Faecal Calprotectin in Inflammatory Bowel Diseases

MP Narayanan and DM Vasudevan*

Senior Resident, Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India

*Corresponding Author: DM Vasudevan, Emeritus Professor and Head-P.G. Programmes and Research, Health Sciences Research Department, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India.

Received: September 21, 2021; Published: December 31, 2021

Abstract

Background: Inflammatory bowel diseases (IBD) are chronic intestinal disorders of unknown etiology and with a typically relapsing course. Faecal calprotectin (FC), an important granulocyte cytosolic protein, is closely correlated with faecal excretion of 111 indium labelled leucocytes, deemed to be the gold standard for measuring intestinal inflammation. Assessment of faecal calprotectin levels has been proposed as a non-invasive test for the direct evaluation of intestinal inflammation in patients with IBD. Since mucosal healing of ulcers reduces the need for surgical intervention and hospitalization in IBD, we examined the reliability of calprotectin levels in reflecting mucosal disease severity. The aim of the study was to compare faecal Calprotectin with the standard disease activity indices (UCAI and CDAI) of inflammatory bowel diseases (Ulcerative colitis and Crohn’s disease).

Methods: Patients diagnosed to have IBD based on clinical, endoscopic and histological examination were included. Ulcerative colitis activity index (UCAI) and Crohn’s diseases activity index (CDAI), were calculated. Faecal calprotectin was estimated by a commercially available quantitative ELISA test.

Results: Forty-three patients were included in the study, 20 patients with Ulcerative colitis (UC) and 23 with Crohn’s disease (CD). Patients with active CD (CDAI > 150) were 18/23 (78%) and with active UC (UCAI > 2) were 17. Mean hemoglobin was not different in both the groups. Mean ESR was raised in both groups (37 in UC, 31 in CD; P = 0.361). Mean CRP was raised in both groups (UC 49 ± 60; CD 19 ± 19; P= 0.302). Mean UCAI was 7 (SD ± 3) and mean CDAI was 212 (SD ± 89). Mean faecal calprotectin was 890μg/g (SD ± 503) in UC patients and 641 μg/g (SD ± 739) in CD patients; P = 0.028. Faecal calprotectin was higher in active cases compared to those in remission but the difference did not achieve statistical significance. Correlation of faecal calprotectin with CDAI was strong (P = 0.0008) whereas correlation of faecal calprotectin with UCAI was weak (P = 0.274).

Conclusion: Faecal calprotectin correlated strongly with CDAI but weakly with UCAI. The difference in patients in remission vs active disease (as categorized by UCAI and CDAI) was not statistically significant.

 

Keywords: Inflammatory Bowel Disease; Crohn’s Disease; Ulcerative Colitis; Faecal Calprotectin; Endoscopy; Diagnosis; Biomarker

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Citation

Citation: MP Narayanan and DM Vasudevan. “Faecal Calprotectin in Inflammatory Bowel Diseases". Acta Scientific Paediatrics 5.1 (2022): 21-24.

Copyright

Copyright: © 2022 MP Narayanan and DM Vasudevan. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.