Faecal Lactoferrin- A novel test to differentiate between the irritable and inflamed bowel?

Reena Sidhu (1) , Mark E Mcalindon (2) , Perm Wilson (3) , Alison Wright (2) , Christopher Wh Yau (4) , Francesca A d'Cruz (2) , Alan J Lobo (2) , Stephen Morley (3) , Laura Foye (3)

1 Gastroenterology
2 Gastroenterology
3 Clinical Chemistry
4 Gastroenetrology

Background: Distinguishing between inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) can be challenging. Aims: To investigate the utility of faecal lactoferrin (LF) as a marker of inflammation in patients with IBD, IBS and controls. Methods: Disease activity in IBD patients were assessed using the modified Harvey-Bradshaw Activity Index. Stool samples were analysed using an ELISA assay. Results: 137 patients with IBS, 126 ulcerative colitis (UC) and 104 Crohn's disease (CD) and 98 healthy volunteers were recruited. The median ± IQ LF concentration (ug/g faecal weight) was 0 ± 1.4 for IBS patients, 6.6 ± 42 for UC patients, 4 ± 12.7 for CD patients and 0.5 ± 2 for healthy controls. LF levels were significantly higher in IBD patients compared to IBS/healthy controls (p<0.001). The median LF concentrations were significantly higher in active UC & CD patients compared to inactive patients ((p<0.001 and p=0.002 respectively). The sensitivity, specificity, positive and negative predictive values of LF in distinguishing active IBD from IBS/healthy controls was 67% and 96%, 87% and 86.8% respectively. Conclusion: LF is useful to differentiate between IBD and IBS and can be used as an adjunct to blood parameters to determine IBD patients who have ongoing inflammation.

Mots clés: Medicine

Reena Sidhu, Mark E Mcalindon, Perm Wilson, Alison Wright, Christopher Wh Yau, et al.. Faecal Lactoferrin- A novel test to differentiate between the irritable and inflamed bowel?. Alimentary Pharmacology and Therapeutics, 2010, 31 (12), pp.1365. ⟨10.1111/j.1365-2036.2010.04306.x⟩. ⟨hal-00552552⟩