Langhorst Jost, Elsenbruch Sigrid, Mueller Twyla, Rueffer Andreas, Spahn Guenther, Michalsen Andreas, Dobos Gustav J
Department of Internal Medicine, Kliniken Essen-Mitte, University of Duisburg-Essen, Essen, Germany.
Inflamm Bowel Dis. 2005 Dec;11(12):1085-91. doi: 10.1097/01.mib.0000187980.08686.18.
To evaluate the diagnostic use of fecal concentrations of lactoferrin (Lf), calprotectin (Cal), polymorphonuclear neutrophil-elastase (PMN-e), and lysozyme (Lys) as indicators of disease activity in patients with active and inactive ulcerative colitis (UC).
A total of 76 fecal specimens were collected from 31 patients with UC in times of active and inactive status of disease. Disease activity was determined with the colitis activity index (CAI; Rachmilewitz index), which includes a combination of laboratory parameters and clinical symptoms, with a score of at least 6 indicating active disease. Fecal Lf, Cal, PMN-e, and Lys were measured and reported as micrograms per milliliter feces. Levels of more than 7.25, more than 6.00, at least 0.062, and at least 0.6 for Lf, Cal, PMN-e, and Lys, respectively, were considered elevated as specified by the manufacturers.
Based on the CAI classification, 25 of the samples were from patients with active disease status and 51 were from patients with inactive status. Lf, PMN-e, and Cal but not Lys showed increased levels in samples from patients in active disease compared with those in remission (median for Lf: 28.12 +/- 110.86 versus 179.54 +/- 334.09, P < 0.001; median for Cal: 15.13 +/- 30.27 versus 116.23 +/- 182.29, P < 0.001; median for PMN-e: 0.21 +/- 0.44 versus 1.02 +/- 0.89, P < 0.001; median for Lys: 1.54 +/- 2.39 versus 3.75 +/- 5.39, P > 0.05). All 4 parameters correlated with the CAI (Lf: r = 0.441, P < 0.001; Cal: r = 0.505, P < 0.001; PMN-e: r = 0.604, P < 0.001; Lys: r = 0.295, P < 0.05). Introducing a composite index based on Lf, Cal, and PMN-e, the specificity was 72.5% and the sensitivity 88% compared with the CAI.
Among the neutrophil-derived proteins in feces, PMN-e, Cal, and Lf represent useful markers of disease activity in patients with UC. Using all 3 markers in a composite index may be an additional noninvasive tool for the management of ambulant patients with UC.
评估粪便中乳铁蛋白（Lf）、钙卫蛋白（Cal）、多形核中性粒细胞弹性蛋白酶（PMN-e）和溶菌酶（Lys）的浓度作为活动期和非活动期溃疡性结肠炎（UC）患者疾病活动指标的诊断价值。
从31例UC患者处于疾病活动期和非活动期时共收集76份粪便标本。采用结肠炎活动指数（CAI；Rachmilewitz指数）确定疾病活动情况，该指数综合了实验室参数和临床症状，评分至少为6分表明疾病活动。检测粪便中的Lf、Cal、PMN-e和Lys，并以每毫升粪便中的微克数报告。按照制造商规定，Lf、Cal、PMN-e和Lys的水平分别超过7.25、超过6.00、至少0.062和至少0.6被认为升高。
根据CAI分类，25份样本来自疾病活动期患者，51份来自非活动期患者。与缓解期患者相比，活动期疾病患者样本中的Lf、PMN-e和Cal水平升高，但Lys水平未升高（Lf中位数：28.12±110.86对179.54±334.09，P<0.001；Cal中位数：15.13±30.27对116.23±182.29，P<0.001；PMN-e中位数：0.21±0.44对1.02±0.89，P<0.001；Lys中位数：1.54±2.39对3.75±5.39，P>0.05）。所有4项参数均与CAI相关（Lf：r = 0.441，P<0.001；Cal：r = 0.505，P<0.001；PMN-e：r = 0.604，P<0.001；Lys：r = 0.295，P<0.05）。引入基于Lf、Cal和PMN-e的综合指数，与CAI相比，特异性为72.5%，敏感性为88%。
在粪便中源自中性粒细胞的蛋白质中，PMN-e、Cal和Lf是UC患者疾病活动的有用标志物。在综合指数中使用这3种标志物可能是管理UC门诊患者的另一种非侵入性工具。
