Assessment of disease activity in ulcerative colitis by faecal calprotectin, a novel granulocyte marker protein.

This study comprised 62 outpatients with ulcerative colitis who underwent 64 colonoscopies. The disease activity was evaluated according to endoscopic and histological criteria. The results revealed a significant correlation between both the endoscopic as well as the histological gradings of disease activity and faecal calprotectin. The median faecal calprotectin levels in the control group (6 mg/l) and in the patients with no or low disease activity (11.5 mg/l) were significantly different (p < 0.0001). The median calprotectin level among patients with active disease was 68 mg/l which was significantly different from the latter group (p < 0.0001). Furthermore, we suggest that the degree of inflammation rather than the extent of the disease determined the faecal calprotectin levels. In conclusion, assessment of faecal calprotectin seems to be a marker of disease activity in patients with ulcerative colitis.

Assessment of the neutrophil dominating protein calprotectin in feces. A methodologic study.

This study describes methods for extraction and quantification of calprotectin (L1 protein) in feces by enzyme immunoassay. This protein is a prominent antimicrobial component of neutrophils, monocytes, macrophages, and squamous epithelia. Calprotectin was stable in feces during storage for 7 days at room temperature. Small fecal samples taken from a 24-h feces collection gave a reliable estimate of calprotectin. Within-assay precision was 1.9%, and between-assay precision 14.8%. In healthy subjects (n = 33) median fecal calprotectin was 2025 micrograms/l and in hospital controls (n = 40) 10,500 micrograms/l. Median values in patients with Crohn's disease (n = 21) was 43,000 micrograms/l and in ulcerative colitis (n = 17) 40,000 micrograms/l. Fecal calprotectin was significantly correlated to fecal alpha 1-antitrypsin in the patients with Crohn's disease. Ten of 11 patients with gastrointestinal carcinomas had calprotectin level above the suggested reference limit of 6740 micrograms/l.

A critical evaluation of energy expenditure estimates based on individual O2 consumption/heart rate curves and average daily heart rate.

To test the applicability of indirect estimation of daily energy expenditure from average daily heart rate (HR) and individual O2-intake/heart rate (VO2/HR) regression lines in subjects with metabolic disorders, VO2/HR regression lines were determined on 2 consecutive days in 17 subjects (five healthy, five with obesity, five with untreated thyrotoxicosis, two with anorexia nervosa). Daily energy expenditure was calculated by means of the average 24 h HR. Generally, there was a high correlation coefficient for the relationship between VO2 and HR, but the slopes and intercepts varied considerably from day to day, leading to poor agreement between duplicate estimates of energy expenditures, and not infrequently to physiologically meaningless values. Further studies, comprising determination of the VO2/HR regression lines in three different body positions on 7 different days in one experienced test subject showed great variability of the VO2/HR regression lines, both in the same position and in different positions. The applied procedure seems unsuitable for metabolic studies in individual patients who engage in ordinary daily activities with low energy expenditure.