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Fecal calprotectin, MMP-9, and human beta-defensin-2 levels in pediatric inflammatory bowel disease

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Abstract

Purpose

Fecal MMP-9 and human beta-defensin-2 (HBD-2) levels, potential markers of intestinal inflammation, are insufficiently explored in pediatric inflammatory bowel disease (IBD). The aim was to study fecal MMP-9 and HBD-2 in pediatric IBD to compare their performance to calprotectin and to study whether they would provide additional value in categorizing patients according to their disease subtype.

Methods

Fecal calprotectin, MMP-9, and HBD-2 levels were measured with ELISA in 110 pediatric patients with IBD (Crohn’s disease, n = 68; ulcerative colitis (UC), n = 27; unclassified, n = 15; median age, 14). To compare the performance of the fecal markers, the area under the receiver operating characteristics curve (±95 % CI) was used. In addition, the best cut-off values of each measure to differentiate IBD patients and controls (n = 27 presenting with diarrhea, abdominal pain, and/or anemia) were derived by maximizing sensitivity and specificity.

Results

Of the fecal markers studied, calprotectin performed best for separation of IBD and non-IBD patients with the area under curve (AUC) of 0.944 (95 % CI, 0.907 to 0.981). For MMP-9, AUC was 0.837 (95 % CI, 0.766 to 0.909), the levels being significantly higher in active IBD and in UC compared with Crohn’s disease (p = 0.0013), but categorization of these patient groups did not take place. HBD-2 did not categorize any of the studied groups.

Conclusions

Calprotectin was the best fecal marker in pediatric IBD, but MMP-9 showed almost comparable performance in UC, suggesting applicability as a surrogate marker of inflammation. Fecal HBD-2 did not bring information to the disease characteristics of pediatric IBD patients.

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Acknowledgments

The authors thank Ms. Anne Nikkonen for her excellent assistance in gathering the patient data. The study was supported by the Finnish Pediatric Research Foundation and by the Helsinki University Central Hospital Research Fund and Sigrid Jusélius Foundation.

Conflict of interest statement

There is no conflict of financial interest.

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Authors and Affiliations

  1. Children’s Hospital, Helsinki University Central Hospital and Helsinki University, Box 281, Helsinki, 00029, Finland

    Kaija-Leena Kolho, Elsa Valtonen & Erkki Savilahti

  2. Division of Gastroenterology, Department of Medicine, Helsinki University Central Hospital and Helsinki University, P.O.B. 340, Helsinki, Finland

    Taina Sipponen

Authors
  1. Kaija-Leena Kolho
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  2. Taina Sipponen
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  3. Elsa Valtonen
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  4. Erkki Savilahti
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Corresponding author

Correspondence to Kaija-Leena Kolho.

Additional information

The study was supported by the Finnish Pediatric Research Foundation and the Helsinki University Central Hospital Research Fund and Sigrid Jusélius Foundation.

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Kolho, KL., Sipponen, T., Valtonen, E. et al. Fecal calprotectin, MMP-9, and human beta-defensin-2 levels in pediatric inflammatory bowel disease. Int J Colorectal Dis 29, 43–50 (2014). https://doi.org/10.1007/s00384-013-1775-9

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  • DOI: https://doi.org/10.1007/s00384-013-1775-9

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