Crohnʼs disease activity assessed by fecal calprotectin and lactoferrin: Correlation with Crohnʼs disease activity index and endoscopic findings
Top Cited Papers
- 1 January 2008
- journal article
- research article
- Published by Oxford University Press (OUP) in Inflammatory Bowel Diseases
- Vol. 14 (1), 40-46
- https://doi.org/10.1002/ibd.20312
Abstract
Correlation of endoscopic Crohn's disease activity with fecal calprotectin and lactoferrin is insufficiently studied. We evaluated the clinical significance of these neutrofil-derived proteins in assessment of Crohn's disease activity by comparing them with endoscopic disease activity and with Crohn's disease activity index (CDAI) and serum CRP. A total of 77 CD patients underwent one or more ileocolonoscopies (n = 106) with scoring of Crohn's disease index of severity (CDEIS). Patients provided stool samples for calprotectin and lactoferrin measurements and blood samples for CRP. Clinical activity was based on the CDAI. Both fecal calprotectin and lactoferrin correlated significantly with CDEIS (Spearman's r 0.729 and 0.773, P < 0.001). With a cutoff level of 200 microg/g for a raised fecal calprotectin concentration, sensitivity was 70%, specificity 92%, positive predictive value (PPV) 94%, and negative predictive value (NPV) 61% in predicting endoscopically active disease (CDEIS >/= 3). A fecal lactoferrin concentration of 10 microg/g as the cutoff value gave a sensitivity, specificity, PPV, and NPV of 66%, 92%, 94%, and 59%. Sensitivity of CDAI >/= 150 to detect endoscopically active disease was only 27%, specificity 94%, PPV 91%, and NPV 40%. A raised serum CRP (> 5 mg/l) gave a sensitivity, specificity, PPV, and NPV of 48%, 91%, 91%, and 48%. For evaluation of Crohn's disease activity, based on endoscopic findings, more sensitive surrogate markers than is CDAI or CRP are fecal calprotectin and lactoferrin. These prove to be useful tools for estimation of disease activity in Crohn's disease.Keywords
This publication has 38 references indexed in Scilit:
- Scheduled maintenance treatment with infliximab is superior to episodic treatment for the healing of mucosal ulceration associated with Crohn's diseaseGastrointestinal Endoscopy, 2006
- Endoscopic and histologic evidence of persistent mucosal healing and correlation with clinical improvement following sustained infliximab treatment for Crohn's diseaseCurrent Medical Research and Opinion, 2005
- Crohn's disease: monitoring disease activityAlimentary Pharmacology & Therapeutics, 2003
- Is clinical remission the optimum therapeutic goal in the treatment of Crohn's disease?Alimentary Pharmacology & Therapeutics, 2002
- Lactoferrin in whole gut lavage fluid as a marker for disease activity in inflammatory bowel disease: comparison with other neutrophil-derived proteinsThe American Journal of Gastroenterology, 2002
- Correlation between Faecal Excretion of Indium-111-Labelled Granulocytes and Calprotectin, a Granulocyte Marker Protein, in Patients with Inflammatory Bowel DiseaseScandinavian Journal of Gastroenterology, 1999
- Faecal Calprotectin: A Novel Test for the Diagnosis of Colorectal Cancer?Scandinavian Journal of Gastroenterology, 1993
- Assessment of the Neutrophil Dominating Protein Calprotectin in Feces: A Methodologic StudyScandinavian Journal of Gastroenterology, 1992
- Are activity indices helpful in assessing active intestinal inflammation in Crohn's disease?Gut, 1989
- Development of a Crohn's Disease Activity IndexGastroenterology, 1976