Calprotectin – Inflammation Marker in Stool
Calprotectin is an inflammation marker primarily measured in stool samples to detect intestinal inflammation and diagnose chronic inflammatory bowel diseases at an early stage.
Things worth knowing about "Calprotectin"
Calprotectin is an inflammation marker primarily measured in stool samples to detect intestinal inflammation and diagnose chronic inflammatory bowel diseases at an early stage.
What is Calprotectin?
Calprotectin is a calcium-binding protein found predominantly in neutrophil granulocytes – a specific type of white blood cell. It accounts for approximately 60% of the soluble cytoplasmic protein in these immune cells. When inflammation occurs in the body, granulocytes migrate into the affected tissue and release calprotectin. In the intestine, this protein can pass into the stool, making the measurement of fecal calprotectin a reliable inflammation marker for the gastrointestinal tract.
Medical Significance and Application
The measurement of calprotectin in stool is primarily used to differentiate inflammatory from non-inflammatory bowel conditions. It is especially important for distinguishing between:
- Chronic inflammatory bowel diseases (IBD) such as Crohn's disease and ulcerative colitis
- Irritable bowel syndrome (IBS), in which no true inflammation is present
Because irritable bowel syndrome and chronic inflammatory bowel diseases can cause similar symptoms, an elevated calprotectin level helps guide the decision for further diagnostic steps. Calprotectin is also used to monitor disease activity in patients with known IBD and to assess response to therapy.
Diagnosis – The Calprotectin Test
Fecal calprotectin is measured using a stool sample. The procedure is non-invasive and straightforward for patients. The normal value at most laboratories is below 50 µg/g of stool. Values between 50 and 200 µg/g are considered borderline and should be repeated, while values above 200 µg/g indicate significant intestinal inflammation.
Factors Influencing Calprotectin Levels
Several factors can affect the measured value:
- Use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or diclofenac can elevate levels
- Proton pump inhibitors may also lead to elevated values
- Certain gastrointestinal infections can temporarily raise calprotectin levels
- In children under 4 years of age, normal values are physiologically higher
Calprotectin in Inflammatory Bowel Disease
In patients with Crohn's disease or ulcerative colitis, fecal calprotectin levels correlate closely with histological and endoscopic disease activity. This makes it a valuable tool for:
- Detecting flare-ups early, before clinical symptoms become apparent
- Monitoring treatment response after initiation of therapy
- Better assessing the need for colonoscopy
Calprotectin in Blood
In addition to fecal calprotectin, the protein can also be measured in blood serum. Serum calprotectin serves as a general inflammation marker and is used in rheumatology and in the diagnosis of systemic inflammatory conditions. However, it is less specific for intestinal diseases than the stool-based measurement.
References
- Lehmann FS, Burri E, Beglinger C. – The role and utility of faecal markers in inflammatory bowel disease. – Therapeutic Advances in Gastroenterology, 2015.
- Waugh N et al. – Faecal calprotectin testing for differentiating amongst inflammatory and non-inflammatory bowel diseases. – Health Technology Assessment, 2013.
- Rubin DT et al. – ACG Clinical Guideline: Ulcerative Colitis in Adults. – American Journal of Gastroenterology, 2019.
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