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Fecal calprotectin concentration in celiac disease
Vildan Ertekin1, Mukadder Ayşe Selimoğlu, Ahmet Turgut
1Faculty of Medicine, Division of Pediatric Gastroenterology, Department of Hepatology and Nutrition, Ataturk University, Erzurum, Turkey. vildanertekin@hotmail.com
Insights
Fecal calprotectin (FC) is elevated in children with celiac disease (CD) and correlates with intestinal damage. A gluten-free diet (GFD) significantly reduces FC levels, normalizing them in children with CD.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Gastrointestinal Inflammation
Background:
- Fecal calprotectin (FC) is a recognized biomarker for gastrointestinal inflammation.
- Elevated FC levels are hypothesized in untreated celiac disease (CD) due to gut inflammation.
Purpose of the Study:
- To quantify fecal calprotectin (FC) levels in children diagnosed with celiac disease (CD).
- To investigate the correlation between FC concentrations and histopathologic findings in pediatric CD.
- To assess the impact of a gluten-free diet (GFD) on FC levels in children with CD.
Main Methods:
- Enzyme-linked immunosorbent assay (ELISA) was used to measure FC concentrations.
- FC levels were determined in 29 newly diagnosed pediatric CD patients and 10 healthy controls.
- Histopathologic evaluation of intestinal mucosa was performed using modified Marsh criteria.
Main Results:
- Children with CD exhibited significantly higher mean FC levels (13.40+/-8.5 mg/L) compared to healthy controls (4.3+/-3.3 mg/L).
- FC concentrations in CD patients significantly decreased to 4.6+/-2.7 mg/L after one year on a GFD, nearing levels of healthy children.
- Higher FC levels correlated with more severe histopathologic findings, specifically total-villous atrophy compared to partial-villous atrophy.
Conclusions:
- FC concentration is elevated in pediatric celiac disease and is directly related to the severity of intestinal mucosal damage.
- A gluten-free diet (GFD) effectively reduces FC levels in children with CD, indicating its therapeutic efficacy.
- Further research is warranted to elucidate the specific pathogenetic mechanisms driving elevated FC in celiac disease.
Goals:
We aimed to determine fecal calprotectin (FC) concentration and its relation with histopathologic findings of children with celiac disease (CD) and to observe the probable alterations under gluten-free diet (GFD).
Background:
As FC is regarded as a marker of inflammation in the gastrointestinal tract, we hypothesized that it might be increased in untreated CD.
Study:
The study included 29 newly diagnosed patients with CD (mean age: 6.6+/-0.6 y) and sex and age-matched 10 healthy children. All of the children with CD admitted to the hospital were classical form who has chronic diarrhea and failure to thrive. The degree of mucosal damage was graded according to the modified Marsh criteria. FC concentration was determined by enzyme-linked immunosorbent assay method on admission and after 1 year of GFD.
Results:
Mean FC concentration of children with CD on admission and of healthy children were 13.40+/-8.5 and 4.3+/-3.3 mg/L, respectively (P=0.004). FC concentration under GFD was 4.6+/-2.7 mg/L and there was a significant statistical difference between untreated patients and those under GFD for 1 year (P=0.001). There was no statistical difference between FC concentration of those under GFD and healthy children (P=0.8). Mean FC concentrations of children with total-villous atrophy and partial-villous atrophy were significantly different (13.8+/-9.3 mg/L vs. 3.7+/-1.8 mg/L, P=0.005).
Conclusions:
It was found that FC concentration is increased in childhood CD, related to the severity of histopathologic findings and responsive to GFD. The pathogenetic mechanism by which FC is increased in CD should be investigated in further studies.
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