Role of Fecal Calprotectin in Monitoring Response to Therapy in Inflammatory Bowel Diseases

Antonella Gallo

doi:10.4172/2155-9899.1000252

Abstract

Inflammatory bowel diseases (IBDs) are chronic intestinal disorders characterized by a typically relapsing course. Disease flares occur in a random way and are often unpredictable. In search to provide noninvasive, cheap and rapid methods able to help in diagnosis and monitoring of IBD activity, within the last years, fecal neutrophil-granular proteins, like calprotectin, have been largely studied. Different studies showed a good diagnostic accuracy of fecal calprotectin (FC) in IBDs and a close correlation between levels of this marker and degree of IBD activity.More recently, emerging interest has rising on the role of FC in assessing response to therapy and predicting relapse in IBD. We performed a MEDLINE search for more recent articles published on this topic. Encouraging results show that FC represents a reliable monitoring tool to assess response to treatment, significantly more accurate than serum markers and clinical parameters. Normalization of FC concentrations (FCCs) results as an accurate indicator of endoscopic healing. FC also appears to have a good diagnostic precision in predicting IBD relapse, possibly more in ulcerative colitis than in Crohn’s disease. However, mainly for this last topic, available evidences, although promising, are still heterogeneous and not sufficiently strong. Assessment of usefulness and predictive value of FC according to different medications, frequency of determinations, the establishment of validated cut-off, should be better evaluated in larger and prospective studies.

Highlights

Emerging interest has rising on the role of fecal calprotectin (FC) in assessing response to therapy and predicting relapse in Inflammatory bowel diseases (IBDs)
Emerging interest has rising on the role of FC in assessing response to therapy and predicting relapse in IBD
Sipponen et al evaluated the correlation of FC concentrations (FCCs) with the Crohn’s disease index of severity (CDEIS) in 77 Crohn's disease (CD) patients, showing that FC could discriminate inactive from all the other activity groups, with a sensitivity and specificity in predicting endoscopically active disease (CDEIS ≥ 3) of 70% and 92% respectively, at a cut-off level of 200 μg/g [28]

Summary

Introduction

Emerging interest has rising on the role of FC in assessing response to therapy and predicting relapse in IBD. Sipponen et al evaluated the correlation of FCCs with the Crohn’s disease index of severity (CDEIS) in 77 CD patients, showing that FC could discriminate inactive from all the other activity groups, with a sensitivity and specificity in predicting endoscopically active disease (CDEIS ≥ 3) of 70% and 92% respectively, at a cut-off level of 200 μg/g [28].

Results

Conclusion