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Fecal markers: calprotectin and lactoferrin
Bincy P Abraham1, Sunanda Kane
1Section of Gastroenterology and Hepatology, Baylor College of Medicine, 1709 Dryden Street, Suite 800, Houston, TX 77030, USA. bincya@bcm.edu
Gastroenterology Clinics of North America
|April 17, 2012
Summary
Fecal markers like calprotectin and lactoferrin are more accurate than serum markers for diagnosing inflammatory bowel disease (IBD). While not specific, they help differentiate IBD from functional disorders and monitor treatment response.
Area of Science:
- Gastroenterology
- Clinical Diagnostics
- Biomarker Research
Background:
- Serum markers show limitations in accuracy for inflammatory bowel disease (IBD) diagnosis.
- Fecal markers offer improved accuracy but lack specificity for IBD, potentially rising in various organic conditions.
- Fecal calprotectin and lactoferrin are key biomarkers that can distinguish inflammatory bowel disease from functional bowel disorders.
Purpose of the Study:
- To evaluate the diagnostic accuracy and clinical utility of fecal markers in inflammatory bowel disease (IBD).
- To assess the role of fecal markers in differentiating IBD from functional disorders and monitoring disease activity.
- To determine the predictive value of fecal markers for treatment response, relapse, and postoperative recurrence in IBD patients.
Main Methods:
- Review and synthesis of comparison studies evaluating fecal markers (calprotectin, lactoferrin) against serum markers and colonoscopy.
- Analysis of diagnostic accuracy rates for fecal markers in identifying IBD.
- Correlation analysis of fecal marker levels with mucosal healing, histologic improvement, and clinical outcomes.
Main Results:
- Fecal markers demonstrate 80% to 100% diagnostic accuracy for IBD, surpassing serum markers.
- Elevated fecal calprotectin and lactoferrin levels are observed in both Crohn's disease (CD) and ulcerative colitis (UC), complicating differential diagnosis between the two.
- Fecal markers correlate with mucosal healing and histologic improvement, aiding in monitoring treatment response and predicting relapse and postoperative recurrence.
Conclusions:
- Fecal markers are valuable adjunctive tools for evaluating patients with nonspecific gastrointestinal symptoms.
- These less invasive biomarkers aid in managing inflammatory bowel disease by monitoring activity and relapse risk, offering a cost-effective alternative to colonoscopy.
- Fecal markers show promise in predicting pouchitis and guiding therapeutic decisions in IBD management.
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