Helena Ekoff ^1,2, Niclas Rydell ^1,✉, Per M Hellström ², Robert Movérare ^1,3

Clin Transl Gastroenterol. 2024 Jun 26;15(10):e1.doi: 10.14309/ctg.0000000000000733

INTRODUCTION:

Neutrophilic calprotectin (CP) and myeloperoxidase (MPO), neutrophil gelatinase-associated lipocalin (NGAL), and eosinophil-derived neurotoxin (EDN) are suggested proxy markers for gut inflammation. However, there are insufficient supporting data for MPO, NGAL, and EDN.

METHODS:

In a cross-sectional investigation including adult patients, we studied the ability of CP, MPO, NGAL, and EDN, measured in fecal and serum samples, to differentiate between inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS), and to predict disease activity.

RESULTS:

Fifty-nine patients had ulcerative colitis (UC), 38 had Crohn’s disease, and 100 patients had IBS. The protein concentrations were higher in patients with IBD in the fecal samples (P < 0.001) and the serum samples (P < 0.01), and they correlated weakly (r_s ≤0.38) between the sample sources. Fecal EDN was higher in patients with Crohn’s disease compared with UC (1.79 vs 0.50 mg/kg, P = 0.016). The neutrophilic proteins were superior to EDN in the fecal samples for differentiating between patients with IBD and IBS. Fecal MPO (cutoff: 0.86 mg/kg) had the highest sensitivity (74.7%) and specificity (84.6%). Combining fecal CP and MPO increased the sensitivity to 82.3% (specificity: 73.6%). NGAL (cutoff: 196.9 μg/L) showed the best discriminating performance in serum (sensitivity: 62.9%; specificity: 68.0%). Serum NGAL (cutoff: 272.4 μg/L) predicted active disease in UC (Partial Mayo Score ≥2) with a sensitivity and specificity of 57.1% and 83.3%, respectively.

DISCUSSION: Fecal MPO and serum NGAL are promising novel biomarkers, in addition to fecal CP, for differentiating between IBD and IBS. Serum NGAL may also predict disease activity in patients with UC.

Hideki Fujita ¹, Tadashi Terui ¹, Koremasa Hayama ¹, Masashi Akiyama ², Shigaku Ikeda ³, Tomotaka Mabuchi ⁴, Akira Ozawa ⁴, Takuro Kanekura ⁵, Michiko Kurosawa ⁶, Mayumi Komine ⁷, Kimiko Nakajima ⁸, Shigetoshi Sano ⁸, Osamu Nemoto ⁹, Masahiko Muto ¹⁰, Yasutomo Imai ¹¹, Kiyofumi Yamanishi ¹¹, Yumi Aoyama ¹², Keiji Iwatsuki ¹³, J Dermatol . 2018 Nov;45(11):1235-1270. 

 The aim of the guidelines was to provide current information to aid in the treatment of patients with GPP in Japan. Its contents include the diagnostic and severity classification criteria for GPP, its pathogenesis, and recommendations for the treatment of GPP.

https://pubmed.ncbi.nlm.nih.gov/30230572/