Fecal Calprotectin and Transforming Growth Factor-b1 in the Evaluation of Disease Activity in Patients with Ulcerative Colitis

Arafat A. Kassem; Amir A. Fikry; Doaa Shahin; Hosam Aldeen Salah Shabana; Sadek Mostafa

doi:doi:10.11648/j.cmr.20140304.14

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Fecal Calprotectin and Transforming Growth Factor-b1 in the Evaluation of Disease Activity in Patients with Ulcerative Colitis

Arafat A. Kassem, Amir A. Fikry, Doaa Shahin, Hosam Aldeen Salah Shabana, Sadek Mostafa

Published in Clinical Medicine Research (Volume 3, Issue 4)

Received: 16 July 2014 Accepted: 23 July 2014 Published: 30 July 2014

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Abstract

Aims: to evaluate the correlation between endoscopic disease activity, and fecal calprotectin, transforming growth factor-B1, Clinical Activity Index, C- reactive protein, and blood leucocytes. Methods: Ninety two patients with ulcerative colitis were enrolled and scored according to the endoscopic part of the Rachmilewitz Index. Patients and controls provided fecal and blood samples for measuring calprotectin, TGF-B1, CRP, and leucocytes. Results: The values in ulcerative colitis patients (n = 92) compared to controls (n = 20): calprotectin: 728.9 ± 388.4 versus 22.9 ± 12.9 µg / g, TGF-B1: 350.1 ± 214.7 versus 4.3 ± 2.01 pg /Ml, CRP: 36.9 ± 20.3 versus 3.5 ± 1.9m g/L, blood leucocytes: 13.8 ± 4.5 versus 7.3 ± 1.8 g/ L (all P< 0.001). Endoscopic disease activity correlated significantly with calprotectin (Spearman’s rank correlation coefficient r = 0.545), TGF-B1 (r = 0.531), Clinical Activity Index (r = 0. 520), CRP (r = 0.481), and blood leucocytes (r = 436). Calprotectin and TGF-B1 levels were significantly lower in ulcerative colitis patients with inactive disease ( endoscopic score 0 -3, calprotectin 60.5 ± 47.8 µg / g, TGF-B1 39.9 ± 35.4 pg/Ml , P < 0.001), compared to patients with mild ( score 4 – 6, calprotectin 460.2 ±240 µg/g, TGF-B1 172.4 ± 88.2 pg/ Ml, P < 0.001 ), moderate ( score 7 – 9, calprotectin 797.9 ± 239.2 µg/g, TGF-B1 352.6 ± 89.9 pg/Ml, P < 0.001 ), and high disease ( score 10 – 12 , calprotectin 969.2 ±268.9 µg/g, TGF-B1 486.8 ± 211.2 Pg/ Ml, P < 0.001). The overall accuracy for detection of histopathological active disease was 96.7 % for fecal calprotectin, 94.5 % for TGF-B1, 90 % for Endoscopic Activity Index, 87 % for Clinical Activity Index, and 65 % for both blood leucocytes and CRP. Conclusion: Both fecal calprotectin and TGF-B1 correlated significantly with endoscopic disease activity, clinical activity index, CRP, and blood leucocytes. Furthermore, both calprotectin and TGF-B1 were suitable markers that can differentiate endoscopically and histopathologically inactive from active disease, thus, these two biomarkers may be used for monitoring ulcerative colitis activity.

Published in	Clinical Medicine Research (Volume 3, Issue 4)
DOI	10.11648/j.cmr.20140304.14
Page(s)	96-104
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2014. Published by Science Publishing Group

Keywords

Fecal Calprotectin, Transforming Growth Factor-B1, Ulcerative Colitis, Disease Activity, Biomarkers, Rachmilewitz Activity Index

References

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[17]	Irena CM, Iga WT, Malgorzata S, Danuta F, Konrad J, Dorota C, Tomasz M. TGF-B1 and granulocyte elastase in the evaluation of activity of inflammatory bowel disease. A pilot study. Postepy Hig Med Dosw (Online), 2014; 68: 66 – 72.
[18]	Kanazawa S, Tsunoda T, Onuma E, Majami T, Kagiyama M, Kikuchi K. VEGF, basic- FGF, and TGF-B1 in crohn’s disease and ulcerative colitis: a novel mechanism of chronic intestinal inflammation. Am. j. Gastroenterol; 2001; 96: 822 – 828.
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APA Style

Arafat A. Kassem, Amir A. Fikry, Doaa Shahin, Hosam Aldeen Salah Shabana, Sadek Mostafa. (2014). Fecal Calprotectin and Transforming Growth Factor-b1 in the Evaluation of Disease Activity in Patients with Ulcerative Colitis. Clinical Medicine Research, 3(4), 96-104. https://doi.org/10.11648/j.cmr.20140304.14

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ACS Style

Arafat A. Kassem; Amir A. Fikry; Doaa Shahin; Hosam Aldeen Salah Shabana; Sadek Mostafa. Fecal Calprotectin and Transforming Growth Factor-b1 in the Evaluation of Disease Activity in Patients with Ulcerative Colitis. Clin. Med. Res. 2014, 3(4), 96-104. doi: 10.11648/j.cmr.20140304.14

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AMA Style

Arafat A. Kassem, Amir A. Fikry, Doaa Shahin, Hosam Aldeen Salah Shabana, Sadek Mostafa. Fecal Calprotectin and Transforming Growth Factor-b1 in the Evaluation of Disease Activity in Patients with Ulcerative Colitis. Clin Med Res. 2014;3(4):96-104. doi: 10.11648/j.cmr.20140304.14

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@article{10.11648/j.cmr.20140304.14,
  author = {Arafat A. Kassem and Amir A. Fikry and Doaa Shahin and Hosam Aldeen Salah Shabana and Sadek Mostafa},
  title = {Fecal Calprotectin and Transforming Growth Factor-b1 in the Evaluation of Disease Activity in Patients with Ulcerative Colitis},
  journal = {Clinical Medicine Research},
  volume = {3},
  number = {4},
  pages = {96-104},
  doi = {10.11648/j.cmr.20140304.14},
  url = {https://doi.org/10.11648/j.cmr.20140304.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20140304.14},
  abstract = {Aims: to evaluate the correlation between endoscopic disease activity, and fecal calprotectin, transforming growth factor-B1, Clinical Activity Index, C- reactive protein, and blood leucocytes. Methods: Ninety two patients with ulcerative colitis were enrolled and scored according to the endoscopic part of the Rachmilewitz Index. Patients and controls provided fecal and blood samples for measuring calprotectin, TGF-B1, CRP, and leucocytes. Results: The values in ulcerative colitis patients (n = 92) compared to controls (n = 20): calprotectin: 728.9 ± 388.4 versus 22.9 ± 12.9 µg / g, TGF-B1: 350.1 ± 214.7 versus 4.3 ± 2.01 pg /Ml, CRP: 36.9 ± 20.3 versus 3.5 ± 1.9m g/L, blood leucocytes: 13.8 ± 4.5 versus 7.3 ± 1.8 g/ L (all P< 0.001). Endoscopic disease activity correlated significantly with calprotectin (Spearman’s rank correlation coefficient r = 0.545), TGF-B1 (r = 0.531), Clinical Activity Index (r = 0. 520), CRP (r = 0.481), and blood leucocytes (r = 436). Calprotectin and TGF-B1 levels were significantly lower in ulcerative colitis patients with inactive disease ( endoscopic score 0 -3, calprotectin 60.5 ± 47.8 µg / g, TGF-B1 39.9 ± 35.4 pg/Ml , P < 0.001), compared to patients with mild ( score 4 – 6, calprotectin 460.2 ±240 µg/g, TGF-B1 172.4 ± 88.2 pg/ Ml, P < 0.001 ), moderate ( score 7 – 9, calprotectin 797.9 ± 239.2 µg/g, TGF-B1 352.6 ± 89.9 pg/Ml, P < 0.001 ), and high disease ( score 10 – 12 , calprotectin 969.2 ±268.9 µg/g, TGF-B1 486.8 ± 211.2 Pg/ Ml, P < 0.001). The overall accuracy for detection of histopathological active disease was 96.7 % for fecal calprotectin, 94.5 % for TGF-B1, 90 % for Endoscopic Activity Index, 87 % for Clinical Activity Index, and 65 % for both blood leucocytes and CRP. Conclusion: Both fecal calprotectin and TGF-B1 correlated significantly with endoscopic disease activity, clinical activity index, CRP, and blood leucocytes. Furthermore, both calprotectin and TGF-B1 were suitable markers that can differentiate endoscopically and histopathologically inactive from active disease, thus, these two biomarkers may be used for monitoring ulcerative colitis activity.},
 year = {2014}
}

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TY  - JOUR
T1  - Fecal Calprotectin and Transforming Growth Factor-b1 in the Evaluation of Disease Activity in Patients with Ulcerative Colitis
AU  - Arafat A. Kassem
AU  - Amir A. Fikry
AU  - Doaa Shahin
AU  - Hosam Aldeen Salah Shabana
AU  - Sadek Mostafa
Y1  - 2014/07/30
PY  - 2014
N1  - https://doi.org/10.11648/j.cmr.20140304.14
DO  - 10.11648/j.cmr.20140304.14
T2  - Clinical Medicine Research
JF  - Clinical Medicine Research
JO  - Clinical Medicine Research
SP  - 96
EP  - 104
PB  - Science Publishing Group
SN  - 2326-9057
UR  - https://doi.org/10.11648/j.cmr.20140304.14
AB  - Aims: to evaluate the correlation between endoscopic disease activity, and fecal calprotectin, transforming growth factor-B1, Clinical Activity Index, C- reactive protein, and blood leucocytes. Methods: Ninety two patients with ulcerative colitis were enrolled and scored according to the endoscopic part of the Rachmilewitz Index. Patients and controls provided fecal and blood samples for measuring calprotectin, TGF-B1, CRP, and leucocytes. Results: The values in ulcerative colitis patients (n = 92) compared to controls (n = 20): calprotectin: 728.9 ± 388.4 versus 22.9 ± 12.9 µg / g, TGF-B1: 350.1 ± 214.7 versus 4.3 ± 2.01 pg /Ml, CRP: 36.9 ± 20.3 versus 3.5 ± 1.9m g/L, blood leucocytes: 13.8 ± 4.5 versus 7.3 ± 1.8 g/ L (all P< 0.001). Endoscopic disease activity correlated significantly with calprotectin (Spearman’s rank correlation coefficient r = 0.545), TGF-B1 (r = 0.531), Clinical Activity Index (r = 0. 520), CRP (r = 0.481), and blood leucocytes (r = 436). Calprotectin and TGF-B1 levels were significantly lower in ulcerative colitis patients with inactive disease ( endoscopic score 0 -3, calprotectin 60.5 ± 47.8 µg / g, TGF-B1 39.9 ± 35.4 pg/Ml , P < 0.001), compared to patients with mild ( score 4 – 6, calprotectin 460.2 ±240 µg/g, TGF-B1 172.4 ± 88.2 pg/ Ml, P < 0.001 ), moderate ( score 7 – 9, calprotectin 797.9 ± 239.2 µg/g, TGF-B1 352.6 ± 89.9 pg/Ml, P < 0.001 ), and high disease ( score 10 – 12 , calprotectin 969.2 ±268.9 µg/g, TGF-B1 486.8 ± 211.2 Pg/ Ml, P < 0.001). The overall accuracy for detection of histopathological active disease was 96.7 % for fecal calprotectin, 94.5 % for TGF-B1, 90 % for Endoscopic Activity Index, 87 % for Clinical Activity Index, and 65 % for both blood leucocytes and CRP. Conclusion: Both fecal calprotectin and TGF-B1 correlated significantly with endoscopic disease activity, clinical activity index, CRP, and blood leucocytes. Furthermore, both calprotectin and TGF-B1 were suitable markers that can differentiate endoscopically and histopathologically inactive from active disease, thus, these two biomarkers may be used for monitoring ulcerative colitis activity.
VL  - 3
IS  - 4
ER  -

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Author Information

Arafat A. Kassem

Department of Internal Medicine, Faculty of Medicine, Al- Azhar University, Cairo, Egypt
Amir A. Fikry

Department of Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Doaa Shahin

Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Hosam Aldeen Salah Shabana

Department of Internal Medicine, Faculty of Medicine, Al- Azhar University, Cairo, Egypt
Sadek Mostafa

Department of Internal Medicine, Faculty of Medicine, Al- Azhar University, Cairo, Egypt

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APA Style

Arafat A. Kassem, Amir A. Fikry, Doaa Shahin, Hosam Aldeen Salah Shabana, Sadek Mostafa. (2014). Fecal Calprotectin and Transforming Growth Factor-b1 in the Evaluation of Disease Activity in Patients with Ulcerative Colitis. Clinical Medicine Research, 3(4), 96-104. https://doi.org/10.11648/j.cmr.20140304.14

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ACS Style

Arafat A. Kassem; Amir A. Fikry; Doaa Shahin; Hosam Aldeen Salah Shabana; Sadek Mostafa. Fecal Calprotectin and Transforming Growth Factor-b1 in the Evaluation of Disease Activity in Patients with Ulcerative Colitis. Clin. Med. Res. 2014, 3(4), 96-104. doi: 10.11648/j.cmr.20140304.14

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AMA Style

Arafat A. Kassem, Amir A. Fikry, Doaa Shahin, Hosam Aldeen Salah Shabana, Sadek Mostafa. Fecal Calprotectin and Transforming Growth Factor-b1 in the Evaluation of Disease Activity in Patients with Ulcerative Colitis. Clin Med Res. 2014;3(4):96-104. doi: 10.11648/j.cmr.20140304.14

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@article{10.11648/j.cmr.20140304.14,
  author = {Arafat A. Kassem and Amir A. Fikry and Doaa Shahin and Hosam Aldeen Salah Shabana and Sadek Mostafa},
  title = {Fecal Calprotectin and Transforming Growth Factor-b1 in the Evaluation of Disease Activity in Patients with Ulcerative Colitis},
  journal = {Clinical Medicine Research},
  volume = {3},
  number = {4},
  pages = {96-104},
  doi = {10.11648/j.cmr.20140304.14},
  url = {https://doi.org/10.11648/j.cmr.20140304.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20140304.14},
  abstract = {Aims: to evaluate the correlation between endoscopic disease activity, and fecal calprotectin, transforming growth factor-B1, Clinical Activity Index, C- reactive protein, and blood leucocytes. Methods: Ninety two patients with ulcerative colitis were enrolled and scored according to the endoscopic part of the Rachmilewitz Index. Patients and controls provided fecal and blood samples for measuring calprotectin, TGF-B1, CRP, and leucocytes. Results: The values in ulcerative colitis patients (n = 92) compared to controls (n = 20): calprotectin: 728.9 ± 388.4 versus 22.9 ± 12.9 µg / g, TGF-B1: 350.1 ± 214.7 versus 4.3 ± 2.01 pg /Ml, CRP: 36.9 ± 20.3 versus 3.5 ± 1.9m g/L, blood leucocytes: 13.8 ± 4.5 versus 7.3 ± 1.8 g/ L (all P< 0.001). Endoscopic disease activity correlated significantly with calprotectin (Spearman’s rank correlation coefficient r = 0.545), TGF-B1 (r = 0.531), Clinical Activity Index (r = 0. 520), CRP (r = 0.481), and blood leucocytes (r = 436). Calprotectin and TGF-B1 levels were significantly lower in ulcerative colitis patients with inactive disease ( endoscopic score 0 -3, calprotectin 60.5 ± 47.8 µg / g, TGF-B1 39.9 ± 35.4 pg/Ml , P < 0.001), compared to patients with mild ( score 4 – 6, calprotectin 460.2 ±240 µg/g, TGF-B1 172.4 ± 88.2 pg/ Ml, P < 0.001 ), moderate ( score 7 – 9, calprotectin 797.9 ± 239.2 µg/g, TGF-B1 352.6 ± 89.9 pg/Ml, P < 0.001 ), and high disease ( score 10 – 12 , calprotectin 969.2 ±268.9 µg/g, TGF-B1 486.8 ± 211.2 Pg/ Ml, P < 0.001). The overall accuracy for detection of histopathological active disease was 96.7 % for fecal calprotectin, 94.5 % for TGF-B1, 90 % for Endoscopic Activity Index, 87 % for Clinical Activity Index, and 65 % for both blood leucocytes and CRP. Conclusion: Both fecal calprotectin and TGF-B1 correlated significantly with endoscopic disease activity, clinical activity index, CRP, and blood leucocytes. Furthermore, both calprotectin and TGF-B1 were suitable markers that can differentiate endoscopically and histopathologically inactive from active disease, thus, these two biomarkers may be used for monitoring ulcerative colitis activity.},
 year = {2014}
}

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TY  - JOUR
T1  - Fecal Calprotectin and Transforming Growth Factor-b1 in the Evaluation of Disease Activity in Patients with Ulcerative Colitis
AU  - Arafat A. Kassem
AU  - Amir A. Fikry
AU  - Doaa Shahin
AU  - Hosam Aldeen Salah Shabana
AU  - Sadek Mostafa
Y1  - 2014/07/30
PY  - 2014
N1  - https://doi.org/10.11648/j.cmr.20140304.14
DO  - 10.11648/j.cmr.20140304.14
T2  - Clinical Medicine Research
JF  - Clinical Medicine Research
JO  - Clinical Medicine Research
SP  - 96
EP  - 104
PB  - Science Publishing Group
SN  - 2326-9057
UR  - https://doi.org/10.11648/j.cmr.20140304.14
AB  - Aims: to evaluate the correlation between endoscopic disease activity, and fecal calprotectin, transforming growth factor-B1, Clinical Activity Index, C- reactive protein, and blood leucocytes. Methods: Ninety two patients with ulcerative colitis were enrolled and scored according to the endoscopic part of the Rachmilewitz Index. Patients and controls provided fecal and blood samples for measuring calprotectin, TGF-B1, CRP, and leucocytes. Results: The values in ulcerative colitis patients (n = 92) compared to controls (n = 20): calprotectin: 728.9 ± 388.4 versus 22.9 ± 12.9 µg / g, TGF-B1: 350.1 ± 214.7 versus 4.3 ± 2.01 pg /Ml, CRP: 36.9 ± 20.3 versus 3.5 ± 1.9m g/L, blood leucocytes: 13.8 ± 4.5 versus 7.3 ± 1.8 g/ L (all P< 0.001). Endoscopic disease activity correlated significantly with calprotectin (Spearman’s rank correlation coefficient r = 0.545), TGF-B1 (r = 0.531), Clinical Activity Index (r = 0. 520), CRP (r = 0.481), and blood leucocytes (r = 436). Calprotectin and TGF-B1 levels were significantly lower in ulcerative colitis patients with inactive disease ( endoscopic score 0 -3, calprotectin 60.5 ± 47.8 µg / g, TGF-B1 39.9 ± 35.4 pg/Ml , P < 0.001), compared to patients with mild ( score 4 – 6, calprotectin 460.2 ±240 µg/g, TGF-B1 172.4 ± 88.2 pg/ Ml, P < 0.001 ), moderate ( score 7 – 9, calprotectin 797.9 ± 239.2 µg/g, TGF-B1 352.6 ± 89.9 pg/Ml, P < 0.001 ), and high disease ( score 10 – 12 , calprotectin 969.2 ±268.9 µg/g, TGF-B1 486.8 ± 211.2 Pg/ Ml, P < 0.001). The overall accuracy for detection of histopathological active disease was 96.7 % for fecal calprotectin, 94.5 % for TGF-B1, 90 % for Endoscopic Activity Index, 87 % for Clinical Activity Index, and 65 % for both blood leucocytes and CRP. Conclusion: Both fecal calprotectin and TGF-B1 correlated significantly with endoscopic disease activity, clinical activity index, CRP, and blood leucocytes. Furthermore, both calprotectin and TGF-B1 were suitable markers that can differentiate endoscopically and histopathologically inactive from active disease, thus, these two biomarkers may be used for monitoring ulcerative colitis activity.
VL  - 3
IS  - 4
ER  -

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