IADR Abstract Archives
Salivary Calprotectin as an Early Marker of Inflammatory Bowel Disease
Objectives: Calprotectin is clinically most established as a fecal biomarker of inflammatory bowel disease (IBD). The calcium-binding antimicrobial protein complex is routinely used in diagnostic work-up of IBD patients to monitor disease activity and predict therapy response. This pilot study aimed to assess whether salivary calprotectin can aid in diagnosing and monitoring IBD.
Methods: Whole saliva (unstimulated and stimulated) was collected from 17 IBD patients with active intestinal inflammation verified by endoscopy, and from 15 healthy donors (mean age: 44±17 versus 24±2). Re-sampling of the IBD patients was performed 10-12 weeks after treatment intervention, during remission. Calprotectin concentrations were measured with an enzyme-linked immunoassay and related to clinical outcome and routine laboratory parameters. Statistical analysis was performed using analysis of covariance, Wilcoxon signed rank test and the area under the curve of Receiver- Operator Characteristic (AU-ROC). Data presented as mean ± SD.
Results: Calprotectin concentrations in stimulated whole saliva were up to 3-fold higher in IBD patients compared to healthy controls (16.9±2.0 versus 6.3±1.7 µg/ml, p=0.036). Calprotectin levels in unstimulated and stimulated saliva of newly diagnosed, treatment naïve patients were significantly higher compared to those previously diagnosed and treated (p=0.029, p=0.007). Further, calprotectin tends to decrease in unstimulated whole saliva of newly diagnosed, treatment naïve IBD patients (18.4±5.8 versus 7.1±4.0 µg/ml, n=5, p=0.063). The AU-ROC of calprotectin in unstimulated and stimulated whole saliva was 0.91 (95% CI: 0.79-1.02) and 0.85 (95% CI: 0.72-0.99) respectively (both p<0.001).
Conclusions: Our preliminary results suggest that salivary calprotectin is a potential early marker of IBD, with promising sensitivity and specificity in diagnosing and monitoring intestinal inflammation. We aim to further validate our findings in larger cohorts and investigate whether dental status confounds with our conclusion. If consistent, salivary calprotectin, which is easy to sample, might accelerate disease diagnosis and provide patients with possibilities of self-monitoring disease
Methods: Whole saliva (unstimulated and stimulated) was collected from 17 IBD patients with active intestinal inflammation verified by endoscopy, and from 15 healthy donors (mean age: 44±17 versus 24±2). Re-sampling of the IBD patients was performed 10-12 weeks after treatment intervention, during remission. Calprotectin concentrations were measured with an enzyme-linked immunoassay and related to clinical outcome and routine laboratory parameters. Statistical analysis was performed using analysis of covariance, Wilcoxon signed rank test and the area under the curve of Receiver- Operator Characteristic (AU-ROC). Data presented as mean ± SD.
Results: Calprotectin concentrations in stimulated whole saliva were up to 3-fold higher in IBD patients compared to healthy controls (16.9±2.0 versus 6.3±1.7 µg/ml, p=0.036). Calprotectin levels in unstimulated and stimulated saliva of newly diagnosed, treatment naïve patients were significantly higher compared to those previously diagnosed and treated (p=0.029, p=0.007). Further, calprotectin tends to decrease in unstimulated whole saliva of newly diagnosed, treatment naïve IBD patients (18.4±5.8 versus 7.1±4.0 µg/ml, n=5, p=0.063). The AU-ROC of calprotectin in unstimulated and stimulated whole saliva was 0.91 (95% CI: 0.79-1.02) and 0.85 (95% CI: 0.72-0.99) respectively (both p<0.001).
Conclusions: Our preliminary results suggest that salivary calprotectin is a potential early marker of IBD, with promising sensitivity and specificity in diagnosing and monitoring intestinal inflammation. We aim to further validate our findings in larger cohorts and investigate whether dental status confounds with our conclusion. If consistent, salivary calprotectin, which is easy to sample, might accelerate disease diagnosis and provide patients with possibilities of self-monitoring disease