Comparisons between myeloperoxidase, lactoferrin, calprotectin and lipocalin-2, as fecal biomarkers of intestinal inflammation in malnourished children

Mara De Moura Gondim Prata,Havta Havta,Pinkerton R,Lima Aam,Guerrant Rl,Bolick Dt

doi:10.15761/jts.1000130

Mara De Moura Gondim Prata, Havta Havta + Show 4 more

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https://doi.org/10.15761/jts.1000130

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Abstract

Fecal biomarkers have emerged as important tools to assess intestinal inflammation and enteropathy. The aim of this study was to investigate the correlations between the fecal markers, myeloperoxidase (MPO), lactoferrin (FL), calprotectin (FC) and lipocalin-2 (Lcn-2), and to compare differences by breastfeeding status as well as normalization by fecal protein or by fecal weight. Simultaneous, quantitative MPO, FL, FC and Lcn-2, levels were determined in frozen fecal specimens collected from 78 children (mean age 15.2 ± 5.3 months) in a case-control study of childhood malnutrition in Brazil. The biomarker concentrations were measured by enzymelinked immunosorbent assay. The correlations among all biomarkers were significant (P<0.01). There were stronger correlations of fecal MPO with fecal lactoferrin and calprotectin, with lower, but still highly significant correlations of all 3 inflammatory biomarkers with Lcn-2 likely because the latter may also reflect enterocyte damage as well as neutrophil presence. Furthermore, the biomarker results with protein normalized compared to simple fecal weight normalized values showed only a slightly better correlation suggesting that the added cost and time for protein normalization added little to carefully measured fecal weights as denominators. In conclusion, fecal MPO correlates tightly with fecal lactoferrin and calprotectin irrespective of breastfeeding status and provides a common, available biomarker for comparison of human and animal model studies.

Highlights

Fecal biomarkers have emerged as important tools to assess intestinal inflammation, whether due to inflammatory infections, such as shigellosis or C. difficile colitis, or to inflammatory bowel disease (IBD), be it ulcerative colitis or Crohn’s disease [1,2,3,4]
Studies evaluating lactoferrin in the diagnosis of IBD show that it exhibited similar performance to fecal calprotectin and correlated better than C-reactive protein with mucosal inflammation by endoscopy [12,13,14]
The goal of this study was to investigate the correlation between fecal myeloperoxidase (MPO), lactoferrin (FL), calprotectin (FC) and lipocalin-2 (Lcn-2)

Summary

Introduction

Fecal biomarkers have emerged as important tools to assess intestinal inflammation, whether due to inflammatory infections, such as shigellosis or C. difficile colitis, or to inflammatory bowel disease (IBD), be it ulcerative colitis or Crohn’s disease [1,2,3,4]. Lactoferrin (LF) is a long and widely used fecal biomarker of intestinal inflammation It is an iron-biding glycoprotein present in secondary (specific) granules especially in mature neutrophilic granulocytes [1,7,8,9]. It provides an excellent quantifiable marker of neutrophilic inflammation, several exocrine cells secrete lower amounts of this protein that are often present in lower concentrations in many fluids such as normal human milk, tears, synovial fluid, and serum. Joishy et al [10] found that FL correlated with disease activity indices and erythrocyte sedimentation rate in pediatric patients with IBD

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