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Fecal Calprotectin and Transforming Growth Factor-b1 in the Evaluation of Disease Activity in Patients with Ulcerative Colitis

Received: 16 July 2014    Accepted: 23 July 2014    Published: 30 July 2014
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Abstract

Aims: to evaluate the correlation between endoscopic disease activity, and fecal calprotectin, transforming growth factor-B1, Clinical Activity Index, C- reactive protein, and blood leucocytes. Methods: Ninety two patients with ulcerative colitis were enrolled and scored according to the endoscopic part of the Rachmilewitz Index. Patients and controls provided fecal and blood samples for measuring calprotectin, TGF-B1, CRP, and leucocytes. Results: The values in ulcerative colitis patients (n = 92) compared to controls (n = 20): calprotectin: 728.9 ± 388.4 versus 22.9 ± 12.9 µg / g, TGF-B1: 350.1 ± 214.7 versus 4.3 ± 2.01 pg /Ml, CRP: 36.9 ± 20.3 versus 3.5 ± 1.9m g/L, blood leucocytes: 13.8 ± 4.5 versus 7.3 ± 1.8 g/ L (all P< 0.001). Endoscopic disease activity correlated significantly with calprotectin (Spearman’s rank correlation coefficient r = 0.545), TGF-B1 (r = 0.531), Clinical Activity Index (r = 0. 520), CRP (r = 0.481), and blood leucocytes (r = 436). Calprotectin and TGF-B1 levels were significantly lower in ulcerative colitis patients with inactive disease ( endoscopic score 0 -3, calprotectin 60.5 ± 47.8 µg / g, TGF-B1 39.9 ± 35.4 pg/Ml , P < 0.001), compared to patients with mild ( score 4 – 6, calprotectin 460.2 ±240 µg/g, TGF-B1 172.4 ± 88.2 pg/ Ml, P < 0.001 ), moderate ( score 7 – 9, calprotectin 797.9 ± 239.2 µg/g, TGF-B1 352.6 ± 89.9 pg/Ml, P < 0.001 ), and high disease ( score 10 – 12 , calprotectin 969.2 ±268.9 µg/g, TGF-B1 486.8 ± 211.2 Pg/ Ml, P < 0.001). The overall accuracy for detection of histopathological active disease was 96.7 % for fecal calprotectin, 94.5 % for TGF-B1, 90 % for Endoscopic Activity Index, 87 % for Clinical Activity Index, and 65 % for both blood leucocytes and CRP. Conclusion: Both fecal calprotectin and TGF-B1 correlated significantly with endoscopic disease activity, clinical activity index, CRP, and blood leucocytes. Furthermore, both calprotectin and TGF-B1 were suitable markers that can differentiate endoscopically and histopathologically inactive from active disease, thus, these two biomarkers may be used for monitoring ulcerative colitis activity.

Published in Clinical Medicine Research (Volume 3, Issue 4)
DOI 10.11648/j.cmr.20140304.14
Page(s) 96-104
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Fecal Calprotectin, Transforming Growth Factor-B1, Ulcerative Colitis, Disease Activity, Biomarkers, Rachmilewitz Activity Index

References
[1] Langhorst J, ELsenbruch S, Muller T. Comparison of 4 neutrophil-derived proteins in feces as indicators of disease activity in ulcerative colitis. Inflamm Bowel Dis. 2005; 11: 1085 – 1091.
[2] Xiang JY, Ouyang Q, Li GD, Xiao NP. Clinical value of fecal calprotectin in determining disease activity of ulcerative colitis. World J Gastroenterol. 2008; 14 (1): 53 – 57.
[3] Iman H, Mona N, Sahar T. Preliminary evaluation of the role of fecal calprotectin in the diagnosis of ulcerative colitis among Egyptian patients. Med. J. Cairo Univ. 2009; 77 (3): 95 – 102.
[4] Alain MS, Christoph B, Alex S, Michael T, Pietro R, Frank S. Ulcerative Colitis: Correlation of the Rachmilewitz Endoscopic Activity Index with Fecal Calprotectin, Clinical Activity Index, C- reactive protein, and blood leukocytes. Inflamm Bowel Dis. 2009; 15: 1851 – 1858.
[5] De Jong NSH, Leach ST, Day AS. Fecal S100 A12: A novel Non-invasive marker in children with Crohn’s disease. Inflamm Bowel Dis. 12 (7): 566 – 572, 2006.
[6] Hassan N, Tarang T, Iradj M, Farshad N, Hafez F,Vahid H, Seyed MY. Calprotectin: a promising non-invasive tool for ulcerative colitis monitoring. Life Science Journal 2013; 10 (3): 1356 – 1360.
[7] Aomatsu T, Yoden A, Matsumotol K. Fecal calprotectin is a useful marker for disease activity in pediatric patients with inflammatory bowel disease. Digestive Diseases and Sciences, Vol.56, 8, PP. 2372- 2377, 2011.
[8] Z. Mesut YK, Selime A, Yasemin O, Isilay N, Basak C, Aysel U. Plasma transforming growth factor- B1 level in inflammatory bowel disease. Turk J Gastroenterol 2009; 20 (3): 165 – 170.
[9] Sipos F, Galambo O. Epithelial and Mesenchymal to epithelial transitions in the colon. World J. Gastroenterol., 212 – 18: 601 – 608.
[10] Kilic ZM, Ayaz S, Ozin Y, Nadir I, Cakal B, Ulker A. Plasma transforming growth factor-B1 level in inflammatory bowel disease. Turk J. Gastroenterol. 2009; 20: 165 -170.
[11] Rachmilewitz D. Coated mesalazine (5-aminosalicylic acid) versus sulphasalazine in the treatment of active ulcerative colitis; a randomized trial. Br Med j. 1989; 298: 82 – 86.
[12] Silberer H, Kuppers B, Mickisch O. Fecal leukocyte proteins in inflammatory bowel disease and irritable bowel syndrome. Clin Lab 2005, 51: 117 – 26.
[13] Vermiere S, Van Assche G, Rutgeerts P. Laboratory markers in inflammatory bowel disease: useful, magic, or unnecessary toys? Gut, 55: 426-431, 2006.
[14] Gisbert JP, Gonzalez LY, Mate J. Role of biological markers in inflammatory bowel disease. Gastroenterol Hepatol 2007; 30: 117 – 129.
[15] Sheta SY, Salem MI, Ismail AW, Hafez MA. Value of fecal calprotectin as a non-invasive marker differentiating organic from functional bowel diseases. Clinical and histopathological study. Z.U.M.J 19 (4): 524 – 529. 2010.
[16] Langhorst J. Non-invasive markers in the assessment of intestinal inflammation in inflammatory bowel diseases: performance of fecal lactoferrin, calprotectin, and PMN-elastase, CRP, and Clinical indices. Am. J. Gastroenterol. 103 (1): 162 – 9. 2008.
[17] Irena CM, Iga WT, Malgorzata S, Danuta F, Konrad J, Dorota C, Tomasz M. TGF-B1 and granulocyte elastase in the evaluation of activity of inflammatory bowel disease. A pilot study. Postepy Hig Med Dosw (Online), 2014; 68: 66 – 72.
[18] Kanazawa S, Tsunoda T, Onuma E, Majami T, Kagiyama M, Kikuchi K. VEGF, basic- FGF, and TGF-B1 in crohn’s disease and ulcerative colitis: a novel mechanism of chronic intestinal inflammation. Am. j. Gastroenterol; 2001; 96: 822 – 828.
[19] Kader HA, Tchernev VT, Satyara JE, Lejnine S, Kotler G, Kings-more SF, Patel DD. Protein microarray analysis of disease activity in pediatric inflammatory bowel disease demonstrates elevated serum PLGF, IL-7, TGF-B1, and IL-12P40 levels in crohn’s disease and ulcerative colitis patients in remission versus active disease. Am. J. Gastroenterol. 2005; 100: 414 – 423.
[20] Wedrychowicz A, Kowalska-Duplaga K, Jedynak-Wasowicz U, Pieczarkowicz S, Sladek M, Tomasik P, Fyderek K. Serum concentration of VEGF, and TGF-B1 during exclusive enteral nutrition in inflammatory bowel disease. J Pediat. Gastroenterol. Nutr. 2011; 53: 150 – 155.
[21] Canani RB, Terrin G, Rapacciuolo L. Fecal calprotectin as a reliable non-invasive marker to assess the severity of mucosal inflammation in children with inflammatory bowel disease. Dig. Liver Dis.2008; 40: 547 – 553.
[22] Carlson CS, Aldred SF, Lee PK. Polymorphisms within the C-reactive protein promoter region is associated with plasma CRP levels. Am J Hum Genet. 2005; 77: 64 – 77.
[23] Limburg PJ, Ahlquist DA, Sandborn WJ. Fecal calprotectin levels predict colorectal inflammation among patients with chronic diarrhea referred for colonoscopy. Am J Gastroenterol. 2000; 95: 2831 – 2837.
[24] Tibble JA, Teahon K, Thjodleifsson B. A simple method for assessing intestinal inflammation in crohn’s disease. Gut 2000; 47: 506 – 513.
[25] Hesham EDS, Ahmed AM, Manal MEA, Engy VE, Sherif SS, Ahmed SAS. The diagnostic value of fecal calprotectin in differentiating inflammatory bowel disease from irritable bowel syndrome. Report and Opinion 2011; 3 (1): 1 – 8.
[26] Belei O, Sinedria I, Illie R, Daescu C, Tamara M, Militaru A, Brad G. Correlation of fecal calprotectin with clinical and endoscopic scores in inflammatory bowel disease in children . J Pedia Trului. 2011 Vol.XIV, 55 – 56.
[27] Victoria RS, Ian P, Christos P, Ann CW. TGF-B1 signaling, connecting aberrant inflammation and colorectal tumorigenesis. Curr. Pharmaceutical Design, 2012; 18: 1 – 15.
[28] Kolho KL, and Turner D. Fecal calprotectin and clinical disease activity in pediatric ulcerative colitis. ISRN Gastroenterology 2013; 179024: 1 – 5.
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  • APA Style

    Arafat A. Kassem, Amir A. Fikry, Doaa Shahin, Hosam Aldeen Salah Shabana, Sadek Mostafa. (2014). Fecal Calprotectin and Transforming Growth Factor-b1 in the Evaluation of Disease Activity in Patients with Ulcerative Colitis. Clinical Medicine Research, 3(4), 96-104. https://doi.org/10.11648/j.cmr.20140304.14

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    ACS Style

    Arafat A. Kassem; Amir A. Fikry; Doaa Shahin; Hosam Aldeen Salah Shabana; Sadek Mostafa. Fecal Calprotectin and Transforming Growth Factor-b1 in the Evaluation of Disease Activity in Patients with Ulcerative Colitis. Clin. Med. Res. 2014, 3(4), 96-104. doi: 10.11648/j.cmr.20140304.14

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    AMA Style

    Arafat A. Kassem, Amir A. Fikry, Doaa Shahin, Hosam Aldeen Salah Shabana, Sadek Mostafa. Fecal Calprotectin and Transforming Growth Factor-b1 in the Evaluation of Disease Activity in Patients with Ulcerative Colitis. Clin Med Res. 2014;3(4):96-104. doi: 10.11648/j.cmr.20140304.14

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  • @article{10.11648/j.cmr.20140304.14,
      author = {Arafat A. Kassem and Amir A. Fikry and Doaa Shahin and Hosam Aldeen Salah Shabana and Sadek Mostafa},
      title = {Fecal Calprotectin and Transforming Growth Factor-b1 in the Evaluation of Disease Activity in Patients with Ulcerative Colitis},
      journal = {Clinical Medicine Research},
      volume = {3},
      number = {4},
      pages = {96-104},
      doi = {10.11648/j.cmr.20140304.14},
      url = {https://doi.org/10.11648/j.cmr.20140304.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20140304.14},
      abstract = {Aims: to evaluate the correlation between endoscopic disease activity, and fecal calprotectin, transforming growth factor-B1, Clinical Activity Index, C- reactive protein, and blood leucocytes. Methods: Ninety two patients with ulcerative colitis were enrolled and scored according to the endoscopic part of the Rachmilewitz Index. Patients and controls provided fecal and blood samples for measuring calprotectin, TGF-B1, CRP, and leucocytes. Results: The values in ulcerative colitis patients (n = 92) compared to controls (n = 20): calprotectin: 728.9 ± 388.4 versus 22.9 ± 12.9 µg / g, TGF-B1: 350.1 ± 214.7 versus 4.3 ± 2.01 pg /Ml, CRP: 36.9 ± 20.3 versus 3.5 ± 1.9m g/L, blood leucocytes: 13.8 ± 4.5 versus 7.3 ± 1.8 g/ L (all P< 0.001). Endoscopic disease activity correlated significantly with calprotectin (Spearman’s rank correlation coefficient r = 0.545), TGF-B1 (r = 0.531), Clinical Activity Index (r = 0. 520), CRP (r = 0.481), and blood leucocytes (r = 436). Calprotectin and TGF-B1 levels were significantly lower in ulcerative colitis patients with inactive disease ( endoscopic score 0 -3, calprotectin 60.5 ± 47.8 µg / g, TGF-B1 39.9 ± 35.4 pg/Ml , P < 0.001), compared to patients with mild ( score 4 – 6, calprotectin 460.2 ±240 µg/g, TGF-B1 172.4 ± 88.2 pg/ Ml, P < 0.001 ), moderate ( score 7 – 9, calprotectin 797.9 ± 239.2 µg/g, TGF-B1 352.6 ± 89.9 pg/Ml, P < 0.001 ), and high disease ( score 10 – 12 , calprotectin 969.2 ±268.9 µg/g, TGF-B1 486.8 ± 211.2 Pg/ Ml, P < 0.001). The overall accuracy for detection of histopathological active disease was 96.7 % for fecal calprotectin, 94.5 % for TGF-B1, 90 % for Endoscopic Activity Index, 87 % for Clinical Activity Index, and 65 % for both blood leucocytes and CRP. Conclusion: Both fecal calprotectin and TGF-B1 correlated significantly with endoscopic disease activity, clinical activity index, CRP, and blood leucocytes. Furthermore, both calprotectin and TGF-B1 were suitable markers that can differentiate endoscopically and histopathologically inactive from active disease, thus, these two biomarkers may be used for monitoring ulcerative colitis activity.},
     year = {2014}
    }
    

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  • TY  - JOUR
    T1  - Fecal Calprotectin and Transforming Growth Factor-b1 in the Evaluation of Disease Activity in Patients with Ulcerative Colitis
    AU  - Arafat A. Kassem
    AU  - Amir A. Fikry
    AU  - Doaa Shahin
    AU  - Hosam Aldeen Salah Shabana
    AU  - Sadek Mostafa
    Y1  - 2014/07/30
    PY  - 2014
    N1  - https://doi.org/10.11648/j.cmr.20140304.14
    DO  - 10.11648/j.cmr.20140304.14
    T2  - Clinical Medicine Research
    JF  - Clinical Medicine Research
    JO  - Clinical Medicine Research
    SP  - 96
    EP  - 104
    PB  - Science Publishing Group
    SN  - 2326-9057
    UR  - https://doi.org/10.11648/j.cmr.20140304.14
    AB  - Aims: to evaluate the correlation between endoscopic disease activity, and fecal calprotectin, transforming growth factor-B1, Clinical Activity Index, C- reactive protein, and blood leucocytes. Methods: Ninety two patients with ulcerative colitis were enrolled and scored according to the endoscopic part of the Rachmilewitz Index. Patients and controls provided fecal and blood samples for measuring calprotectin, TGF-B1, CRP, and leucocytes. Results: The values in ulcerative colitis patients (n = 92) compared to controls (n = 20): calprotectin: 728.9 ± 388.4 versus 22.9 ± 12.9 µg / g, TGF-B1: 350.1 ± 214.7 versus 4.3 ± 2.01 pg /Ml, CRP: 36.9 ± 20.3 versus 3.5 ± 1.9m g/L, blood leucocytes: 13.8 ± 4.5 versus 7.3 ± 1.8 g/ L (all P< 0.001). Endoscopic disease activity correlated significantly with calprotectin (Spearman’s rank correlation coefficient r = 0.545), TGF-B1 (r = 0.531), Clinical Activity Index (r = 0. 520), CRP (r = 0.481), and blood leucocytes (r = 436). Calprotectin and TGF-B1 levels were significantly lower in ulcerative colitis patients with inactive disease ( endoscopic score 0 -3, calprotectin 60.5 ± 47.8 µg / g, TGF-B1 39.9 ± 35.4 pg/Ml , P < 0.001), compared to patients with mild ( score 4 – 6, calprotectin 460.2 ±240 µg/g, TGF-B1 172.4 ± 88.2 pg/ Ml, P < 0.001 ), moderate ( score 7 – 9, calprotectin 797.9 ± 239.2 µg/g, TGF-B1 352.6 ± 89.9 pg/Ml, P < 0.001 ), and high disease ( score 10 – 12 , calprotectin 969.2 ±268.9 µg/g, TGF-B1 486.8 ± 211.2 Pg/ Ml, P < 0.001). The overall accuracy for detection of histopathological active disease was 96.7 % for fecal calprotectin, 94.5 % for TGF-B1, 90 % for Endoscopic Activity Index, 87 % for Clinical Activity Index, and 65 % for both blood leucocytes and CRP. Conclusion: Both fecal calprotectin and TGF-B1 correlated significantly with endoscopic disease activity, clinical activity index, CRP, and blood leucocytes. Furthermore, both calprotectin and TGF-B1 were suitable markers that can differentiate endoscopically and histopathologically inactive from active disease, thus, these two biomarkers may be used for monitoring ulcerative colitis activity.
    VL  - 3
    IS  - 4
    ER  - 

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Author Information
  • Department of Internal Medicine, Faculty of Medicine, Al- Azhar University, Cairo, Egypt

  • Department of Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt

  • Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt

  • Department of Internal Medicine, Faculty of Medicine, Al- Azhar University, Cairo, Egypt

  • Department of Internal Medicine, Faculty of Medicine, Al- Azhar University, Cairo, Egypt

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