16 weeks gestation was 29.5 (10–476), median level from 34 weeks gestation was 25.6 (10–259), from 4 weeks post-partum was 23.4 (10–318) and 12 weeks post-partum was 29.4 (10–216) (Table 1). There was no significant change in median FCP levels over the course of pregnancy and post-partum (p = 0.294). Interestingly median FCP levels were normal at all time points however we saw a slight numerical increase in FCP levels during pregnancy in patients whose BMI was > 25 and this reached statistical significance at 4weeks post-partum (p = 0.01) (Table 1, Graph 1). There was also a significant increase in FCP at 4 weeks post-partum in patients who were ex-smokers (p = 0.004). (Table 1, Graph 1). Conclusion FCP levels are not affected by physiological changes in pregnancy or post-partum in normal healthy individuals without IBD. This confirms FCP is an effective tool for identifying flares of colitis during pregnancy. However, when using this tool, one should be aware that levels can be slightly altered by a patients’ smoking history and their weight and a detailed clinical history is essential when interpreting results.

scholarly journals P320 Accuracy of faecal calprotectin level to select patients with inflammatory bowel disease for a chromoendoscopy surveillance programme

2018 ◽  
Vol 12 (supplement_1) ◽  
pp. S262-S263
Author(s):  
M L De Castro ◽  
A Lopez-Martínez ◽  
R Fernandez-Victoria ◽  
L Sanromán ◽  
J R Pineda ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Faecal Calprotectin ◽  
Surveillance Programme ◽  
Calprotectin Level ◽  
Inflammatory Bowel

MICROBIAL SHIFTS ARE ASSOCIATED WITH PATIENT-REPORTED SYMPTOMS IRRESPECTIVE OF MUCOSAL INFLAMMATION IN PEDIATRIC PATIENTS WITH INFLAMMATORY BOWEL DISEASE

2021 ◽  
Vol 27 (Supplement_1) ◽  
pp. S40-S41
Author(s):  
Jennifer Hellmann ◽  
Allison Ta ◽  
David Haslam ◽  
Kathleen Lake ◽  
Ramona Bezold ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Rectal Bleeding ◽  
Abundant Species ◽  
Fecal Calprotectin ◽  
Mucosal Inflammation ◽  
Patient Reported ◽  
Calprotectin Level ◽  
Inflammatory Bowel ◽  
Stool Samples ◽  
Children And Young Adults

Abstract Objectives Inflammatory bowel diseases (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), are characterized by an aberrant host response to intestinal microbiota causing mucosal inflammation and gastrointestinal symptoms. Patient reported outcome measures (PROs) are increasingly utilized in clinical care and research. Our study aim was to determine if fecal microbial shifts were associated with PROs in children and young adults with IBD. Methods A longitudinal prospective single center study of 93 patients tested for association between fecal microbial shifts, mucosal inflammation as measured by fecal calprotectin, and self-reported symptoms including diarrhea, rectal bleeding, and abdominal pain. For CD, abdominal pain and diarrhea determined disease activity or overall PRO. For UC, diarrhea and rectal bleeding were used. Fecal calprotectin and shotgun metagenomic sequencing were performed on all samples. Demographic and clinical characteristics (Table 1) were incorporated into a negative binomial mixed-effects model in “R” to identify differentially abundant species by PRO and fecal calprotectin. Metabolic pathways were mapped using the HUMAnN2 pipeline and compared to overall PRO, individual symptoms and fecal calprotectin level. Results In 70 CD patients with 244 stool samples, there was no association between symptoms and fecal calprotectin. In 23 UC patients with 76 stool samples, increased fecal calprotectin was associated with rectal bleeding (OR 4.93 [1.18, 20.64], p=0.03). Examination of differentially abundant species in those with self-reported active UC showed increased Klebsiella species and reduced Bacteroides. Conversely, UC patients with fecal calprotectin < 100 µg/gm had reduction in Klebsiella and increase in Bifidobacteria and Bacteroides (Figure 1). Analysis of differentially abundant species in those with abdominal pain in CD showed increase in Haemophilus and reduction in Bacteroides. No microbial shifts were identified in CD patients in association with overall PRO, diarrhea, nor with fecal calprotectin < 250 µg/gm. Metabolic pathway analysis showed no differences in those with CD. In UC patients, increases in sulfoglycolysis and ornithine biosynthesis were associated with overall PROs. Conclusions Fecal microbial shifts including decreased commensals such as Bacteroides correlate with UC patient symptoms. Increased fecal calprotectin level was associated with rectal bleeding in these patients, but not diarrhea. In CD, there was no association with fecal calprotectin and symptoms, and microbial shifts were detected in association with abdominal pain. Similarly, metabolic pathways differed relative to patient-reported symptoms in UC, but not in CD. Data suggests that microbial shifts may directly contribute to symptoms in children and young adults with IBD.

scholarly journals Variability of Faecal Calprotectin in Inflammatory Bowel Disease Patients: An Observational Case-control Study

2019 ◽  
Vol 13 (11) ◽  
pp. 1372-1379 ◽  
Author(s):  
Anneline Cremer ◽  
Jade Ku ◽  
Leila Amininejad ◽  
Marie-Rose Bouvry ◽  
Fabian Brohet ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Case Control Study ◽  
Intraclass Correlation ◽  
Case Control ◽  
Individual Variability ◽  
Faecal Calprotectin ◽  
Inflammatory Bowel ◽  
Stool Samples ◽  
Control Study

AbstractBackground and AimsSeveral factors have been reported to affect faecal calprotectin [FC] values, and significant variation in FC concentrations has been observed in inflammatory bowel disease [IBD] patients. We aimed to evaluate FC variability in IBD patients, and to assess the robustness of a single stool punch.MethodsThis is a single-centre observational case-control study. Disease activity was assessed using endoscopic and clinical activity scores, as well as C-reactive protein levels. Stool samples were collected twice within a 1 to 6 days interval, and FC was measured on punches and homogenates by fluorometric enzyme immunocapture assay.ResultsIn all, 260 stool samples were collected from 120 patients. Intrastool variability was low, with an intraclass correlation coefficient for single measures between three punches from a single stool sample of 0.91, and median coefficient of variation [CV] of 17%. CV of two stool samples a few days apart [intra-individual variability] were significantly higher [p <0.01] with median CV of 36%. FC standard deviations correlated with mean FC levels either for intrastool or for intra-individual variability, with a Spearman’s coefficient of rank correlation of 0.85 and 0.78, respectively [p <0.01]. Disease type, location, activity, and FC levels did not influence variability.ConclusionsA single stool punch is reliable for FC measurement, considering that intrastool variability is low. Intra-individual variability a few days apart is significantly higher. Therefore, decision-making strategies based on single measurements should consider this variability, to determine the minimum optimal variation to be achieved, rather than a cut-off, especially in high FC levels.

scholarly journals P685 Gut microbiota in patients with Inflammatory Bowel Disease during remission

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S604-S605
Author(s):  
A Pisani ◽  
P Rausch ◽  
S Ellul ◽  
C Bang ◽  
T Tabone ◽  
...  
Keyword(s):  
Gut Microbiota ◽  
Alpha Diversity ◽  
Health Condition ◽  
Healthy Controls ◽  
Unifrac Distance ◽  
Healthy Control ◽  
Minimal Data ◽  
Inflammatory Bowel ◽  
Stool Samples ◽  
Curtis Dissimilarity

Abstract Background Dysbiosis in patients with active IBD has been described in many studies and populations. There is, however, minimal data on whether dysbiosis persists during remission and the extent to which it does. The aim of this study was to assess the gut microbiota in Maltese IBD patients who are in remission as compared to a healthy control population. Methods Stool samples of patients with IBD in remission and healthy controls were analyzed by 16S rRNA sequencing. High quality Amplicon sequence variants (ASV) were derived and classified via DADA2. Results Ninety-eight patients with IBD (UC: 67.3%; CD: 32.7%) and 97 controls were recruited. Patients with IBD had a decrease in alpha diversity compared to healthy controls (Figure 1) with significant differences in beta diversity (Bray-Curtis dissimilarity, Jaccard distance and Generalized UniFrac distance: all p=0.0001). At the phylum level, abundances differed significantly with respect to health condition (Figure 2). Twenty-five ASVs that were differentially abundant between the different cohorts were identified (Table 1); 13 being over abundant in healthy individuals, while 6 being least abundant among controls. In both CD and UC, 3 different ASVs were found to be more abundant. Conclusion Despite remission, the faecal gut microbiota in IBD is dysbiotic. Future studies could be directed at assessing whether species identified as being more abundant in controls can be used as probiotics to either reduce or be able to stop the standard medications.

scholarly journals Disease monitoring of biologic treatment in IBD: early impact and future implications of COVID-19 pandemic

2020 ◽  
pp. flgastro-2020-101563
Author(s):  
Stephanie Shields ◽  
Allan Dunlop ◽  
John Paul Seenan ◽  
Jonathan Macdonald
Keyword(s):  
Clinical Care ◽  
Chronic Illnesses ◽  
Therapeutic Drug ◽  
Disease Monitoring ◽  
Biologic Treatment ◽  
Faecal Calprotectin ◽  
Routine Clinical Care ◽  
Risk Of Disease ◽  
Inflammatory Bowel ◽  
The Impact

COVID-19 has dominated life in 2020 with, at the time of writing, over 4.9M global cases and >320 000 deaths. The impact has been most intensely felt in acute and critical care environments. However, with most UK elective work postponed, laboratory testing of faecal calprotectin halted due to potential risk of viral transmission and non-emergency endoscopies and surgeries cancelled, the secondary impact on chronic illnesses such as inflammatory bowel disease (IBD) is becoming apparent. Data from the Scottish Biologic Therapeutic Drug Monitoring (TDM) service shows a dramatic drop in TDM testing since the pandemic onset. April 2020 saw a 75.6% reduction in adalimumab testing and a 36.2% reduction in infliximab testing when compared with February 2020 data, a reduction coinciding with the widespread cancellation of outpatient and elective activity. It is feared that disruption to normal patterns of care and disease monitoring of biologic patients could increase the risk of disease flare and adverse clinical outcomes. Urgent changes in clinical practice have been instigated to mitigate the effects of the pandemic on routine clinical care. Further transformations are needed to maintain safe, effective, patient-centred IBD care in the future.

scholarly journals Sarcopenia, severe anxiety and increased C-reactive protein are associated with severe fatigue in patients with inflammatory bowel diseases

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Laura Tasson ◽  
Fabiana Zingone ◽  
Brigida Barberio ◽  
Romina Valentini ◽  
Pamela Ballotta ◽  
...  
Keyword(s):  
Fecal Calprotectin ◽  
Healthy Population ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Severe Fatigue ◽  
High Prevalence ◽  
Bowel Diseases ◽  
Moderate Fatigue ◽  
Inflammatory Bowel ◽  
Severe Anxiety

AbstractPatients with inflammatory bowel disease (IBD) report fatigue more frequently than healthy population, but the precise mechanisms underlying its presence are unknown. This study aimed to evaluate the prevalence of fatigue in IBD and its relation with potential causative factors. A survey on fatigue, depression, anxiety, sleep disorders, and the presence of sarcopenia and malnutrition, was sent by email to 244 IBD outpatients of the Gastroenterology Unit of Academic Hospital of Padua. Demographics and clinical data, including the levels of fecal calprotectin (FC) and C-reactive protein (CRP), and current pharmacological treatments were obtained from patients’ medical records. Ninety-nine (40.5%) subjects answered the survey. Ninety-two (92.9%) patients reported fatigue, with sixty-six having mild to moderate fatigue and twenty-six severe fatigue. Multivariate analysis showed that abnormal values of CRP (OR 5.1), severe anxiety (OR 3.7) and sarcopenia (OR 4.4) were the factors independently associated with severe fatigue. Fatigue has a high prevalence in subject affected by IBD. Subjects with altered CRP, sarcopenia and severe anxiety appear more at risk of severe fatigue.

scholarly journals Predicting disease course in ulcerative colitis using stool proteins identified through an aptamer-based screen

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Sanam Soomro ◽  
Suresh Venkateswaran ◽  
Kamala Vanarsa ◽  
Marwa Kharboutli ◽  
Malavika Nidhi ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Fecal Calprotectin ◽  
Disease Monitoring ◽  
Disease Course ◽  
Lipocalin 2 ◽  
Time Points ◽  
Inflammatory Bowel ◽  
Stool Samples

AbstractIn the search for improved stool biomarkers for inflammatory bowel disease (IBD), an aptamer-based screen of 1129 stool proteins was conducted using stool samples from an IBD cohort. Here we report that of the 20 proteins subsequently validated by ELISA, stool Ferritin, Fibrinogen, Haptoglobin, Hemoglobin, Lipocalin-2, MMP-12, MMP-9, Myeloperoxidase, PGRP-S, Properdin, Resistin, Serpin A4, and TIMP-1 are significantly elevated in both ulcerative colitis (UC) and Crohn’s disease (CD) compared to controls. When tested in a longitudinal cohort of 50 UC patients at 4 time-points, fecal Fibrinogen, MMP-8, PGRP-S, and TIMP-2 show the strongest positive correlation with concurrent PUCAI and PGA scores and are superior to fecal calprotectin. Unlike fecal calprotectin, baseline stool Fibrinogen, MMP-12, PGRP-S, TIMP-1, and TIMP-2 can predict clinical remission at Week-4. Here we show that stool proteins identified using the comprehensive aptamer-based screen are superior to fecal calprotectin alone in disease monitoring and prediction in IBD.

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