Application of fecal calprotectin and myeloperoxidase in evaluation of disease activity of ulcerative colitis

Abstract

Objective To explore the clinical value of fecal calprotectin and myeloperoxidase in evaluation of ulcerative colitis (UC) activity. Methods Specimens of serum and feces over the same period were collected from 49 ulcerative colitis (UC) patients (32 male and 17 female) and 35 healthy controls (23 male and 12 female).ELISA was used to measure the concentration of calprotectin and myeloperoxidase in feces.The clinical information (including Mayo clinic activity index.Baron endoscopic score) of UC patients were collected.All patients were divided into active and inactive group by Mayo clinic activity index,the active group was further divided into three subgroups,the mild group,the moderate group and the severe group.Fecal calprotectin and myeloperoxidase,serum ESR and CRP were compared among different groups,receiver operating curve (ROC) were obtained to evaluate the diagnostic efficacy of the UC activity. Results The fecal calprotectin concentration was significantly higher in active UC group than that in inactive UC group[6000.0 (3050.8,8759.5) vs. 336.8 (227.5,1731.0),Z=-3.357,P=0.001],the same to inactive UC group and the controls[336.8 (227.5,1731.0) vs. 29.0 (21.3,48.8),Z=-5.607,P=0.001].The fecal myeloperoxidase concentration of the active UC group was significantly higher than that of the inactive UC group[1231.2 (757.9,1481.1) vs. 603.6 (265.2,819.4),Z=-3.658,P=0.001],but there was no significant difference between the inactive UC group and the controls[603.6 (265.2,819.4) vs. 453.5 (140.8,750.2),Z=-1.033,P=0.302].There was no significant difference of fecal calprotectin levels among different active subgroups.Fecal myeloperoxidase concentration between the mild activity group and the moderate activity group was significant[667.3 (467.5,1000.4) vs.1259.6 (1213.3,1932.8),Z=-2.475,P=0.005],but there was no significant difference between the moderate activity group and the severe activity group[1259.6 (1213.3,1932.8) vs. 1239.0 (793.9,1403.0),Z=-1.350,P=0.193].The four biomarkers were all positively correlated with the endoscopic score and Mayo clinic activity index of UC. Conclusions Considered as noninvasive biomarkers of disease activity fecal calprotectin and myeloperoxidase is similar to ESR and serum CRP.Fecal calprotectin is superior to myeloperoxidase in differentiating the inactive UC group from the controls.(Chin J Lab Med,2013,36:348-351) Key words: Colitis; ulcerative; Leukocyte L1 antigen complex; Peroxidase; Feces; Biological markers; Sensitivity and specificity