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P239. Faecal lactoferrin and calprotectin level in fistulizing and non fistulizing Crohn's disease

M. Manelska1, L. Paradowski1, 1Medical University in Wroclaw Poland, Clinic of Gastroenterology and Hepatology, Wroclaw, Poland

Background

Fistulas are the one of most common Crohn's Disease (CD) complications. In patients with fistulizing CD phentotype is observed higher disease activity index (CDAI) than in non-fistulizing patients and lower ability to achive deep mucosal healing. Lactoferrin and calprotectin are the neutrophil-derived proteins released into mucosa and intestine lumen in the case of inflammation. Their concentration reflects local inflammation and due to predict the mucosal deep healing. The aim of the study was to evaluate the clinical usefulness of determining the fecal lactoferrin and calprotectin concentration of each specific Crohn's disease phenotypes: penetrating and non-penetrating depend on fistulas localization.

Methods

We examined 70 patients with CD, who were divided into two groups depending on the disease penetrating phenotype defined on the basis of the Montreal Classification. Penetrating group which enrolled patients with ileo-cunaneus fistulas consisted of 14 patients (64.5% from all fistulizing patients), ileo-ileal fistulas in 4 (17.5%), ileo-vescicular fistulas in 3 (13.5%) and 1 female patient with ileo-vaginal fistula (4.5%). Stool samples were analysed with the ELISA for assessement of lactoferrin and calprotectin concentration. Patients after extensive bowel resections or during glucocrticoid and non-steroidal anti-inflammatory drugs therapy were exluded.

Results

We found lactoferrin concentration exeeding the norm in 20/22 (91%) patients with penetrating disease, and in 18/48 (37.5%) with non-penetrating disease. Statistically significant higher faecal lactoferrin concentration was found in penetrating group (p = 0.014). No significant correlation was fund for faecal calprotctin concetration (p = 0.06). We found no statistically significant correlation between faecal lactoferrin concentration and localization of the fistulas (p = 0.051).

Conclusion

We conclude that faecal lactoferrin concentration is valuable tool to evaluate CD fistulizing patients. It is dependent on higher inflammation activity in patients with fistulas. There was no evidence of such close relationship for faecal calprotectin concentration.