Fecal calprotectin and lactoferrin as noninvasive markers of pediatric inflammatory bowel disease

Area of Science:

• Pediatric Gastroenterology
• Inflammatory Bowel Disease Diagnostics
• Biomarker Research

Background:

• Inflammatory bowel disease (IBD) diagnosis in children often requires invasive procedures.
• Noninvasive biomarkers are needed for early detection and monitoring of pediatric IBD.
• Fecal calprotectin (FC) and fecal lactoferrin (FL) are potential inflammatory markers.

Purpose of the Study:

• To assess the utility of fecal calprotectin (FC) and fecal lactoferrin (FL) as noninvasive markers for active IBD in children aged 4-17 years.
• To compare the diagnostic performance of FC and FL, individually and in combination, against control groups.

Main Methods:

• Stool samples were analyzed from children with active IBD, gastrointestinal (GI) controls, and non-GI controls.
• Fecal calprotectin (FC) and fecal lactoferrin (FL) levels were quantified using enzyme-linked immunoassays.
• Diagnostic accuracy metrics including area under the curve (AUC), sensitivity, and specificity were evaluated.

Main Results:

• Median concentrations of FC and FL, and their interaction, were significantly higher in children with active IBD compared to both control groups (P < 0.001).
• FC, FL, and their interaction demonstrated diagnostic performance significantly better than chance.
• The combined FC x FL interaction yielded the highest area under the curve, suggesting superior diagnostic capability.

Conclusions:

• Both FC and FL are significantly elevated in pediatric patients with active IBD.
• The combined assessment of FC and FL (FC x FL interaction) shows promise as an improved initial diagnostic tool for pediatric IBD compared to using either marker alone.