Fecal Calprotectin and Transforming Growth Factor-b1 in the Evaluation of Disease Activity in Patients with Ulcerative Colitis
Clinical Medicine Research
Volume 3, Issue 4, July 2014, Pages: 96-104
Received: Jul. 16, 2014; Accepted: Jul. 23, 2014; Published: Jul. 30, 2014
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Authors
Arafat A. Kassem, Department of Internal Medicine, Faculty of Medicine, Al- Azhar University, Cairo, Egypt
Amir A. Fikry, Department of Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Doaa Shahin, Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Hosam Aldeen Salah Shabana, Department of Internal Medicine, Faculty of Medicine, Al- Azhar University, Cairo, Egypt
Sadek Mostafa, Department of Internal Medicine, Faculty of Medicine, Al- Azhar University, Cairo, Egypt
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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.
Keywords
Fecal Calprotectin, Transforming Growth Factor-B1, Ulcerative Colitis, Disease Activity, Biomarkers, Rachmilewitz Activity Index
To cite this article
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, Clinical Medicine Research. Vol. 3, No. 4, 2014, pp. 96-104. doi: 10.11648/j.cmr.20140304.14
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