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Calprotectin and lactoferrin in the assessment of intestinal inflammation and organic disease

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Abstract

Background and aims

Calprotectin and lactoferrin are specific neutrophil-derived proteins, which can be measured in the feces because they are released by cells in inflammatory conditions. We evaluated the efficacy of calprotectin and lactoferrin in detecting organic disease as assessed by colonoscopy.

Methods

The study comprised 144 patients undergoing colonoscopy for lower gastrointestinal symptoms (abdominal pain, altered bowel habits, and bloody stools) (67), or inflammatory bowel disease activity, or surveillance for dysplasia (77). A single stool sample was assayed for calprotectin and lactoferrin. The proportion of patients correctly diagnosed with each test and the relationship with endoscopic and histological findings were measured.

Results

Fecal excretion of calprotectin significantly correlated with the finding of colonic inflammation at endoscopy, both in ulcerative colitis and in Crohn’s disease (p<0,001 and p<0,008, respectively), while lactoferrin excretion significantly correlated with histological inflammation (p=0.001 and p=0.009 respectively). Recommended cut-off values need to be adjusted in the inflammatory bowel disease group. Overall sensitivity, specificity, positive predictive value, and diagnostic efficacy were 78, 83, 86, and 80% for calprotectin and 80, 85, 87, and 81% for lactoferrin, respectively.

Conclusions

Fecal calprotectin and lactoferrin appear to be equally recommendable as inflammatory disease markers in patients with lower gastrointestinal symptoms. Both tests are needed to accurately discriminate activity in inflammatory bowel disease patients.

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Acknowledgements

Dr. R. D’Incà and Dr. E. Dal Pont contributed equally to this work. This is supported in part by a grant from MIUR ex 40% 2004 (2004063577_004).

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Authors and Affiliations

  1. Department of Surgical and Gastroenterological Sciences, University of Padua, Padova, Italy

    Renata D’Incà, Elisabetta Dal Pont, Vincenza Di Leo, Antonio Ferronato, Maria Grazia Vettorato, Diego Martines & Giacomo Carlo Sturniolo

  2. Department of Internal Medicine and Medical Therapy, University of Messina, Messina, Italy

    Walter Fries

  3. Divisione di Gastroenterologia, Ospedale Civile, Via Giustiniani, 2, 35128, Padova, Italy

    Renata D’Incà

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  1. Renata D’Incà
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  2. Elisabetta Dal Pont
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Correspondence to Renata D’Incà.

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D’Incà, R., Dal Pont, E., Di Leo, V. et al. Calprotectin and lactoferrin in the assessment of intestinal inflammation and organic disease. Int J Colorectal Dis 22, 429–437 (2007). https://doi.org/10.1007/s00384-006-0159-9

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