Abstract
Rationale: Increased gut permeability and inflammation occurs during active inflammatory bowel disease (IBD), however, a proper understanding in clinical remission remains to be elucidated. Objective: Measured fecal zonulin and calprotectin of patients with ulcerative colitis (UC) and Crohn’s disease (CD) in clinical remission and predicting relapse.
Methods: Prospective longitudinal cohort study of 40 IBD patients (20 CD and 20 UC) in clinical remission and 45 matched healthy controls. Fecal zonulin and calprotectin levels were measured using enzyme-linked immunosorbent assays. Receiver operating characteristic curve analyses were used to determine the diagnostic index values for zonulin fecal levels. Correlations of fecal zonulin and calprotectin with biochemical and clinical markers were tested using Spearman and Pearson correlations. Adjusted linear regression models were used to predict relapse activity disease after 6-months.
Results: Fecal zonulin concentrations were higher in IBD patients (UC and CD) than in healthy controls (p < 0.010) and showed excellent accuracy in discriminating these groups of patients (area under the curve = 0.9483). Levels of fecal zonulin exhibited an inverse correlation with serum 25(OH)D levels (p = 0.045). High fecal zonulin concentrations were significantly associated with high fecal calprotectin levels, but did not predict disease activity. Baseline fecal calprotectin levels > 250 μg/g predicted clinical relapse after 6 months (adjusted odds ratio = 8.838; 95% confidence interval [CI] 1.116–66.997; p = 0.035).
Conclusion: Fecal zonulin showed excellent performance identifying intestinal permeability in these patients, and its levels were influenced by calprotectin levels, predictor of relapse in 6-months.
Disclosure of Interest: None declared
