Faecal calprotectin: factors affecting levels and its potential role as a surrogate marker for risk of development of Crohn’s Disease


Background:
Faecal calprotectin (FC) is one of the most widely used non-invasive tests for the diagnosis and assessment of Crohn’s disease (CD) activity. Despite this, factors other than disease activity which affect levels have not been extensively reviewed. This is of importance when using FC in the diagnostic setting but also may be of utility in studying the aetiology of disease.

Objectives:
Our review outlines environmental risk factors that affect FC levels influencing diagnostic accuracy and how these may be associated with risk of developing CD. FC as a surrogate marker could be used to validate risk factors established in case control studies where prospective studies are not feasible. Proof of this concept is provided by our identification of obesity as being associated with elevated FC, our subsequent confirmation of obesity as risk factor for CD and the subsequent verification in prospective studies, as well as associations of lack of physical activity and dietary fibre intake with elevated FC levels and their subsequent confirmation as risk factors in prospective studies.

Conclusion:
We believe that FC is likely to prove a useful surrogate marker for risk of developing CD. This review has given a theoretical basis for considering the epidemiological determinants of CD which to date has been missing.

Keywords:
Crohn’s disease, Calprotectin, Surrogate marker, Environment, Diet


Autoři: Michael A. Mendall 1;  Derek Chan 2;  Roshani Patel 3;  Devinder Kumar 3*
Působiště autorů: Department of Gastroenterology, Croydon University Hospital, 5 0 London Road, Surrey CR7 7YE, UK. 1;  Department of Gastroenterology, Blackshaw Road, London SW17 0QT, UK. 2;  Department of Colorectal Surgery, St George’s Hospital, Blackshaw Road, London SW17 0QT, UK. 3
Vyšlo v časopise: BMC Gastroenterology 2016, 16:126
Kategorie: Debate
prolekare.web.journal.doi_sk: 10.1186/s12876-016-0535-z

© 2016 The Author(s).

Open access
This article is 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, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
The electronic version of this article is the complete one and can be found online at: http://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-016-0535-z

Souhrn

Background:
Faecal calprotectin (FC) is one of the most widely used non-invasive tests for the diagnosis and assessment of Crohn’s disease (CD) activity. Despite this, factors other than disease activity which affect levels have not been extensively reviewed. This is of importance when using FC in the diagnostic setting but also may be of utility in studying the aetiology of disease.

Objectives:
Our review outlines environmental risk factors that affect FC levels influencing diagnostic accuracy and how these may be associated with risk of developing CD. FC as a surrogate marker could be used to validate risk factors established in case control studies where prospective studies are not feasible. Proof of this concept is provided by our identification of obesity as being associated with elevated FC, our subsequent confirmation of obesity as risk factor for CD and the subsequent verification in prospective studies, as well as associations of lack of physical activity and dietary fibre intake with elevated FC levels and their subsequent confirmation as risk factors in prospective studies.

Conclusion:
We believe that FC is likely to prove a useful surrogate marker for risk of developing CD. This review has given a theoretical basis for considering the epidemiological determinants of CD which to date has been missing.

Keywords:
Crohn’s disease, Calprotectin, Surrogate marker, Environment, Diet


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Gastroenterológia a hepatológia
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