Da li je fekalni kalprotektin pouzdan marker kod inflamatornih bolesti creva?

Abstract

Introduction/Aim: Fecal calprotectin (FCP) is an S100 protein bio-marker used in diagnostic and monitoring algorithms of inflammato-ry bowel diseases (IBD). The role of FCP is established in differentiating inflammatory from functional bowel diseases, predicting relapse of IBD, and monitoring response to IBD therapy. The therapeutic strategy "treat-to-target" includes the normalization of laboratory biomarkers including FCP to attain mucosal healing (MH) as a result of effective Crohn's disease (CD) and ulcerative colitis (UC) treatment. Our research aimed to assess the relationship of FCP values in IBD patients with endoscopic and histological scores of disease activity. Material and methods: We performed a cross-sectional study at the Clinic for Gastroenterohepatology, University Clinical Center of Ser-bia, encompassing 223 diagnosed IBD patients (110 CD and 113 UC). The concentration of FCP was analyzed from the first morning stool. The endoscopic activity of IBD was evaluated using the endoscopic Mayo score for UC, Simple Endoscopic Score (SES-CD) for CD, and Rut-geerts score in case of a prior operation. The Geboes grading score was used to evaluate IBD histological activity. Due to discontinuous bowel involvement in CD, histopathological grading was limited. Results: Our results did not identify any statistically significant relationship between FCP and histological scores in patients with Crohn's disease (FCP median 950.98, PH median 3.57; p= 0.22). While FCP values did not show a correlation with the Rutgeerts score, we did observe a notable correlation between FCP and the SES-CD. In UC patients, values of FCP strongly correlated with endoscopic and his-tological grading (FCP median 1162.62, PH median 3.67; p = 0.011). Conclusion: FCP has shown to be a useful and reliable biomarker for assessing UC disease activity, while its applicability is restricted when it comes to CD.