Kolho Kaija-Leena, Raivio Taneli, Lindahl Harry, Savilahti Erkki
Hospital for Children and Adolescents, University of Helsinki, Finland.
Scand J Gastroenterol. 2006 Jun;41(6):720-5. doi: 10.1080/00365520500419623.
Fecal calprotectin is a promising marker for the assessment of gastrointestinal inflammation. Fecal calprotectin levels were followed-up in children with inflammatory bowel disease (IBD) who were introduced to glucocorticoid therapy. The aim of this study was to assess whether the changes in fecal calprotectin levels reflect therapeutic responses.
Fecal calprotectin was measured by enzyme immunoassay in 57 children (mean age 9.8 years, range 0.9-18 years) who underwent colonoscopies (IBD n=31, non-IBD disease n=13, normal n=13) and followed-up in 15 children (mean age 13 years, range 3.6-18 years) who were introduced to glucocorticoid therapy because of active IBD at 0, 2, and 4 weeks and at 4-week intervals until one month after discontinuation of the therapy.
Fecal calprotectin was <100 microg/g in 70% of the children with normal findings on colonoscopy or a non-IBD disease. Fecal calprotectin was >100 microg/g in all but one child with active IBD and in 13/15 of those children who were introduced to glucocorticoids by the clinicians. Fecal calprotectin values decreased within 4 weeks in line with clinical improvement in 7 children and normalized in 4/15 children during the follow-up. Fecal calprotectin increased in 5/8 of the non-steroid-dependent children after discontinuation of glucocorticoids.
Fecal calprotectin is a sensitive marker for chronic colitis. In active disease treated with glucocorticoids, fecal calprotectin levels declined in line with the clinical improvement but seldom fell within the normal range, which suggests ongoing inflammation in a clinically silent disease. The measurement of fecal calprotectin may provide new tools for the assessment of the level of gut inflammation in children with chronic colitis in the follow-up of clinical responses.
粪便钙卫蛋白是评估胃肠道炎症的一个有前景的标志物。对接受糖皮质激素治疗的炎症性肠病（IBD）患儿的粪便钙卫蛋白水平进行随访。本研究的目的是评估粪便钙卫蛋白水平的变化是否反映治疗反应。
采用酶免疫分析法对57例接受结肠镜检查的儿童（平均年龄9.8岁，范围0.9 - 18岁）进行粪便钙卫蛋白检测（IBD组n = 31，非IBD疾病组n = 13，正常组n = 13），并对15例因活动性IBD接受糖皮质激素治疗的儿童（平均年龄13岁，范围3.6 - 18岁）在0、2、4周及停药后1个月内每4周进行随访。
结肠镜检查结果正常或患有非IBD疾病的儿童中，70%的粪便钙卫蛋白<100μg/g。除1例活动性IBD患儿外，所有活动性IBD患儿及临床医生给予糖皮质激素治疗的患儿中13/15的粪便钙卫蛋白>100μg/g。7例患儿的粪便钙卫蛋白值在4周内随临床改善而下降，随访期间4/15的患儿粪便钙卫蛋白值恢复正常。糖皮质激素停药后，8例非激素依赖型患儿中有5例粪便钙卫蛋白升高。
粪便钙卫蛋白是慢性结肠炎的敏感标志物。在接受糖皮质激素治疗的活动性疾病中，粪便钙卫蛋白水平随临床改善而下降，但很少降至正常范围，这表明在临床无症状的疾病中仍存在炎症。粪便钙卫蛋白的检测可为评估慢性结肠炎患儿肠道炎症水平及临床反应随访提供新工具。
