scholarly journals Global Studies of Using Fecal Biomarkers in Predicting Relapse in Inflammatory Bowel Disease

2020 ◽  
Vol 7 ◽  
Author(s):  
Fang Liu ◽  
Seul A. Lee ◽  
Stephen M. Riordan ◽  
Li Zhang ◽  
Lixin Zhu
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Intestinal Inflammation ◽  
Fecal Calprotectin ◽  
Global Studies ◽  
Chronic Inflammatory Condition ◽  
Inflammatory Bowel ◽  
Random Patterns ◽  
Positive Correlations ◽  
Fecal Biomarkers

Inflammatory bowel disease (IBD) is a chronic inflammatory condition of the gastrointestinal tract mainly comprising two forms including Crohn's disease (CD) and ulcerative colitis (UC). IBD is a lifelong relapsing remitting disease and relapses occur at random patterns which are unpredictable. Fecal biomarkers have been increasingly used to assess disease activity in IBD due to their positive correlations with intestinal inflammation. Recent studies have also assessed the use of fecal biomarkers in predicting relapse and post-operative recurrence. This review provides information from global studies of using fecal calprotectin, lactoferrin and S100A12 to predict relapse in IBD. Strategies for further studies and the use of these fecal biomarkers for personalized management in IBD are also discussed.

scholarly journals Surrogate Fecal Biomarkers in Inflammatory Bowel Disease: Rivals or Complementary Tools of Fecal Calprotectin?

2017 ◽  
Vol 24 (1) ◽  
pp. 78-92 ◽  
Author(s):  
Mirko Di Ruscio ◽  
Filippo Vernia ◽  
Antonio Ciccone ◽  
Giuseppe Frieri ◽  
Giovanni Latella
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Intestinal Inflammation ◽  
Fecal Calprotectin ◽  
Response To Therapy ◽  
Polymorphonuclear Neutrophil ◽  
Cochrane Library ◽  
Clinical Relapse ◽  
Inflammatory Bowel ◽  
Fecal Biomarkers

Abstract Background Current noninvasive methods for assessing intestinal inflammation in inflammatory bowel disease (IBD) remain unsatisfactory. Along with C-reactive protein and erythrocyte sedimentation rate, fecal calprotectin (FC) is the standard test for assessing IBD activity, even though its specificity and accuracy are not optimal and it lacks a validated cutoff. Over the past few decades, several fecal markers released from intestinal inflammatory cells have been investigated in IBD; they are the subject of this systematic review. Methods A systematic electronic search of the English literature up to April 2017 was performed using Medline and the Cochrane Library. Only papers written in English that analyzed fecal biomarkers in IBD were included. In vitro studies, animal studies, studies on blood/serum samples, and studies analyzing FC or fecal lactoferrin alone were excluded. Results Out of 1023 citations, 125 eligible studies were identified. Data were grouped according to each fecal marker including S100A12, high-mobility group box 1, neopterin, polymorphonuclear neutrophil elastase, fecal hemoglobin, alpha1-antitrypsin, human neutrophil peptides, neutrophil gelatinase-associated lipocalin, chitinase 3-like-1, matrix metalloproteinase 9, lysozyme, M2-pyruvate kinase, myeloperoxidase, fecal eosinophil proteins, human beta-defensin-2, and beta-glucuronidase. Some of these markers showed a high sensitivity and specificity and correlated with disease activity, response to therapy, and mucosal healing. Furthermore, they showed a potential utility in the prediction of clinical relapse. Conclusions Several fecal biomarkers have the potential to become useful tools complementing FC in IBD diagnosis and monitoring. However, wide variability in their accuracy in assessment of intestinal inflammation suggests the need for further studies.

scholarly journals Rational Use of Fecal Calprotectin in Irritable Bowel Syndrome and Inflammatory Bowel Disease

2021 ◽  
Author(s):  
Roberto Catanzaro ◽  
Alfio Maugeri ◽  
Morena Sciuto ◽  
Fang He ◽  
Baskar Balakrishnan ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Irritable Bowel Syndrome ◽  
Differential Diagnosis ◽  
Bowel Disease ◽  
Intestinal Inflammation ◽  
Gastrointestinal Disorder ◽  
Fecal Calprotectin ◽  
Mean Values ◽  
Inflammatory Bowel ◽  
Irritable Bowel

The gastrointestinal pathologies have increased over the last years. The clinical pictures of inflammatory and irritable bowel disease might overlap, leading to expensive and invasive tests. Our study aims to investigate fecal calprotectin as an effective tool for differential diagnosis of gastrointestinal disorders. Two hundred fifty-six patients with the diagnosis of the gastrointestinal disorder and subjected to colonoscopy were collected for the statistical analysis of fecal calprotectin. The differential diagnosis of intestinal inflammation or non-inflammation was performed according to the Receiver Operating Characteristic (ROC) curve that outlines the Area Under Curve (AUC), Sensitivity (Se), Specificity (Sp). Fecal calprotectin was significantly elevated in patients with inflammatory bowel disease compared with patients with irritable bowel syndrome. Especially, the mean values of fecal calprotectin were 522 g/g (IQR=215-975) and 21 g/g (IQR=14-34.5) in patients with and without inflammation, respectively (P<0.0001). AUC value of fecal calprotectin was 0.958 (Se=88.9%, Sp=91.1%, with a cut-off value of 50 g/g) for differentiating between inflammatory bowel disease and irritable bowel syndrome. Fecal calprotectin seems to be a non-invasive and inexpensive biomarker useful for the purpose of a differential diagnosis between inflammatory bowel disease and irritable bowel syndrome.

scholarly journals Telomere dysfunction instigates inflammation in inflammatory bowel disease

2021 ◽  
Vol 118 (29) ◽  
pp. e2024853118
Author(s):  
Deepavali Chakravarti ◽  
Rumi Lee ◽  
Asha S. Multani ◽  
Andrea Santoni ◽  
Zachery Keith ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Dna Damage ◽  
Intestinal Epithelium ◽  
Bowel Disease ◽  
Intestinal Inflammation ◽  
Telomere Maintenance ◽  
Intestinal Biopsy ◽  
Telomere Dysfunction ◽  
Chronic Inflammatory Condition ◽  
Inflammatory Bowel

Inflammatory bowel disease (IBD) is a chronic inflammatory condition driven by diverse genetic and nongenetic programs that converge to disrupt immune homeostasis in the intestine. We have reported that, in murine intestinal epithelium with telomere dysfunction, DNA damage-induced activation of ataxia-telangiectasia mutated (ATM) results in ATM-mediated phosphorylation and activation of the YAP1 transcriptional coactivator, which in turn up-regulates pro-IL-18, a pivotal immune regulator in IBD pathogenesis. Moreover, individuals with germline defects in telomere maintenance genes experience increased occurrence of intestinal inflammation and show activation of the ATM/YAP1/pro-IL-18 pathway in the intestinal epithelium. Here, we sought to determine the relevance of the ATM/YAP1/pro-IL-18 pathway as a potential driver of IBD, particularly older-onset IBD. Analysis of intestinal biopsy specimens and organoids from older-onset IBD patients documented the presence of telomere dysfunction and activation of the ATM/YAP1/precursor of interleukin 18 (pro-IL-18) pathway in the intestinal epithelium. Employing intestinal organoids from healthy individuals, we demonstrated that experimental induction of telomere dysfunction activates this inflammatory pathway. In organoid models from ulcerative colitis and Crohn’s disease patients, pharmacological interventions of telomerase reactivation, suppression of DNA damage signaling, or YAP1 inhibition reduced pro-IL-18 production. Together, these findings support a model wherein telomere dysfunction in the intestinal epithelium can initiate the inflammatory process in IBD, pointing to therapeutic interventions for this disease.

scholarly journals Biological diagnosis of inflammatory bowel disease: current ideas and future achievements.

2021 ◽  
Vol 2021 (1) ◽  
pp. 103-108
Author(s):  
T.D. Zvyagintseva ◽  
◽  
A.V. Yaroshenko ◽  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Fecal Calprotectin ◽  
Phase Changes ◽  
Clinical Activity ◽  
Adequate Treatment ◽  
Reactive Protein ◽  
Inflammatory Bowel ◽  
Biological Methods ◽  
Fecal Biomarkers

Article presents review of new biological methods for the diagnosis of IBD. The problem of late diagnosis of IBD remains relevant because of increased frequency of adverse consequences of the disease by increasing the length of the period when patients do not receive adequate treatment. Well-known today are biological markers of inflammatory bowel disease, which are determined by non-invasive methods and are often an alternative to colonoscopy. C-reactive protein (CRP) is recognized as one of the most important proteins in the acute inflammation phase. Changes in the content of fecal calprotectin (FCP) in patients with IBD due to the clinical activity of inflammatory bowel disease and are closely related to the extent of colon damage. New fecal biomarkers such as Defensin, Myeloperoxidase, Pyruvate kinase, Lipocalin and others are a sensitive tool for screening for inflammation of the intestine and an indicator of its severity. New fecal markers may help improve the diagnosis, evaluation, and clinical outcomes of treatment of patients with inflammatory bowel disease.

scholarly journals A Patient Self-Made Point-of-Care Fecal Test Improves Diagnostic Accuracy Compared with Fecal Calprotectin Alone in Inflammatory Bowel Disease Patients

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2323
Author(s):  
Gonzalo Hijos-Mallada ◽  
Raul Velamazán ◽  
Raúl Marti ◽  
Eduardo Chueca ◽  
Samantha Arechavaleta ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Clinical Practice ◽  
Bowel Disease ◽  
Point Of Care ◽  
Fecal Calprotectin ◽  
Inflammatory Activity ◽  
Point Of Care Test ◽  
Inflammatory Bowel ◽  
Fecal Biomarkers

Background: Monitoring inflammatory bowel disease patients may be challenging. Fecal calprotectin is one of the most performed tests. Other fecal biomarkers are less used in clinical practice. Rapid fecal tests that could be performed by patients may be a useful strategy to closely monitor disease activity. Methods: We performed a prospective observational study including consecutive inflammatory bowel disease patients referred for colonoscopy in a single center. Certest FOB + Transferrin + Calprotectin + Lactoferrin® (Certest Biotec S.L, Zaragoza, Spain), a one-step point-of-care test which simultaneously detects these four biomarkers was performed. Endoscopic inflammatory activity was defined using the Mayo score (≥1) in ulcerative colitis, SES-CD (>3) and Rutgeerts scores (≥1) for Crohn’s disease. Results: Out of a total of 106 patients (56.5% female, mean age 51 years), 54 (50.9%) were diagnosed with ulcerative colitis and 52 (49.1%) with Crohn’s disease. Endoscopic activity was detected in 42 patients (39.0%). Fecal calprotectin provided the best sensitivity (97.6%), with limited specificity (34.4%). Compared to calprotectin, the other 3 fecal biomarkers showed better specificity (87.5–92.1%) and lower sensitivity (45.2–59.5%). Patients with a negative result in all biomarkers (19/106—17.9%) had 100% (CI 95% 97.4–100) negative predictive value, while patients with the 4 biomarkers positive (13/106—12.3%) had 100% (CI 95% 96.1–100) positive predictive value of endoscopic inflammatory activity. AUROC of this 4 biomarker point-of-care test was 0.845 (95% CI 0.771–0.920), significantly higher than the AUROCs of any of the 4 biomarkers. Conclusions: This test may be a useful strategy to monitor inflammatory activity in clinical practice by excluding or prioritizing patients in need of a colonoscopy.

Rapid Fecal Calprotectin Level Assessment and the SIBDQ Score Can Accurately Detect Active Mucosal Inammation in IBD Patients in Clinical Remission: a Prospective Study

2014 ◽  
Vol 23 (3) ◽  
pp. 273-278 ◽  
Author(s):  
Theodor Voiosu ◽  
Andreea Bengus ◽  
Roxana Dinu ◽  
Andrei M. Voiosu ◽  
Paul Balanescu ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Clinical Remission ◽  
Intestinal Inflammation ◽  
Activity Index ◽  
Fecal Calprotectin ◽  
Clinical Activity ◽  
Inflammatory Bowel ◽  
Inflammatory Changes

Background & Aims: Mucosal healing is an important predictor of disease-related outcome in inflammatory bowel disease (IBD) patients, including those in clinical remission. However, colonoscopy is an invasive procedure and many patients decline repeated endoscopic examinations. We aimed to assess whether noninvasive biomarkers could accurately detect endoscopic mucosal inflammatory activity in IBD patients in clinical remission.Methods: We conducted a prospective observational cohort study on IBD patients in clinical remission at Colentina Hospital, Bucharest. Clinical activity was assessed using the Mayo score and Crohn’s Disease Activity Index (CDAI), quality of life was assessed using the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). Serum C-reactive protein (CRP) and fecal calprotectin (FC) levels were determined. All patients underwent ileo-colonoscopy to assess mucosal inflammatory activity.Results: 48 patients were included in this study, with 67% showing endoscopic disease activity. SIBD questionnaire and FC performed well as noninvasive markers of intestinal inflammation (AUROC 0.78 and 0.77, respectively), while CRP could not accurately predict endoscopic disease activity. Fecal calprotectin levels > 30 ľg/g showed a 93% sensitivity and a 50% specificity for detecting inflammatory changes of the mucosa while a combined test using FC > 30µg/g and a SIBDQ score < 6 achieved 81.2% sensitivity and 75% specificity, respectively, in detecting active endoscopic disease.Conclusion: Fecal calprotectin and SIBDQ have good diagnostic accuracy in detecting mucosal inflammatory changes in IBD patients in clinical remission. Combining simple, noninvasive tests such as the SIBDQ and FC levels appears to be a practical method for monitoring disease activity in these patients, possibly reducing the need for repeat endoscopic examinations.

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