Fecal Lactoferrin as a New Marker of Disease Activity in Inflammatory Bowel Diseases

Abstract

Background: Inflammatory bowel diseases (IBD) including ulcerative colitis (UC) and Crohn's disease (CD) are organic inflammatory diseases, caused by chronic mucosal inflammation of the gasrtointetinal tract. As the presenting manifestations of IBD and other diseases are similar, obtaining a clinical diagnosis can be difficult, and further invasive diagnostic procedures may be required in order to obtain a confirmed diagnosis. The aim of this study is to evaluate the diagnostic utility of measuring fecal concentrations of lactoferrin as a simple and noninvasive indicator of disease activity in patients IBD and to be correlated with endoscopic findings and disease activity index and acute inflammatory response including leucocytic count, high sensitive CRP, ESR. Methods: This study was carried on 40 patients with IBD; 24 patients with active IBD (16 UC patients and8 CD patients) and 16 patients with inactive IBD (10 UC patients and 6 CD patients) versus 40 healthy controls. All patients underwent blood and stool sampling as well as an interview to assess the disease severity utilizing UC activity measured by the Truelove and Witts Severity Index and Crohn's Disease Activity Index. Measurement of FLA levels at different stages of inflammatory bowel disease activity to detect its role in assessment of disease severity. Results: This study showed that FLA levels were highest in patients with IBD in comparison with healthy group. FLA levels also correlated significantly with disease severity in patients with IBD where higher levels of FLA were found in patients with severe UC or Crohn`s disease. At cutoff value 9.68 ug/ml FLA showed 100% sensitivity and specificity in identification of patients with IBD from healthy subjects. Conclusions: FLA is a sensitive and specific biochemical marker of inflammation for use in the diagnosis of suspected IBD cases, and its level correlates well with both clinical disease activity indices.