Fecal calprotectin as a biomarker for gastrointestinal involvement in systemic sclerosis: Associations and limitations

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Aim: This study aimed to evaluate the association of FC with gastrointestinal involvement in SSc, focusing on factors such as small intestine wall thickness, esophageal dilation, and skin involvement. Background: Fecal calprotectin (FC) has emerged as a promising biomarker for intestinal inflammation, and its role in systemic sclerosis (SSc) remains under investigation. Gastrointestinal involvement in SSc is common and can significantly impact quality of life, making it crucial to identify reliable biomarkers for early detection. Objective: GI disorders significantly impact the quality of life of systemic sclerosis (SSc) patients. Materials and methods: We gathered information from the 39 patients by filling out a UCLA SCTS 2.0 questionnaire regarding their GI symptoms. Additionally, we examined their skin and determined their skin score. Blood samples were taken to assess malnutrition, and stool samples were collected to measure the calprotectin level. We also conducted a non-aggressive Barium Swallow and CT Enterography to check for GI disorders. Results: Increased levels of FC didn’t have any correlation with age ( p Value = .79), disease type ( p Value = .59), slight intestine wall thickening ( p Value = .10), esophageal dilatation ( p Value = .18), skin score ( p Value = .25), final GI score ( p Value = .30) and none of the serum tests. In our study, just 5 cases had evidence of wall thickening in CT Enterography, and all 5 cases had increased calprotectin levels. Also, as most of our patients take vitamin and mineral supplements, we couldn’t find any signs of micronutrient deficiencies or correlation with FC level. Conclusion: Our study found no significant link between fecal calprotectin and gastrointestinal involvement in systemic sclerosis. Due to sample size and design limitations, fecal calprotectin may not be a reliable biomarker. Larger studies are needed to confirm these findings.