Fecal calprotectin diagnostic level gradient along the small bowel in patients with Crohn's disease.

Autor:	Ukashi O; Gastroenterology Institute, Sheba Medical Center Tel Hashomer, Ramat Gan, and the Faculty of Medical and Health Sciences, Tel-Aviv University, Tel Aviv, Israel., Kopylov U; Gastroenterology Institute, Sheba Medical Center Tel Hashomer, Ramat Gan, and the Faculty of Medical and Health Sciences, Tel-Aviv University, Tel Aviv, Israel., Ungar B; Gastroenterology Institute, Sheba Medical Center Tel Hashomer, Ramat Gan, and the Faculty of Medical and Health Sciences, Tel-Aviv University, Tel Aviv, Israel., Talan Asher A; Gastroenterology Institute, Sheba Medical Center Tel Hashomer, Ramat Gan, and the Faculty of Medical and Health Sciences, Tel-Aviv University, Tel Aviv, Israel., Shachar E; Gastroenterology Institute, Sheba Medical Center Tel Hashomer, Ramat Gan, and the Faculty of Medical and Health Sciences, Tel-Aviv University, Tel Aviv, Israel., Engel T; Gastroenterology Institute, Sheba Medical Center Tel Hashomer, Ramat Gan, and the Faculty of Medical and Health Sciences, Tel-Aviv University, Tel Aviv, Israel., Albshesh A; Gastroenterology Institute, Sheba Medical Center Tel Hashomer, Ramat Gan, and the Faculty of Medical and Health Sciences, Tel-Aviv University, Tel Aviv, Israel., Yablecovitch D; Gastroenterology Institute, Sheba Medical Center Tel Hashomer, Ramat Gan, and the Faculty of Medical and Health Sciences, Tel-Aviv University, Tel Aviv, Israel., Lahat A; Gastroenterology Institute, Sheba Medical Center Tel Hashomer, Ramat Gan, and the Faculty of Medical and Health Sciences, Tel-Aviv University, Tel Aviv, Israel.; Department of Gastroenterology, Assuta Ashdod Hospital, Ashdod, Israel., Eliakim R; Gastroenterology Institute, Sheba Medical Center Tel Hashomer, Ramat Gan, and the Faculty of Medical and Health Sciences, Tel-Aviv University, Tel Aviv, Israel., Ben-Horin S; Gastroenterology Institute, Sheba Medical Center Tel Hashomer, Ramat Gan, and the Faculty of Medical and Health Sciences, Tel-Aviv University, Tel Aviv, Israel.
Jazyk:	angličtina
Zdroj:	Journal of Crohn's & colitis [J Crohns Colitis] 2024 Aug 09. Date of Electronic Publication: 2024 Aug 09.
DOI:	10.1093/ecco-jcc/jjae123
Abstrakt:	Background and Aims: Fecal calprotectin (FC) is known to be a sensitive biomarker of colonic inflammation but to a lesser degree of small bowel (SB) inflammation. Moreover, data on FC's diagnostic levels in different SB segments are scarce. We aimed to examine FC's diagnostic levels along the SB-axis in CD. Methods: This was a post-hoc aggregated analysis of five prospective studies of adult CD patients, who underwent FC testing and SB video capsule endoscopy (VCE). Lewis score (LS) inflammation in different SB segments was tested for correlation with FC level after exclusion of colonic disease. The diagnostic levels of FC for SB inflammatory topographical-gradient were assessed using a receiver operating characteristic. Results: 214 patients were included (age:30 [24-43] year-old, males-57%). For a similar SB inflammatory-activity (LS≥135), FC levels incrementally increased from proximal to distal SB segments (63 [30-121] versus 190 [78-549], p=0.005) and from distal SB segment to the colon (190 [78-549] versus 542 [185-1000], p=0.010). The best FC cutoffs to identify isolated mild proximal/distal SB-inflammation (LS≥135) were 77μgg and 123μgg, respectively. A cutoff of 234μgg was best to detect more significant proximal inflammation (LS≥350) when only mild distal SB-inflammation was present. In sensitivity analyses, this proximal-to-distal FC gradient was maintained when LS≥350 and LS≥790 were used as the inflammatory reference-values. Unlike FC, the magnitude of CRP elevation was unrelated to the topography of inflammation along the SB-axis. Conclusions: FC may serve as a topographical biomarker of CD-activity, with its sensitivity to identify mucosal inflammation increases from proximal to distal SB segments. (© The Author(s) 2024. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
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