Faculty of Medicine, Division of Pediatric Gastroenterology, Department of Hepatology and Nutrition, Ataturk University, Erzurum, Turkey.
J Clin Gastroenterol. 2010 Sep;44(8):544-6. doi: 10.1097/MCG.0b013e3181cadbc0.
We aimed to determine fecal calprotectin (FC) concentration and its relation with histopathologic findings of children with celiac disease (CD) and to observe the probable alterations under gluten-free diet (GFD).
As FC is regarded as a marker of inflammation in the gastrointestinal tract, we hypothesized that it might be increased in untreated CD.
The study included 29 newly diagnosed patients with CD (mean age: 6.6+/-0.6 y) and sex and age-matched 10 healthy children. All of the children with CD admitted to the hospital were classical form who has chronic diarrhea and failure to thrive. The degree of mucosal damage was graded according to the modified Marsh criteria. FC concentration was determined by enzyme-linked immunosorbent assay method on admission and after 1 year of GFD.
Mean FC concentration of children with CD on admission and of healthy children were 13.40+/-8.5 and 4.3+/-3.3 mg/L, respectively (P=0.004). FC concentration under GFD was 4.6+/-2.7 mg/L and there was a significant statistical difference between untreated patients and those under GFD for 1 year (P=0.001). There was no statistical difference between FC concentration of those under GFD and healthy children (P=0.8). Mean FC concentrations of children with total-villous atrophy and partial-villous atrophy were significantly different (13.8+/-9.3 mg/L vs. 3.7+/-1.8 mg/L, P=0.005).
It was found that FC concentration is increased in childhood CD, related to the severity of histopathologic findings and responsive to GFD. The pathogenetic mechanism by which FC is increased in CD should be investigated in further studies.
本研究旨在确定粪便钙卫蛋白(FC)浓度及其与儿童乳糜泻(CD)的组织病理学发现之间的关系,并观察无麸质饮食(GFD)下可能发生的变化。
由于 FC 被认为是胃肠道炎症的标志物,我们假设它在未经治疗的 CD 中可能会增加。
该研究纳入了 29 例新诊断的 CD 患儿(平均年龄:6.6+/-0.6 岁)和 10 例性别和年龄匹配的健康儿童。所有入院的 CD 患儿均为经典型,表现为慢性腹泻和生长发育不良。根据改良 Marsh 标准对黏膜损伤程度进行分级。入院时和 GFD 治疗 1 年后采用酶联免疫吸附试验法测定 FC 浓度。
CD 患儿入院时和健康儿童的 FC 浓度平均值分别为 13.40+/-8.5 和 4.3+/-3.3mg/L(P=0.004)。GFD 下的 FC 浓度为 4.6+/-2.7mg/L,与未治疗患者和 GFD 治疗 1 年后的患者相比,差异有统计学意义(P=0.001)。GFD 治疗组与健康儿童的 FC 浓度无统计学差异(P=0.8)。全绒毛萎缩和部分绒毛萎缩患儿的 FC 浓度差异有统计学意义(13.8+/-9.3mg/L 比 3.7+/-1.8mg/L,P=0.005)。
本研究发现,FC 浓度在儿童 CD 中增加,与组织病理学发现的严重程度相关,并对 GFD 有反应。进一步的研究应探讨 FC 在 CD 中增加的发病机制。