REVIEW PAPER
Application of faecal calprotectin as marker of gastrointestinal tract disorders
More details
Hide details
1
Department of Allergology, Gastroenterology and Child Nutrition, Medical University in Lodz, Poland
Submission date: 2021-03-25
Final revision date: 2021-06-23
Acceptance date: 2021-06-23
Publication date: 2021-09-29
Pediatr Pol 2021;96(3):198-206
KEYWORDS
TOPICS
ABSTRACT
Calprotectin refers to the S100A8 and S100A9 protein complex, also known as the 27E10 antigen, L1L and L1H, MRP-8/14, or calgranulin A/B protein. Faecal calprotectin (FC) is a marker of intestinal inflammation and neutrophil infiltration. This article aimed to review the methods of FC measurement and the importance of the test in the diagnostic workup of children with different disorders of the GI tract, including GI involvement in COVID-19. We found that it is helpful in differentiating between functional and organic disorders and monitoring patients with inflammatory bowel diseases. Different cut-off values are applied in children depending on the patient’s age; hence, variability of the parameter for a given patient should be analysed.
REFERENCES (63)
1.
Střiž I, Trebichavský I. Calprotectin – a pleiotropic molecule in acute and chronic inflammation. Physiol Res 2004; 53: 245-253.
2.
Montalto M, Gallo A, Santoro L, et al. Role of fecal calprotectin in gastrointestinal disorders. Eur Rev Med Pharmacol Sci 2013; 17: 1569-1582.
3.
Ribes Koninckx C, Donat E, Benninga M, et al. The Use of Fecal Calprotectin Testing in Paediatric Disorders: A Position Paper of the European Society for Paediatric Gastroenterology and Nutrition Gastroenterology Committee. J Pediatr Gastroenterol Nutr 2021; 72: 617-640.
4.
Olender K, Bergmann K, Odrowąż-Sypniewska G. Kalprotektyna w kale jako marker zapalny w nieswoistych zapaleniach jelit. J Lab Diagn 2012; 48: 433-439.
5.
Jędrzejczyk M, Bartnik K, Funkowicz M, Toporowska-Kowalska E. Locust bean gum induced FPIES in infant. J Investig Allergol Clin Immunol 2020; 30: 197-199.
6.
Gisbert JP, McNicholl AG. Questions and answers on the role of faecal calprotectin as a biological marker in inflammatory bowel disease. Dig Liver Dis 2009; 41: 56-66.
7.
Li F, Ma J, Geng S, et al. Fecal Calprotectin Concentrations in Healthy Children Aged 1-18 Months. PLoS One 2015; 10: e0119574.
8.
Oord T, Hornung N. Fecal calprotectin in healthy children. Scand J Clin Lab Invest 2014; 74: 254-258.
9.
Olafsdottir E, Aksnes L, Fluge G, Berstad A. Faecal calprotectin levels in infants with infantile colic, healthy infants, children with inflammatory bowel disease, children with recurrent abdominal pain and healthy children. Acta Paediatr 2002; 91: 45-50.
10.
Hestvik E, Tumwine JK, Tylleskar T, et al. Faecal calprotectin concentrations in apparently healthy children aged 0-12 years in urban Kampala, Uganda: a community-based survey. BMC Pediatr 2011; 11: 9.
11.
Berni Canani R, Rapacciuolo L, Romano MT, et al. Diagnostic value of faecal calprotectin in paediatric gastroenterology clinical practice. Dig Liver Dis 2004; 36: 467-470.
12.
Ezri J, Nydegger A. Pediatrics. Fecal calprotectin in children: use and interpretation. Rev Med Suisse 2011; 7: 69-70.
13.
Acevedoa D, Salvadora M, Girbesa J, Estana N. Fecal Calprotectin: A Comparison of Two Commercial Enzymoimmunoassays and Study of Fecal Extract Stability at Room Temperature. J Clin Med Res 2018; 10: 396-404.
14.
Naess-Andresen CF, Egelandsdal B, Fagerhol MK. Calcium binding and concomitant changes in the structure and heat stability of calprotectin (L1 protein). Clin Mol Pathol 1995; 48: M278-M284.
15.
Piekkala M, Alfthan H, Merras-Salmio L, et al. Fecal calprotectin test performed at home – a prospective study of pediatric patients with inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2018; 66: 926-931.
16.
Heida A, Knol M, Kobold AM, et al. Agreement Between Home-Based Measurement of Stool Calprotectin and ELISA Results for Monitoring Inflammatory Bowel Disease Activity. Clin Gastroenterol Hepatol 2017; 15: 1742-1749.
17.
Haisma SM, Galaurchi A, Almahwzi S, et al. Head-to-head comparison of three stool calprotectin tests for home use. PLoS One 2019; 14: e0214751.
18.
Sridhar M, Kesavelu D. Fecal calprotectin as a screening marker for inflammatory bowel disease. Indian Pediatr 2019; 56: 249-250.
19.
Chen CC, Huang JL, Chang CJ, Kong MS. Fecal calprotectin as a correlative marker in clinical severity of infectious diarrhea and usefulness in evaluating bacterial or viral pathogens in children.
20.
J Pediatr Gastroenterol Nutr 2012; 55: 541-547.
21.
Yang Z, Clark N, Park KT. Effectiveness and cost-effectiveness of measuring fecal calprotectin in diagnosis of inflammatory bowel disease in adults and children. Clin Gastroenterol Hepatol 2014; 12: 253.e2–62.e2.
22.
Kolho K, Raivio T, Lindahl H, et al. Fecal calprotectin remains high during glucocorticoid therapy in children with inflammatory bowel disease. Scand J Gastroenterol 2006; 41: 720-725.
23.
Bunn SK, Bisset WM, Main MJ, et al. Fecal calprotectin as a measure of disease activity in childhood inflammatory bowel disease.
24.
J Pediatr Gastroenterol Nutr 2001; 32: 171-177.
25.
Bunn SK, Bisset WM, Main MJ, et al. Fecal calprotectin: validation as a noninvasive measure of bowel inflammation in childhood inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2001; 33: 14-22.
26.
Jusué V, Chaparro M, Gisbert JP. Accuracy of fecal calprotectin for the prediction of endoscopic activity in patients with inflammatory bowel disease. Dig Liver Dis 2018; 50: 353-359.
27.
Henderson P, Anderson NH, Wilson DC. The diagnostic accuracy of fecal calprotectin during the investigation of suspected pediatric inflammatory bowel disease: a systematic review and meta-analysis. Am J Gastroenterol 2014; 109: 637.
28.
Kostas A, Siakavellas SI, Kosmidis C, et al. Fecal calprotectin measurement is a marker of shortterm clinical outcome and presence of mucosal healing in patients with inflammatory bowel disease. World J Gastroenterol 2017; 23: 7387-7396.
29.
Walkiewicz D, Werlin SL, Fish D, et al. Fecal calprotectin is useful in predicting disease relapse in pediatric inflammatory bowel disease. Inflamm Bowel Dis 2008; 14: 669-673.
30.
van Rheenen PF. Role of fecal calprotectin testing to predict relapse in teenagers with inflammatory bowel disease who report full disease control. Inflamm Bowel Dis 2012; 18: 2018-2025.
31.
Szczapa J. Martwicze zapalenie jelit. In: Standardy opieki medycznej nad noworodkiem w Polsce. Zalecenia Polskiego Towarzystwa Neonatologicznego. Wyd. Media-Press, Warszawa 2017; 233-239.
32.
Fitzgibbons SC, Ching Y, Yu D, et al. Mortality of necrotizing enterocolitis expressed by birth weight categories. J Pediatr Surg 2009; 44: 1072-1075.
33.
Pergialiotis V, Konstantopoulos P, Karampetsou N, et al. Calprotectin levels in necrotizing enterocolitis: a systematic review of the literaturę. Inflamm Res 2016; 65: 847-852.
34.
Shenoy MT, Shenoy KT, Roseth A, et al. Diagnostic utility of fecal calprotectin as a biomarker of gut inflammation in neonates to predict necrotizing enterocolitis: a prospective study. Indian J Child Health 2014; 1: 99-104.
35.
Bin-Nun A, Booms C, Sabag N, et al. Rapid fecal calprotectin (FC) analysis: point of care testing for diagnosing early necrotizing enterocolitis. Am J Perinatol 2015; 32: 337-342.
36.
Terrin G, Passariello A, De Curtis M, et al. S100 A8/A9 protein as a marker for early diagnosis of necrotising enterocolitis in neonates. Arch Dis Child 2012; 97: 1102.
37.
Thuijls G, Derikx JP, van Wijck K, et al. Non-invasive markers for early diagnosis and determination of the severity of necrotizing enterocolitis. Ann Surg 2010; 251: 1174-1180.
38.
Husby S, Koletzko S, Korponay-Szabó I, et al. European Society Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for Diagnosing Coeliac Disease 2020. J Pediatr Gastroenterol Nutr 2020; 70: 141-156.
39.
Montalto M, Santoro L, Curigliano V, et al. Fecal calprotectin concentrations in untreated coeliac patients. Scand J Gastroenterol 2007; 42: 957-961.
40.
Ertekin V, Selimoğlu MA, Turgut A, Bakan N. Fecal calprotectin concentration in celiac disease. J Clin Gastroenterol 2010; 44: 544-546.
41.
Balamtekın N, Baysoy G, Uslu N, et al. Fecal calprotectin concentration is increased in children with celiac disease: relation with histopathological findings. Turk J Gastroenterol 2012; 23: 503-508.
42.
Biskou O, Gardner-Medwin J, Mackinder M, et al. Faecal calprotectin in treated and untreated children with coeliac disease and juvenile idiopathic arthritis. J Pediatr Gastroenterol Nutr 2016; 63: e112-e115.
43.
Sicherer SH. Epidemiology of food allergy. J Allergy Clin Immunol 2011; 127: 594-602.
44.
Rona RJ, Keil T, Summers C, et al. The prevalence of food allergy: a meta-analysis. J Allergy Clin Immunol 2007; 120: 638-646.
45.
Merras-Salmio L, Kolho KL, Pelkonen AS, et al. Markers of gut mucosal inflammation and cow’s milk specific immunoglobulins in non-IgE cow’s milk allergy. Clin Transl Allergy 2014; 4: 8.
46.
Trillo Belizón C, Ortega Páez E, Medina Claros AF, et al. Faecal calprotectin as an aid to the diagnosis of non-IgE mediated cow’s milk protein allergy. An Pediatr (Barc) 2016; 84: 318-323.
47.
Nowak-Węgrzyn A, Chehade M, Groeth ME, et al. International consensus guidelines for the diagnosis and management of food protein-induced enterocolitis syndrome: Executive summary—Workgroup Report of the Adverse Reactions to Foods Committee, American Academy of Allergy, Asthma & Immunology. J Allergy Clin Immunol 2017; 139: 1111-1126.
48.
Vila Sexto L. Latest Insights on Food Protein-Induced Enterocolitis Syndrome: An Emerging Medical Condition. J Investig Allergol Clin Immunol 2018; 28: 13-23.
49.
Czub E, Nowak J, Moczko J, et al. Comparison of fecal pyruvate kinase isoform M2 and calprotectin in acute diarrhea in hospitalized children. Sci Rep 2014; 4: 4769.
50.
Walkowiak J, Lisowska A. Mukowiscydoza. In: Socha P, Lebensztejn D,.
51.
Kamińska D. Gastroenterologia Dziecięca. Podręcznik do specjalizacji. Wyd. Media-Press, Warszawa 2016; 382-386.
52.
Colombo C, Ellemunter H, Houwen R, et al.; ECFS. Guidelines for the diagnosis and management of distal intestinal obstruction syndrome in cystic fibrosis patients. J Cyst Fibros 2011; 10 (suppl 2): S24-S28.
53.
Werlin SL, Benuri-Silbiger I, Kerem E, et al. Evidence of intestinal inflammation in patients with cystic fibrosis. J Pediatr Gastroenterol Nutr 2010; 51: 304-308.
54.
Więcek S, Woś H, Kordys-Darmolińska B, et al. The concentration of calprotectin in the stools of children with diagnosed cystic fibrosis. Prz Gastroenterol 2017; 12: 38-43.
55.
Enaud R, Hooks K, Barre A, et al. Intestinal Inflammation in Children with Cystic Fibrosis Is Associated with Crohn’s-Like Microbiota Disturbances. J Clin Med 2019; 8: 645.
57.
Llanos-Chea A, Saps M. Utility of Diagnostic Tests in Children With Functional Abdominal Pain Disorders. Gastroenterol Hepatol (N Y) 2019; 15: 414-422.
58.
Maslennikov R, Poluektova E, Ivashkin V, et al. Diarrhoea in adults with coronavirus disease-beyond incidence and mortality: a systematic review and meta-analysis. Infect Dis (Lond) 2021; 53: 348-360.
59.
Souza TH, Nadal JA, Nogueira RJN, et al. Clinical manifestations of children with COVID-19: A systematic review. Pediatr Pulmonol 2020; 55: 1892-1899.
60.
Ojetti V, Saviano A, Covino M, et al.; GEMELLI AGAINST COVID‐19 group. COVID-19 and intestinal inflammation: Role of fecal calprotectin. Dig Liver Dis 2020; 52: 1231-1233.
61.
Effenberger M, Grabherr F, Mayr L, et al. Faecal calprotectin indicates intestinal inflammation in COVID-19. Gut 2020; 69: 1543-1544.
62.
Kennedy NA, Hansen R, Younge L, et al. Organisational changes and challenges for inflammatory bowel disease services in the UK during the COVID-19 pandemic. Frontline Gastroenterol 2020; 11: 343-350.
63.
Jere M, Garrick V, Curtis L, et al. Point-of-care faecal calprotectin testing in patients with paediatric inflammatory bowel disease during the COVID-19 pandemic. BMJ Open Gastroenterol 2021; 8: e000631.