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Multicenter Study
. 2020 May;70(5):580-585.
doi: 10.1097/MPG.0000000000002615.

Fecal Markers of Inflammation and Disease Activity in Pediatric Crohn Disease: Results from the ImageKids Study

Steven T Leach  1 , Andrew S Day  2 , Rachel Messenger  3 , Thomas D Walters  4 , Victor M Navas-López  5 , Malgorzata Sladek  6 , Annecarin Brückner  7 , Baruch Yerushalmi  8 , Shehzad Saeed  9 , Anthony Otley  10 , David Mack  11   12 , Matan Gavish  13 , Dan Turner  14 , Anne M Griffiths  4 , Daniel A Lemberg  3 ; ImageKids study group
Affiliations
Multicenter Study

Fecal Markers of Inflammation and Disease Activity in Pediatric Crohn Disease: Results from the ImageKids Study

Steven T Leach et al. J Pediatr Gastroenterol Nutr. 2020 May.

Abstract

Background: Noninvasive and accurate methods to monitor inflammatory bowel disease are required. As a planned ancillary study of the prospective ImageKids cohort, we aimed to assess the performance of fecal calprotectin (FC) with comparison to 3 fecal inflammatory markers; S100A12 (FA12), tumor pyruvate kinase isoenzyme type M2 (FM2PK) and fecal osteoprotegerin (FOPG) as indicators of a number of disease characteristics.

Methods: The ImageKids study was a multicenter study designed to develop 2 magnetic resonance enterography-based measures for children with Crohn disease (6-18 years old). All patients underwent magnetic resonance enterography, a complete ileocolonoscopic evaluation and provided a fecal sample. Fecal samples were assay for FC, FA12, FM2PK, and FOPG by ELISA.

Results: One-hundred fifty-six children provided 190 fecal samples. Median (interquartile range) for fecal makers were FC, 602 (181-1185) μg/g; FA12, 21 (3-109) μg/g; FM2PK, 16 (2-20) U/mL; and FOPG, 125 (125-312) μg/g. All markers correlated with simple endoscopic severity index for Crohn disease and with other constructs of disease activity, but FC had the highest overall correlations. FA12, however, predicted mucosal healing with significantly higher specificity (87% vs 70%, P = 0.004) and equivalent sensitivity (91% vs 90%) compared to FC.

Conclusion: This study has confirmed that FC is useful, and overall best, marker to monitor mucosal inflammation in inflammatory bowel disease. FA12, however, appears to be a more suitable maker for prediction of mucosal healing in children.

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References

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