Allergy Asthma Immunol Res.  2014 Jan;6(1):33-38. 10.4168/aair.2014.6.1.33.

Can Fecal Calprotectin Level Be Used as a Markers of Inflammation in the Diagnosis and Follow-Up of Cow's Milk Protein Allergy?

• Beser OF
• Sancak S
• Erkan T
• Kutlu T
• Cokugras H
• Cokugras F

• KMID: 2166926
• DOI: http://doi.org/10.4168/aair.2014.6.1.33

Abstract

PURPOSE
Calprotectin is a cytosolic protein with immunomodulatory, antimicrobial, and antiproliferative actions. The concentration of calprotectin increases in infection, inflammation, and malignancy. We determined if calprotectin can be used as a marker for the diagnosis and follow-up of bowel inflammation in cow's milk protein allergy (CMPA).
METHODS
In total, 32 patients newly diagnosed with CMPA were included (24 IgE-mediated, 8 non-IgE-mediated). In all subjects, a complete blood count, total IgE, cow's milk-specific IgE, and fecal calprotectin (FC) were assessed before and after a cow's milk protein (CMP) elimination diet was started. The results were compared with those of 39 healthy children.
RESULTS
The mean FC value before the CMP elimination diet was 516+/-311 microg/g in the 32 patients with CMPA and 296+/-94 microg/g in the control group (P=0.011). The mean FC value after the diet in these patients was 254+/-169 microg/g, which was significantly different from the mean value before the CMP elimination diet (P<0.001). When we compared FC levels before the CMP elimination diet in the IgE-mediated group with the control group, we found no significant statistical difference (P=0.142). The mean FC value before the CMP elimination diet was 886+/-278 microg/g in the non-IgE-mediated group and 296+/-94 microg/g in the control group; this difference was statistically significant (P<0.001). In the IgE-mediated and non-IgE-mediated groups, FC values after CMP elimination diet were 218+/-90 microg/g and 359+/-288 microg/g, respectively, and FC values before CMP elimination diet were 392+/-209 microg/g and 886+/-278 microg/g, respectively; these differences were statistically significant (P=0.001 and P=0.025, respectively).
CONCLUSIONS
FC levels may be a useful marker for follow-up treatment and recurrence determination in CMPA.

Keyword

Milk hypersensitivity; milk protein; fecal calprotectin

MeSH Terms

Blood Cell Count
Child
Cytosol
Diagnosis*
Diet
Follow-Up Studies*
Humans
Hypersensitivity*
Immunoglobulin E
Inflammation*
Leukocyte L1 Antigen Complex*
Milk Hypersensitivity
Milk Proteins*
Milk*
Recurrence
Immunoglobulin E
Leukocyte L1 Antigen Complex
Milk Proteins

Figure

• 

  Fig. 1 Algorithm for infants and children with symptoms suggestive of cow's-milk protein allergy (CMPA).

• 

  Fig. 2 Comparison of fecal calprotectin levels before diet in CMPA patients with those in the control group.

• 

  Fig. 3 Comparison of fecal calprotectin levels before and after diet in patients with CMPA.

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