Department of Pediatrics, Hvidovre Hospital, University of Copenhagen, Hvidovre.
Department of Pediatrics, Hospital South West Jutland, Esbjerg.
J Pediatr Gastroenterol Nutr. 2019 May;68(5):669-675. doi: 10.1097/MPG.0000000000002244.
Fecal calprotectin (FC) is a well-integrated parameter in the monitoring of adolescent patients with inflammatory bowel disease (IBD). However, measurement of FC is limited by day-to-day-variation and by the feces consistency. Furthermore, adolescents are often noncompliant to deliver fecal sampling leading to suboptimal monitoring. Consequently, we see the need of a substitute biomarker whenever measurement of FC fails and aimed to investigate serum calprotectin (SC) in adolescents with IBD.
In cross sectional data from 19 ulcerative colitis (UC) patients <18 years old, a Spearman correlation was used to analyze the correlation between SC, FC, C-reactive protein (CRP) and endoscopic and symptom scores. In longitudinal data collected from 20 UC and Crohn disease (CD) patients (10-17 years old), Mixed Effect Models (MEM) were used to analyze the association between SC, FC, CRP, and symptom scores.
We found positive correlations between SC (19 samples) and the endoscopic score, symptom score, and CRP (r = 0.56, P = 0.01; r = 0.64, P = 0.003; r = 0.97, P < 0.0001). We found no significant correlation between SC and FC. In 27 samples from UC patients, the association of SC with FC and CRP were positive and significant (P = 0.004, estimate = 0.32; P = 0.0001, estimate = 0.002). The association between SC and symptom score was insignificant. In 49 samples from CD patients, the association between SC and CRP was significant (P = 0.02, estimate = 0.002) whereas associations between SC and FC and symptom score were insignificant.
In the current pilot study, we found a correlation between SC and the endoscopically assessed inflammation in UC. SC may have the potential to improve disease monitoring of adolescent patients.
粪便钙卫蛋白（FC）是监测青少年炎症性肠病（IBD）患者的一个综合参数。然而，FC 的测量受到日常变化和粪便稠度的限制。此外，青少年通常不遵守提供粪便样本的要求，导致监测效果不佳。因此，当 FC 测量失败时，我们需要寻找替代生物标志物，并旨在研究血清钙卫蛋白（SC）在青少年 IBD 中的作用。
在 19 名年龄小于 18 岁的溃疡性结肠炎（UC）患者的横断面数据中，使用 Spearman 相关分析来分析 SC、FC、C 反应蛋白（CRP）与内镜和症状评分之间的相关性。在从 20 名 UC 和克罗恩病（CD）患者（10-17 岁）收集的纵向数据中，使用混合效应模型（MEM）分析 SC、FC、CRP 和症状评分之间的关系。
我们发现 SC（19 个样本）与内镜评分、症状评分和 CRP 之间呈正相关（r=0.56，P=0.01；r=0.64，P=0.003；r=0.97，P<0.0001）。我们发现 SC 与 FC 之间无显著相关性。在 27 个 UC 患者样本中，SC 与 FC 和 CRP 的相关性为正且显著（P=0.004，估计值=0.32；P=0.0001，估计值=0.002）。SC 与症状评分之间的相关性无统计学意义。在 49 个 CD 患者样本中，SC 与 CRP 的相关性显著（P=0.02，估计值=0.002），而 SC 与 FC 和症状评分之间的相关性无统计学意义。
在本研究中，我们发现 SC 与 UC 内镜评估的炎症之间存在相关性。SC 可能有潜力改善青少年患者的疾病监测。
