Abstract
BackgroundFecal biomarkers are considered to be useful surrogate markers for endoscopic activity. Given the mechanisms of fecal biomarkers, we hypothesized that the extent of ulcerative colitis (UC; pancolitis, left-sided colitis, and proctitis) could affect the usefulness of fecal biomarkers for assessing endoscopic and clinical disease activity; however, few studies have evaluated the utility of fecal biomarkers in the disease extent of UC.MethodsFecal calprotectin, a fecal immunochemical test for hemoglobin, and fecal lactoferrin were used as fecal biomarkers. UC patients, who underwent colonoscopy within 30 days of the fecal biomarker test, participated in this observational study. Clinical and endoscopic disease activity was assessed using the Lichtiger Index and Mayo endoscopic subscore (MES), respectively.ResultsA total of 162 colonoscopies were performed on 133 UC patients. A correlation analysis between each biomarker and the MES for each disease-extent subgroup showed a decreased correlation in the proctitis compared with the other groups. With the exception of proctitis, it was possible to distinguish between MES 0 and MES ≥ 1 with high area-under-the-curve values for fecal calprotectin and fecal lactoferrin. The fecal immunochemical test for hemoglobin was superior at discriminating MES 0 for proctitis.ConclusionsFor the practical application of fecal biomarkers for UC patients, it is necessary to consider disease extent before use. In particular, patients with proctitis exhibit a low correlation between stool biomarkers and endoscopic findings. The usefulness of these biomarkers for endoscopic remission is reduced, except for the fecal immunochemical test for hemoglobin.
Highlights
Fecal biomarkers are considered to be useful surrogate markers for endoscopic activity
ulcerative colitis (UC) clinical disease activity was assessed by the Lichtiger Index (LI), which is composed of the following metrics: the number of daily bowel movements, entity of abdominal pain and tenderness, use of antidiarrheal drugs, blood in stool samples, general well-being, fecal incontinence, and nocturnal diarrhea [11]
Patients characteristics Patients (n = 133) who fulfilled the criteria for UC were enrolled, and colonoscopies were performed with fecal biomarker examination a total of 162 times
Summary
Fecal biomarkers are considered to be useful surrogate markers for endoscopic activity. Given the mechanisms of fecal biomarkers, we hypothesized that the extent of ulcerative colitis (UC; pancolitis, left-sided colitis, and proctitis) could affect the usefulness of fecal biomarkers for assessing endoscopic and clinical disease activity; few studies have evaluated the utility of fecal biomarkers in the disease extent of UC. Fecal calprotectin values represent their concentration in stool samples, and they may be affected by inflammatory burden and disease extent. Few studies have evaluated the usefulness of fecal biomarkers with respect to the disease extent of UC. We evaluated fecal biomarkers as surrogate markers of the MES for the extent of disease (total colitis, left-sided colitis, and proctitis)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
