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High faecal calprotectin levels in healthy, exclusively breast-fed infants
Francesco Savino1, Emanuele Castagno, Roberto Calabrese
1Department of Paediatrics, Regina Margherita Children's Hospital, University of Turin, Turin, Italy. francesco.savino@unito.it
Insights
Faecal calprotectin levels are higher in exclusively breast-fed infants compared to formula-fed infants. This study highlights how infant feeding type impacts this important marker of gastrointestinal inflammation.
Area of Science:
- Pediatrics
- Gastroenterology
- Immunology
Background:
- Faecal calprotectin is a sensitive marker for gastrointestinal inflammation.
- Elevated levels are noted in newborns, but feeding's impact is debated.
Purpose of the Study:
- To assess faecal calprotectin levels in healthy, exclusively breast-fed (BF) versus formula-fed (FF) infants.
- To investigate the influence of feeding type on faecal calprotectin concentrations.
Main Methods:
- Analyzed stool samples from 74 healthy infants (39 BF, 35 FF) aged 13-90 days.
- Used a commercial enzyme-linked immunoassay for faecal calprotectin detection.
- Excluded infants with infections or on anti-inflammatory drugs.
Main Results:
- Median faecal calprotectin was significantly higher in BF infants (555.00 µg/g) than FF infants (206.60 µg/g).
- BF infants had higher stool frequency, but feeding type, not frequency, significantly influenced calprotectin levels.
Conclusions:
- Infant feeding type significantly impacts faecal calprotectin concentrations.
- Higher levels in BF infants may relate to human milk components like growth factors and cytokines.
- Further research is needed to elucidate the precise mechanisms.
Background:
Faecal calprotectin has been proposed as a sensitive marker for gastrointestinal inflammation in children and adults. High levels have been reported in healthy newborns and during the first months of life; the effect of the kind of feeding on the calprotectin concentration in stools is controversial.
Objective:
To evaluate faecal calprotectin values in healthy, exclusively breast-fed (BF) or formula-fed (FF) infants.
Methods:
Stool samples were obtained from 74 healthy infants (39 exclusively BF and 35 exclusively FF) with a median age of 51 days (range 13-90). Exclusion criteria were acute infections and treatment with anti-inflammatory drugs. Stool samples were stored at -20 degrees C until they were analysed, and the faecal calprotectin concentration was detected using a commercial quantitative enzyme-linked immunoassay (Calprest; Eurospital SpA, Trieste, Italy).
Results:
The median faecal calprotectin concentration was significantly higher in BF infants (555.00 microg/g, range 122.5-2,000.0 microg/g) than in FF ones (206.60 mug/g, range 31.2-797.6 microg/g) (p < 0.001). We observed a significantly higher median stool frequency in BF infants than in FF ones (p < 0.001), but multiple regression analysis (independent variables: kind of feeding and stool frequency; dependent variable: calprotectin) showed a significant coefficient for the kind of feeding, but not for stool frequency (p = 0.937).
Conclusions:
Our findings show that the kind of feeding influences the faecal calprotectin concentration, with higher values in healthy exclusively BF infants than in FF ones. Our study does not allow us to clearly identify the reason for our finding; this could be due to hormones (such as ghrelin and leptin), cytokines and other immunostimulating and growth factors (such as epidermal growth factor and granulocyte colony-stimulating factor) in human milk, which contribute to the development of the gastrointestinal immune system. Further investigations are needed to better clarify the mechanism underlying the relationship between feeding and faecal calprotectin levels in young infants.
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