Calprotectin

Marker of Bowel Inflammation

Only a small proportion of patients with abdominal discomfort have a disease, but a correct diagnosis can seldom be made by simple clinical examination. The acute protein calprotectin (MRP 8/14) is useful in distinguishing between organic and functional intestinal diseases.

Calprotectin is the major protein of the neutrophil cytosol. It is excreted in excess in stool during inflammatory bowel disease.

The molecule has an important role in inflammatory processes and has direct antibacterial effects. Calprotectin is a surrogate marker of neutrophil influx into the bowel lumen.

Indications for the Determination of Fecal Calprotectin

Calprotectin has been established as a fecal marker of inflammatory bowel diseases (IBD). It allows a differentiation between organic and functional intestinal diseases and is ideal for monitoring disease activity and early detection of relapse. Also calprotectin differentiates between organic and functional diarrhea.

Prediction of IBD Relapse

Crohn's disease and ulcerative colitis are related conditions characterized by periods of remission marked by episodes of clinical relapse. The clinical implications of predicting which patients with (IBD) are likely to relapse are considerable. Such knowledge may allow targeted treatment at an earlier stage, with fewer side effects, to avert the relapse, as well as an assessment of new therapeutic strategies for maintaining symptomatic remission (Hodgson, 1999). A study has demonstrated the usefulness of fecal calprotectin in predicting relapse of IBD (Tibble et al., 2000). Calprotectin is ideal for monitoring disease activity (e.g. of Crohn's or after polyp resection) and early detection of the relapse. The differentiation between negative values, slightly increased values and high calprotectin values is important for excluding functional intestinal diseases (e.g. irritable bowel syndrome) and for the diagnosis and monitoring of organic intestinal diseases.