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Fecal alpha1--antitrypsin in healthy and intestinal-disorder Thai children
Duangsmorn Tangsilsat1, Kalayanee Atamasirikul, Suporn Treepongkaruna
1Clinical Immunology Laboratory, Department of Pathology, Faculty of Medicine-Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Insights
Stool alpha1-antitrypsin (FA1-AT) levels were determined in Thai children. Elevated FA1-AT in stool supports diagnosis of protein-losing enteropathy.
Area of Science:
- Pediatric Gastroenterology
- Clinical Chemistry
- Diagnostic Immunology
Background:
- Alpha1-antitrypsin (FA1-AT) is a key protein involved in inflammatory processes.
- Measuring FA1-AT in stool can aid in diagnosing gastrointestinal disorders.
- Establishing reference ranges in pediatric populations is crucial for accurate diagnosis.
Purpose of the Study:
- To establish normal fecal FA1-AT levels in healthy Thai children.
- To compare two measurement methods: nephelometry (NPL) and radial immunodiffusion (RID).
- To assess the utility of fecal FA1-AT as a diagnostic marker for protein-losing enteropathy.
Main Methods:
- Collection of random wet stool samples from healthy children and patients with intestinal disorders in Thailand.
- Quantification of FA1-AT using both NPL and RID methods.
- Statistical analysis to determine normal ranges and method correlation.
Main Results:
- Newborns exhibited the highest FA1-AT levels on day 1, decreasing by day 3-4.
- Median FA1-AT levels in healthy children (1 month-15 years) were 1.23 mg/dL (NPL).
- Children with severe intestinal disorders showed significantly higher median FA1-AT levels (6.77 mg/dL, NPL).
- NPL and RID methods demonstrated a strong correlation (r=0.87, R²=0.75).
Conclusions:
- Fecal FA1-AT measurement is a simple, non-invasive test.
- This assay supports the diagnosis of protein-losing enteropathy in children.
- The study provides reference values for fecal FA1-AT in Thai children.
Objective:
Determine the normal FA1-AT level in random wet stool of Thai children using RID and NPL, and to study the correlation between RID and NPL methods for measurement of FA1-AT.
Material And Method:
Random stool samples were collected from healthy children and intestinal-disorders patients. Alpha1-antitrypsin (FA1-AT) in wet stool samples was measured by nephelometry (NPL) and radial-immunodiffusion (RID) methods.
Results:
Newborn infants had the highest FA1-AT level during the first day of life and declined to the same level as older children on day 3-4. Median and geometric mean of FA1-AT levels by NPL from healthy children aged 1 month-15 years was 1.23 and 1.11 mg/dL respectively. FA1-AT levels by NPL from children with severe intestinal disorders, displaying median and geometric mean at 6.77 and 12.39 mg/dL respectively, were much higher than healthy children. The RID and NPL methods showed a correlation of r = 0.87 (p < 0.01) and R2 = 0.75.
Conclusion:
Random FA1-AT assay in wet stool is a non-invasive and simple test for supporting diagnosis of protein-losing enteropathy.
