Article

[Elevated concentrations of fecal calprotectin in patients with liver cirrhosis].

Institut für Klinische Chemie und Pathobiochemie, Universitätsklinikum Aachen.
DMW - Deutsche Medizinische Wochenschrift (impact factor: 0.53). 09/2006; 131(36):1930-4. DOI:10.1055/s-2006-949189 pp.1930-4
Source: PubMed

ABSTRACT BACKGROUND AND OBJECTION: Bacterial translocation from the gut lumen is considered to play an important role in the development of infectious complications in patients with liver cirrhosis. This translocation might be increased by inflammation of the gut mucosa. Calprotectin is a cytoplasmatic protein of neutrophilic granulocytes and is an established marker for the assessment of localized intestinal inflammation. It was the aim of the current study to systematically evaluate a localized intestinal inflammation in patients with liver cirrhosis by means of fecal calprotectin concentrations.
Fecal calprotectin concentrations were determined in 53 consecutive patients with liver cirrhosis and in 18 subjects without intestinal or liver diseases, who were comparable with respect to age and gender. Patients with diarrhoea, inflammatory bowel disease and a positive stool test for occult blood were excluded from the study. Fecal calprotectin concentrations were measured by a sandwich ELISA. The systemic inflammatory reaction of the patients was assessed by C-reactive protein, white blood cells counts and the serum concentrations of the cytokines IL-6, IL-8 and IL-10.
Fecal calprotectin concentrations were significantly increased in patients with liver cirrhosis (median 37.0 mg/kg) compared to controls patients (median 2.2, P < 0.0001). There were no significant correlations of calprotectin concentrations with systemic inflammatory parameters, like CRP, white blood cell count or serum cytokines. However, fecal calprotectin concentrations were significantly associated with the stage of liver cirrhosis as expressed by the Child-Pugh score ( P < 0.001). A trend towards higher concentrations of calprotectin was found in patients with alcoholic liver cirrhosis ( P = 0.1).
Patients with liver cirrhosis display elevated fecal calprotectin concentrations as a potential sign of intestinal inflammation. Further studies are warranted to establish a role of calprotectin for the risk assessment of infectious complications secondary to bacterial translocation in patients with liver cirrhosis.

0 0
 · 
0 Bookmarks
 · 
29 Views
  • Source
    Article: Fecal calprotectin concentration is increased in children with celiac disease: relation with histopathological findings.
    Necati Balamtekın, Gökhan Baysoy, Nuray Uslu, Diclehan Orhan, Zuhal Akçören, Hasan Ozen, Figen Gürakan, Inci Nur Saltik-Temızel, Aysel Yüce
    [show abstract] [hide abstract]
    ABSTRACT: Background/aims: The aim of this study was to compare the fecal calprotectin concentration in children with newly diagnosed celiac disease, children with celiac disease strictly adhering to a gluten-free diet and healthy controls. We also tried to correlate the fecal calprotectin concentration with the clinical presentation, degree of neutrophilic infiltration and the severity of histopathological injury (Marsh grade) in the small bowel mucosa. Material and Methods: The study included three groups: children with untreated celiac disease, children with treated celiac disease, and healthy controls. Moreover, we obtained a second fecal sample from nine newly diagnosed children when their endomysial antibody became negative after gluten-free diet. Results: Fecal calprotectin concentrations were significantly higher in newly diagnosed celiac patients (n=31) compared to patients on gluten-free diet (n=33) and healthy controls (n=34) (117.2 μg/g (3.2-306) vs. 3.7 μg/g (0.5-58.2) and 9.6 μg/g (1-70), respectively, p<0.001). Patients presenting with gastrointestinal symptoms had higher fecal calprotectin concentration compared to the patients presenting with nongastrointestinal symptoms [142.8 (12.2-306) vs. 79.7 (3.2-243.2) respectively, p=0.04]. Nine newly diagnosed patients gave a second fecal sample after starting gluten-free diet when endomysial antibody became negative. Their fecal calprotectin concentration had decreased from 113.7 μg/g (8.7-295.2) to 4.2 μg/g (0.5-20.7) (p<0.01). Conclusions: Increased fecal calprotectin concentration can be used as a non-invasive marker that might aid in the diagnosis of celiac disease, especially in patients with gastrointestinal presentation. Fecal calprotectin concentration returns to normal on a strict gluten-free diet. Fecal calprotectin may be used as a marker of diet adherence and improvement in gastrointestinal inflammation in children with celiac disease. Additionally, it may be used for the differentiation of celiac disease from functional disorders of the gastrointestinal system.
    The Turkish journal of gastroenterology: the official journal of Turkish Society of Gastroenterology 10/2012; 23(5):503-8. · 0.47 Impact Factor
  • Source
    Article: Características generales
    Rodrigo L
    [show abstract] [hide abstract]
    ABSTRACT: calprotectina (CP) es una proteína que se encuentra en el organismo de forma abundante y ampliamente distribuida. Va unida al calcio y pertenece a la familia S100. Está contenida principalmente en los leucocitos polimorfonucleares neutrófi-los (PMNs) y también se encuentra presente, aunque en una menor proporción, los monocitos y en los macrófagos reactivos (1). La CP representa aproximadamente el 5% del contenido total proteico de los leu-cocitos neutrófilos y un 60% del contenido total de proteínas que están presentes en su citoplasma (2). Presenta claras propiedades bacteriostáticas y fungicidas y sus niveles plasmáticos se elevan de 5 a 40 veces, en presencia de procesos infecciosos y/o inflamatorios (3). También se encuentra presente en las heces y la concentración fecal de calpro-tectina (CPF) es muy superior comparada con sus niveles plasmáticos (aproximada-mente unas 6 veces) (4). Se encuentran niveles elevados de CP en las heces de pacientes con diversos pro-cesos inflamatorios intestinales, tanto localizados a nivel del intestino delgado como en cualquier parte del colon (5-7). Método de determinación de la CPF y valores de referencia En 1992 Roseth y cols. (2) desarrollaron el primer método de determinación de CPF, mediante una técnica de ELISA. Desde entonces, se ha mejorado y validado extensamente el método y se emplean muestras muy pequeñas de heces (0,1 g) que se mezclan con una solución tampón, en un tubo de 5 ml (8). Los resultados de su determinación muestran una muy buena correlación con la excreción fecal en 3 días de granulocitos marcados con un isótopo radiactivo como el Indio 111 (9). Los nuevos métodos expresan la concentración de CPF en microgramos por gra-mo, a diferencia de los anteriores que lo medían en miligramos por litro. La CP es una proteína muy estable y resistente a la degradación proteolítica de las he-ces. Las muestras pueden ser guardadas hasta 5 días a temperatura normal, sin observar pérdida apreciable de su concentración y se pueden enviar por correo sin refrigeración. El límite superior de la normalidad se establece en 50 µg/g. Los valores de refe-rencia para los niños son similares a los encontrados en los adultos, aunque de for-ma curiosa los niños sanos en el primer año de vida, presentan valores hasta 10 ve-ces superiores a los normales para niños mayores de dicha edad, sin existir una explicación clara al respecto (10).
    Revista espanola de enfermedades digestivas: organo oficial de la Sociedad Espanola de Patologia Digestiva 01/2007; 99:683-8. · 1.55 Impact Factor
  • Source
    Article: Presence of anti-microbial antibodies in liver cirrhosis--a tell-tale sign of compromised immunity?
    Maria Papp, Gary L Norman, Zsuzsanna Vitalis, Istvan Tornai, Istvan Altorjay, Ildiko Foldi, Miklos Udvardy, Zakera Shums, Tamas Dinya, Peter Orosz, Bela Lombay, Gabriella Par, Alajos Par, Gabor Veres, Timea Csak, Janos Osztovits, Ferenc Szalay, Peter Laszlo Lakatos
    [show abstract] [hide abstract]
    ABSTRACT: Bacterial translocation plays important role in the complications of liver cirrhosis. Antibody formation against various microbial antigens is common in Crohn's disease and considered to be caused by sustained exposure to gut microflora constituents. We hypothesized that anti-microbial antibodies are present in patients with liver cirrhosis and may be associated with the development of bacterial infections. Sera of 676 patients with various chronic liver diseases (autoimmune diseases: 266, viral hepatitis C: 124, and liver cirrhosis of different etiology: 286) and 100 controls were assayed for antibodies to Saccharomyces cerevisiae (ASCA) and to antigens derived from two intestinal bacterial isolates (one gram positive, one gram negative, neither is Escherichia coli). In patients with liver cirrhosis, we also prospectively recorded the development of severe episodes of bacterial infection. ASCA and anti-OMP Plus™ antibodies were present in 38.5% and 62.6% of patients with cirrhosis and in 16% and 20% of controls, respectively (p<0.001). Occurrence of these antibodies was more frequent in cases of advanced cirrhosis (according to Child-Pugh and MELD score; p<0.001) or in the presence of ascites (p<0.001). During the median follow-up of 425 days, 81 patients (28.3%) presented with severe bacterial infections. Anti-microbial antibody titers (p = 0.003), as well as multiple seroreactivity (p = 0.036), was associated with infectious events. In logistic regression analysis, the presence of ascites (OR: 1.62, 95%CI: 1.16-2.25), co-morbidities (OR: 2.22, 95%CI: 1.27-3.86), and ASCA positivity (OR: 1.59, 95%CI: 1.07-2.36) were independent risk factors for severe infections. A shorter time period until the first infection was associated with the presence of ASCA (p = 0.03) and multiple seropositivity (p = 0.037) by Kaplan-Meier analysis, and with Child-Pugh stage (p = 0.018, OR: 1.85) and co-morbidities (p<0.001, OR: 2.02) by Cox-regression analysis. The present study suggests that systemic reactivity to microbial components reflects compromised mucosal immunity in patients with liver cirrhosis, further supporting the possible role of bacterial translocation in the formation of anti-microbial antibodies.
    PLoS ONE 01/2010; 5(9):e12957. · 4.09 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

53 consecutive patients
 
C-reactive protein
 
calprotectin concentrations
 
controls patients
 
cytoplasmatic protein
 
established marker
 
Fecal calprotectin concentrations
 
gut mucosa
 
higher concentrations
 
infectious complications secondary
 
liver cirrhosis display
 
liver diseases
 
localized intestinal inflammation
 
neutrophilic granulocytes
 
occult blood
 
positive stool test
 
risk assessment
 
serum concentrations
 
systemic inflammatory parameters
 
white blood cells counts