Fecal
Calprotectin: A Marker of Crohn's Disease Activity
Mladen Maksić1,5, Tijana Veljković2,
Mirjana Cvetković3, Marija Marković4, Sasa Perić4,
Olivera Marinković3, Natasa Zdravković5,1
1University Clinical Center Kragujevac,
Clinic for Gastroenterology and Hepatology, Kragujevac, Serbia
2University Clinical Center Kragujevac,
Clinic for Pediatrics, Kragujevac, Serbia
3UHMC Bezanijska Kosa, Belgrade, Serbia
4Military Medical Academy, Belgrade,
Serbia
5University of Kragujevac Faculty of Medical
Sciences, Department of Internal Medicine, Kragujevac, Serbia
SUMMARY
Introduction. Crohn's disease (CD) is a chronic inflammatory bowel
disease (IBD) with periods of remission and exacerbation. Numerous
studies have been conducted in order to identify the ideal marker
when it comes to the inflammatory bowel diseases. In the literature,
fecal calprotectin is mentioned as a marker of inflammation.
Elevated levels of calprotectin can be detected in stool and they
indicate the migration of neutrophils to the intestinal mucosa that
occurs with intestinal inflammation.
The aim. The main goal of this study was to examine the
concentration of fecal calprotectin and CRP depending on the
clinical, endoscopic and histological characteristics of patients
with Crohn's disease and whether there is a correlation of these
markers with disease activity.
Methods. The research was conducted in the period from January 2015
to January 2016. The study included subjects who had been diagnosed
with Crohn's disease. The study involved 45 respondents, aged 20 -
58 years. All subjects included in the study underwent a
colonoscopic examination with biopsy and pathohistological analysis.
Fecal calprotectin was determined in one stool sample in all
subjects, and that was done quantitatively by a commercial ELISA
assay. Determination of serum CRP concentrations was performed in
the Central Biochemical Laboratory by standard methods.
Results. Fecal concentrations of calprotectin are elevated in all
three forms of the disease, while they are significantly higher in
moderately severe (545 vs. 218, p
˂
0.001) and severe forms of the disease (1000 vs. 218, p
˂
0.001) compared to the mild form. Fecal concentrations of
calprotectin are significantly higher at endoscopic grade 3 compared
to the other three endoscopic grades (765.3 vs. 314, p
˂
0.001), (765.3 vs. 392.8, p
˂
0.001), (765.3 vs. 448.2, p ˂
0.001). Fecal concentrations of calprotectin are significantly
higher in extensive pathological findings compared to normal
epithelial surface (1000 vs. 21, p
˂
0.001) as well as in extensive
pathological findings compared to focal pathological findings (1000
vs. 309, p ˂
0.001).
Conclusion. The more severe form of clinical disease activity is
accompanied by higher fecal values of calprotectin and higher
endoscopic grade, and a more severe histological grade of disease is
accompanied by higher fecal values of calprotectin.
Keywords: Crohn's disease, fecal
calprotectin, C-reactive protein, disease activity
Corresponding author:
Mladen Maksić
e-mail:
asussonicmaster95@gmail.com