Fecal Calprotectin as a Biomarker for Disease Activity in Microscopic Colitis

Area of Science:

• Gastroenterology
• Inflammatory Bowel Disease Research
• Clinical Biomarker Development

Background:

• Microscopic colitis (MC) is an inflammatory intestinal disorder.
• Objective biomarkers for assessing MC disease activity are lacking.
• Fecal calprotectin (FC) is a potential biomarker for intestinal inflammation.

Purpose of the Study:

• To evaluate the utility of fecal calprotectin (FC) measurement in symptomatic individuals diagnosed with microscopic colitis (MC).
• To determine the frequency of elevated FC levels in MC patients experiencing active symptoms.
• To identify predictors of elevated FC levels in this patient cohort.

Main Methods:

• A cohort study design was employed, including patients with confirmed MC and measured FC levels during symptomatic periods.
• The frequency of elevated FC levels (>150 mcg/g and >250 mcg/g) was assessed.
• Univariate and multivariate logistic regression analyses were performed to identify independent predictors of elevated FC.

Main Results:

• The study included 166 subjects, with 234 FC measurements during symptomatic MC.
• Elevated FC levels (>150 mcg/g) were observed in 29.0% of measurements.
• Higher FC levels were associated with older age, nocturnal bowel movements, and fecal incontinence, independent of other factors.

Conclusions:

• Elevated fecal calprotectin concentrations are present in over a quarter of symptomatic microscopic colitis patients.
• Increased FC levels in MC are linked to more severe symptoms, suggesting its utility as a disease activity marker.
• FC levels did not differentiate between steroid-responsive and steroid-refractory disease, indicating a lack of predictive value for treatment response.