uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Fecal markers of inflammation used as surrogate markers for treatment outcome in relapsing inflammatory bowel disease
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. (Gastroenterology research group)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry. (Clinical chemistry)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry. (Clinical Chemistry)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. (Gastroenterology research group)
Show others and affiliations
2008 (English)In: World Journal of Gastroenterology, ISSN 1007-9327, E-ISSN 2219-2840, Vol. 14, no 36, 5584-5589 p.Article in journal (Refereed) Published
Abstract [en]

Aims: To evaluate fecal calprotectin (FC) as a surrogate marker for treatment outcome of a relapse of inflammatory bowel disease (IBD) and, secondly, to compare FC to fecal myeloperoxidase (MPO) and fecal eosinophil protein X (EPX).

Methods: Thirty-eight patients with IBD, whereof twenty-seven with ulcerative colitis (UC) and 11 with Crohn´s disease (CD) were studied before treatment (inclusion), and after four and eight weeks of treatment. Treatment outcome, based on clinical activity and endoscopy in UC patients, and clinical activity in CD patients, were evaluated together with fecal samples analysed for FC with ELISA and MPO and EPX with RIA.

Results: At inclusion 37/38 (97%) patients had elevated FC levels (>94.7 µg/g). At the end of the study 31/38 (82%) patients fulfilled predefined criteria of a complete response [UC 21/27 (78%); CD 10/11 (91%)].  Overall, a normalised FC level at the end of the study predicted a complete response in 100% whereas elevated FC level predicted noncomplete response in 30%. Normalised MPO or EPX levels predicted a complete response in 100% and 90%, respectively. However, elevated MPO or EPX levels predicted noncomplete response in 23% and 22%, respectively.

Conclusion: A normalised FC level poses the potential to be used as a surrogate marker for successful treatment outcome in IBD patients, but cases with persistent elevated FC levels needs further evaluation. FC and MPO appears to discriminate better than EPX to treatment outcome in IBD.

Place, publisher, year, edition, pages
WJG Press , 2008. Vol. 14, no 36, 5584-5589 p.
Keyword [en]
Fecal markers, calprotectin, myeloperoxidase, eosinophil protein X treatment, inflammatory bowel disease, ulcerative colitis, Crohn´s disease
National Category
Gastroenterology and Hepatology
Research subject
Medicine
Identifiers
URN: urn:nbn:se:uu:diva-123028DOI: 10.3748/wjg.14.5584ISI: 000259574400016PubMedID: 18810778OAI: oai:DiVA.org:uu-123028DiVA: diva2:311707
Available from: 2010-04-22 Created: 2010-04-22 Last updated: 2017-12-12Bibliographically approved
In thesis
1. Clinical and Experimental Studies on Inflammatory Bowel Disease with special emphasis on Collagenous Colitis
Open this publication in new window or tab >>Clinical and Experimental Studies on Inflammatory Bowel Disease with special emphasis on Collagenous Colitis
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis describes studies in patients with inflammatory bowel disease (IBD) and collagenous colitis (CC). We investigated mucosal eosinophil and neutrophil granulocytes and T-cells involved in the inflammatory processes and aimed at determining whether these processes are reflected in the faecal (F) contents of specific proteins secreted by cells in the intestinal mucosa. Thus, we measured eosinophil cationic protein (ECP) and eosinophil protein X (EPX) and the neutrophil derived myeloperoxidase (MPO) and calprotectin (C); and in addition, chromogranin A (CgA), Chromogranin B (CgB) and secretoneurin (SN), derived from EEC cells and cells in the enteric nervous system.

We found that a normalised FC level can serve as a surrogate marker for successful treatment in patients with IBD, but persistently high FC levels need further evaluation (study I). Furthermore, FC and F-MPO appear to relate better than F-EPX to treatment outcome in IBD. We evaluated F-ECP, F-EPX, F-MPO and FC as markers of disease activity and treatment outcome in patients with CC (study III) and concluded that F-ECP was the best discriminator of detecting active CC. Normalised F-ECP and F-EPX could serve as markers of successful treatment. We showed that the inflammation in CC is characterised by activated eosinophils, but that there is no neutrophil activity (study II). T-cells have a lower grade of activity in active CC than in control subjects. During budesonide treatment the normal activation of eosinophils and T-cells is restored, with concomitant clinical remission. The findings in studies II and III indicate that the eosinophils have an essential role in the pathophysiology of CC. Markedly higher values of F-CgA, F-CgB and F-SN were found in patients with CC than in those with IBD and controls (study IV) indicating a crucial role for the intestinal neuro-endocrine system in the pathogenesis of collagenous colitis.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2010. 75 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 565
Keyword
Collagenous colitis, inflammatory bowel disease, ulcerative colitis, Crohn´s disease, faecal markers, eosinophil, T-cells, ECP, EPX, MPO, calprotectin, flowcytometry, chromogranin A, chromogranin B, secretoneurin, budesonide
National Category
Gastroenterology and Hepatology
Research subject
Medicine
Identifiers
urn:nbn:se:uu:diva-123053 (URN)978-91-554-7817-9 (ISBN)
Public defence
2010-05-29, Robergsalen, ingång 40, plan 4, Akademiska sjukhuset, UPPSALA, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2010-05-07 Created: 2010-04-22 Last updated: 2010-05-18Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMedhttp://www.wjgnet.com/1007-9327/14/5584.asp

Authority records BETA

Wagner, MichaelPeterson, Christer G. B.Ridefelt, PeterSangfelt, PerCarlson, Marie

Search in DiVA

By author/editor
Wagner, MichaelPeterson, Christer G. B.Ridefelt, PeterSangfelt, PerCarlson, Marie
By organisation
Department of Medical SciencesClinical Chemistry
In the same journal
World Journal of Gastroenterology
Gastroenterology and Hepatology

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 776 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf