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Gut 56:1706-1713 doi:10.1136/gut.2006.113431
  • Inflammatory bowel disease

Faecal S100A12 as a non-invasive marker distinguishing inflammatory bowel disease from irritable bowel syndrome

  1. T Kaiser1,
  2. J Langhorst2,
  3. H Wittkowski3,
  4. K Becker4,
  5. A W Friedrich5,
  6. A Rueffer6,
  7. G J Dobos2,
  8. J Roth7,
  9. D Foell1
  1. 1
    Department of Pediatrics, University of Muenster, Muenster, Germany
  2. 2
    Department of Internal Medicine, Kliniken Essen-Mitte, University of Duisburg, Essen, Germany
  3. 3
    Interdisciplinary Center of Clinical Research, University of Muenster, Muenster, Germany
  4. 4
    Institute of Medical Microbiology, University of Muenster, Muenster, Germany
  5. 5
    Institute of Hygiene, University of Muenster, Muenster, Germany
  6. 6
    Laboratory L+S AG, Bad Bocklet, Grossenbrach, Germany
  7. 7
    Institute of Experimental Dermatology, University of Muenster, Muenster, Germany
  1. Dr D Foell, Department of Pediatrics, University of Muenster, Albert-Schweitzer-Str. 33, D-48149 Muenster, Germany; dfoell{at}uni-muenster.de
  • Revised 28 June 2007
  • Accepted 17 July 2007
  • Published Online First 3 August 2007

Abstract

Objective: S100A12 is a pro-inflammatory protein that is secreted by granulocytes. S100A12 serum levels increase during inflammatory bowel disease (IBD). We performed the first study analysing faecal S100A12 in adults with signs of intestinal inflammation.

Methods: Faecal S100A12 was determined by ELISA in faecal specimens of 171 consecutive patients and 24 healthy controls. Patients either suffered from infectious gastroenteritis confirmed by stool analysis (65 bacterial, 23 viral) or underwent endoscopic and histological investigation (32 with Crohn’s disease, 27 with ulcerative colitis, and 24 with irritable bowel syndrome; IBS). Intestinal S100A12 expression was analysed in biopsies obtained from all patients. Faecal calprotectin was used as an additional non-invasive surrogate marker.

Results: Faecal S100A12 was significantly higher in patients with active IBD (2.45 ± 1.15 mg/kg) compared with healthy controls (0.006 ± 0.03 mg/kg; p<0.001) or patients with IBS (0.05 ± 0.11 mg/kg; p<0.001). Faecal S100A12 distinguished active IBD from healthy controls with a sensitivity of 86% and a specificity of 100%. We also found excellent sensitivity of 86% and specificity of 96% for distinguishing IBD from IBS. Faecal S100A12 was also elevated in bacterial enteritis but not in viral gastroenteritis. Faecal S100A12 correlated better with intestinal inflammation than faecal calprotectin or other biomarkers.

Conclusions: Faecal S100A12 is a novel non-invasive marker distinguishing IBD from IBS or healthy individuals with a high sensitivity and specificity. Furthermore, S100A12 reflects inflammatory activity of chronic IBD. As a marker for neutrophil activation, faecal S100A12 may significantly improve our arsenal of non-invasive biomarkers of intestinal inflammation.

Footnotes

  • The first two authors contributed equally to this work

  • Funding: This work was supported by grants from the Broad Medical Research Program (IBD-0076) and the Interdisciplinary Clinical Research Center at the University of Muenster (Foe2/005/06).

  • Competing interests: None.

  • Abbreviations:
    IBD
    inflammatory bowel disease
    IBS
    irritable bowel syndrome
    CAI
    colitis activity index
    CDAI
    Crohn’s disease activity index
    CRP
    C-reactive protein
    ESR
    erythrocyte sedimentation rate
    RAGE
    receptor for advanced glycation endproducts