Evaluation of the possibility of using fecal calprotectin for the diagnosis of inflammatory bowel diseases in patients with ankylosing spondylitis
https://doi.org/10.33667/2078-5631-2026-12-44-48
Abstract
The aim. To evaluate the possibility of using fecal calprotectin levels for early diagnosis of inflammatory bowel diseases in patients with AS in real clinical practice. Materials and methods. The analysis included 70 patients with a confirmed diagnosis of AS over the age of 18: 52 men (74.3 %) and 18 women (25.7 %), aged 47.4±8.8 years, with a disease duration of 19.6±7.9 years. All patients underwent blood tests (ESR, CRP, HLAB 27 antigen levels), esophagogastroduodenoscopy and colonoscopy, quantitative analysis of the fecal calprotectin levels using the method of lateral immunochromatography with the BUHLMANN Quantum Blue rapid test (standart range: 100–1800 μg/g). Results. All patients had high disease activity: BASDAI was 5.4±1.4, ASDAS CRP – 3.6±0.8. IBD was diagnosed in 18 cases (25.7 %). In 77 % of patients with AS, the FC level exceeded 100 μg/g, and in 28 % it exceeded 1800 μg/l. The FC level was more than 1000 μg/g in 63 %. In patients with IBD, the FC level was more than 100 μg/g, and the average FC level was higher in patients with IBD (1141.3 μg/g) than without IBD (787 μg/g). No active IBD was detected in all patients with FC levels less than 300 μg/g of feces. FC levels correlated with CRP (r=0.366) and ESR (r=0.366) (p<0.001). A positive HLAB 27 antigen was found in all patients with IBD. Conclusion. Patients with AS and IBD had higher FC levels than patients without IBD. Normal FC levels in patients with AS indicate the absence of intestinal inflammation. There was also a correlation between increased FC levels and the severity of AS. According to the study, measuring fecal calprotectin levels may be useful for detecting intestinal inflammation at an early stage.
About the Authors
P. I. Kulakova
A. S. Loginov Moscow Clinical Research Center, Moscow Department of Health
Russian Federation
Russian Federation
Kulakova Polina I., rheumatologist at Dept of Rheumatology
G. V. Lukina
A. S. Loginov Moscow Clinical Research Center, Moscow Department of Health; V. A. Nasonova Scientific and Research Institute of Rheumatology
Russian Federation
Russian Federation
Lukina Galina V., Dr Med Sci (habil.), professor, head of Dept of Rheumatology, Head of the Moscow rheumatology center; leading researcher at the Laboratory of Rheumatoid Arthritis and Comorbid Infections
E. A. Alexandrova
A. S. Loginov Moscow Clinical Research Center, Moscow Department of Health
Russian Federation
Russian Federation
Alexandrova Elena N. Dr Med Sci (habil.), head of Dept of Clinical Immunology
A. A. Novikov
A. S. Loginov Moscow Clinical Research Center, Moscow Department of Health
Russian Federation
Russian Federation
Novikov Alexandr A., Dr Bio Sci (habil.), leading researcher at Dept of Clinical Immunology
M. A. Borisova
A. S. Loginov Moscow Clinical Research Center, Moscow Department of Health
Russian Federation
Russian Federation
Borisova Maria A., PhD Med Sci, senior researcher at Dept of Rheumatology
References
1. Erdes Sh.F., Rebrov A. P., Dubinina T. V. et al. Spondyloarthritis: modern terminology and definitions. Therapeutic Archive. 2019; 91 (5): 84–88. (In Russ.). DOI: 10.26442/00403660.2019.05.000208
2. Magro F., Langner C., Driessen A., Ensari A., Geboes K. et al. Europ. Soc. Pathol. Europ Crohn’s Colitis Org (ECCO). European consensus on the histopathology of inflammatory bowel disease. J. Crohns Colitis. 2013 Nov; 7 (10): 827–51. DOI: 10.1016/j.crohns.2013.06.001
3. Ondrejčáková L., Gregová M., Bubová K., Šenolt L., Pavelka K. Serum biomarkers and their relationship to axial spondyloarthritis associated with inflammatory bowel diseases. Autoimmun Rev. 2024; 23 (3): 103512. DOI: 10.1016/j.autrev.2023.103512
4. Klingberg E., Strid H., Deminger A., Carlsten H. et al. A longitudinal study of fecal calprotectin and the development of inflammatory bowel disease in ankylosing spondylitis. Arthritis Research and Therapy. 2017; 19 (1): 21. (Sweden). DOI: 10.1186/s13075-017-1223-2
5. Cypers H., Varkas G., Beeckman S., Debusschere K., Vogl T., Roth J. et al. Elevated calprotectin levels reveal bowel inflammation in spondyloarthritis. Annals of the Rheumatic Diseases. 2016; 75: 1357–1362. DOI: 10.1136/annrheumdis-2015–208025
6. Campos J., Resende G., Barbosa A., de Carvalho S., Lage J., Cunha P., de Souza S., Ferrari M.. Fecal calprotectin as a biomarker of microscopic bowel inflammation in patients with spondyloarthritis. Int J Rheum Dis. 2022 Sep; 25 (9): 1078–1086. DOI: 10.1111/1756-185X.14388
7. Godzenko A. A., Bochkova A. G., Rumyantseva O. A. et al. The frequency and severity of extraskeletal manifestations of ankylosing spondylitis. Nauchno-Prakticheskaya Revmatologiya = Rheumatology Science and Practice. 2017; 55 (2): 169–176. (In Russ.). DOI: 10.14412/1995-4484-2017-169-176
8. Lukina G. V., Kulakova P. I., Novikov A. A., Savenkova N. A., Alexandrova E. A., Volnukhin E. V., Kovshik A. N. Frequency of inflammatory bowel diseases in patients with ankylosing spondylitis. Medical alphabet. 2019; 2 (37): 12–15. (In Russ.). DOI: 10.33667/2078-5631-2019-2-37(412)-12-15
9. Martin R., Dominique B. Ankylosing spondylitis and bowel disease. Best Practice and Research Clinical Rheumatololgy. 2006; 20 (3): 451–71. DOI: 10.1016/j.berh.2006.03.010
10. Bahri R., Elfarssani F., Khayati S., Eddyb S., Saffour H., Boukhira A., and Chellak S. Analytical characteristics of faecal and serum calprotectin or calprotectin assay: What clinical interest? GSC Advanced Research and Reviews. 2021; 6: 156–163. DOI: 10.30574/gscarr.2021.6.3.0052
11. Inciarte-Mundo J., Frade-Sosa B., Sanmartí R. From bench to bedside: Calprotectin (S 100A8/S 100A9) as a biomarker in rheumatoid arthritis. Front Immunol. 2022 Nov 3; 13: 1001025. DOI: 10.3389/fimmu.2022.1001025
12. Asan G., Derin M., Doğan H., Bayram M., Şahin M., Şahin A. Can Calprotectin Show Subclinical Inflammation in Familial Mediterranean Fever Patients? J Korean Med Sci. 2020 Mar 16; 35 (10): e63. DOI: 10.3346/jkms.2020.35.e63
13. Avdeeva A. S. Clinical significance of calprotectin in rheumatic diseases. Nauchno-Prakticheskaya Revmatologiya = Rheumatology Science and Practice. 2018; 56 (4): 494–499. (In Russ.). DOI: 10.14412/1995-4484-2018-494-499
14. Hu H., Du F., Zhang S., Zhang W. Serum calprotectin correlates with risk and disease severity of ankylosing spondylitis and its change during first month might predict favorable response to treatment. Mod Rheumatol. 2019 Sep; 29 (5): 836–842. DOI: 10.1080/14397595.2018.1519103
15. Lukina G. V., Kulakova P. I., Novikov A. A., Alexandrova E. N., Savenkova N. A., Volnukhin E. V., Kovshik A. N., Klimets A. G. Role of serum calprotectin in diagnosis of inflammatory bowel diseases in patients with ankylosing spondylitis (preliminary results). Medical alphabet. 2021; (33): 16–19. (In Russ.). DOI: 10.33667/2078-5631-2021-33-16-19
16. Lazebnik L. B., Gusein-Zade M.G., Efremov L. I., Saginbaeva V. E., Knyazev O. V. Fecal calprotectin as biomarker of the effectiveness of various medical interventions in patients with inflammatory bowel diseases. Therapeutic gastroenterology. 2013; 8: 11–16. (In Russ.).
17. Ayling R. M., Kok K. Fecal Calprotectin. Advanced in Clinical Chemistry. 2018; 87: 161–190. DOI: 10.1016/bs.acc.2018.07.005
18. Taina S, Kaija-Leena K. Fecal calprotectin in diagnosis and clinical assessment of inflammatory bowel disease. Scandinavian Journal of Gastroenterology. 2015; 5 (1): 74–80. DOI: 10.3109/00365521.2014.987809
19. Hana M., Valеrie C., Hervе P. and Katell P. Fecal calprotectin in inflammatory bowel diseases: update and perspectives. Clinical Chemistry and Laboratory Medicine. 2017; 55 (4): 474–483. DOI: 10.1515/cclm-2016-0522
20. D’Haens G., Ferrante M., Vermeire S., Baert F., Noman M., Moortgat L. Fecal calprotectin is a surrogate marker for endoscopic lesions in inflammatory bowel disease. Inflammatory Bowel Disease. 2012; 18: 2218–24. DOI: 10.1002/ibd.22917
21. Wang W., Cao W., Zhang S., Chen D., Liu L. The Role of Calprotectin in the Diagnosis and Treatment of Inflammatory Bowel Disease. Int J Mol Sci. 2025 Feb 25; 26 (5): 1996. DOI: 10.3390/ijms26051996
22. Michael M., Emanuel B., Claude R., Nuschin T., Christian N., Livio R., Christoph B., Frank S. Value of fecal calprotectin in the evaluation of patients with abdominal discomfort: an observational study. BMC Gastroenterology. 2012. DOI: 10.1186/1471-230X-12-5
23. Hanania A., Jiang, Jang Z., Smiley C., Lasco T., Garey K., Dupont H. Calprotectin in the Diagnosis of Infection. Infectious Diseases in Clinical Practice. 2016; 24 (1): 31–34. DOI: 10.1097/IPC.0000000000000312
24. Poullis A., Foster R., Mendall M. Proton pump inhibitors are associated with elevation of faecal calprotectin and may affect specificity. European Journal of Gastroenterology & Hepatology. 2003; 15: 573–574. DOI: 10.1097/01.meg.0000059108.41030.23
25. Khosravi P., Abroun S., Kaviani S., Masoudifar S., Farahani H. S. Calprotectin as new potential clinical marker for multiple myeloma. PLoS One. 2023 Mar 16; 18 (3): e0282841. DOI: 10.1371/journal.pone.0282841
26. Tibble J., Sigthorsson G., Foster R., Scott D., Fagerhol M., Roseth A., Bjarnason I. High prevalence of NSAID enteropathy as shown by a simple faecal test. Gut. 1999; 45 (3): 362–366. DOI: 10.1136/gut.45.3.362
27. Ercalik C., Baskaya M. C., Ozdem S., Butun B. Investigation of asymptomatic intestinal inflammation in ankylosing spondylitis by fecal calprotectin. Arab J Gastroenterol. 2021 Dec; 22 (4): 272–277. DOI: 10.1016/j.ajg.2021.05.020
28. Arzu D., Senol K., Nazime S., Seniha A., Tennur A., Mehmet O. Fecal calprotectin is associated with disease activity in patients with ankylosing spondylitis. Bosnian Journal of Basic Medical Sciences. 2016; 16 (1): 71–4. DOI: 10.17305/bjbms.2016.752
29. Sternes P. R., Brett L., Phipps J., Ciccia F., Kenna T., et al. Distinctive gut microbiomes of ankylosing spondylitis and inflammatory bowel disease patients suggest differing roles in pathogenesis and correlate with disease activity. Arthritis Res Ther. 2022 Jul 7; 24 (1): 163. DOI: 10.1186/s13075-022-02853-3
30. Coorevits L., Baert F. J., Vanpoucke H. J. Faecal calprotectin: comparative study of the Quantum Blue rapid test and an established ELISA method. Clin Chem Lab Med. 2013 Apr; 51 (4): 825–31. DOI: 10.1515/cclm-2012-0386
31. Hijos-Mallada G., Sostres C., Gomollón F. NSAIDs, gastrointestinal toxicity and inflammatory bowel disease. Gastroenterol Hepatol. 2022 Mar; 45 (3): 215–222. English, Spanish. DOI: 10.1016/j.gastrohep.2021.06.003
32. Long M. D., Kappelman M. D., Martin C. F., Chen W., Anton K., Sandler R. S. Role of Nonsteroidal Anti-Inflammatory Drugs in Exacerbations of Inflammatory Bowel Disease. J Clin Gastroenterol. 2016 Feb; 50 (2): 152–6. DOI: 10.1097/MCG.0000000000000421
33. Korzenik J., Larsen M. D., Nielsen J., Kjeldsen J., Nørgård B. M. Increased risk of developing Crohn's disease or ulcerative colitis in 17018 patients while under treatment with anti-TNFα agents, particularly etanercept, for autoimmune diseases other than inflammatory bowel disease. Aliment Pharmacol Ther. 2019 Aug; 50 (3): 289–294. DOI: 0.1111/apt.15370
34. Letarouilly J. G., Pham T., Pierache A., Acquacalda É., Banneville B., Barbarot S., Baudart P., Bauer É., Claudepierre P., Constantin A., Dernis E. et al. New-onset inflammatory bowel diseases among IL-17 inhibitor-treated patients: results from the case-control MISSIL study. Rheumatology (Oxford). 2022 Jul 6; 61 (7): 2848–2855. DOI: 0.1093/rheumatology/keab819
35. Alsakarneh S., Al Ta'ani O., Aburumman R., Mikhail I., Hashash J. G., Farraye F. A. Risk of De Novo Inflammatory Bowel Disease in Patients With Psoriasis and Psoriatic Arthritis Treated With IL-17A Inhibitors: A Population-Based Study. Aliment Pharmacol Ther. 2025 Jul; 62 (1): 72–76. DOI: 10.1111/apt.70139
36. Lukina G. V., Knyazev O. V., Belousova E. A., Abdulganieva D. I., Aleksandrova E. N., Bakulin I. G., Barysheva O. Yu, Borisova M. А. et al. Russian Cross-disciplinary Consensus on the diagnosis and treatment of spondyloarthritis associated with inflammatory bowel diseases. Terapevticheskii Arkhiv (Ter. Arkh.). 2025; 97 (2): 198–213. DOI: 10.26442/00403660.2025.02.203117
37. Van der Linden S., Valkenburg H., Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheumatology. 1984; 27 (4): 361–8. DOI: 10.1002/art.1780270401
38. Malickova K., Janatkova I., Bortlik M., Komarek V., Lukas M. Calprotectin levels in patients with idiopathic inflammatory bowel disease comparison of two commercial tests. Journal of Epidemiology, Mikrobiology and Imunology. 2008; 57 (4): 147–53.
39. Hengameh C., Bachmann U., Ingdam S., Krogfelt K. and Munk A. Comparison of three com mercial fecal calprotectin ELISA test kits used in patients with Inflammatory Bowel Disease. Scan dinavian Journal of Gastroenterology. 2015; 51 (2): 1–7. DOI: 10.3109/00365521.2015.1081399
40. Simioni J., Skare T. L., Campos A., Kotze L., Messias-Reason I., Ioshii S., Nisihara R. Fecal Calprotectin, Gut Inflammation and Spondyloarthritis. Arch Med Res. 2019 Jan; 50 (1): 41–46. DOI: 10.1016/j.arcmed.2019.04.003
41. Ma Y., Fan D., Xu S., Deng J., Gao X., Guan S., Pan F.. Calprotectin in spondyloarthritis: A systematic review and meta-analysis. Int Immunopharmacol. 2020 Nov; 88: 106948. DOI: 10.1016/j.intimp.2020
42. Duran A., Kobak S., Sen N., Aktakka S., Atabay T., Orman M. Fecal calprotectin is associated with disease activity in patients with ankylosing spondylitis. Bosn J Basic Med Sci. 2016 Jan 1; 16 (1): 71–4. DOI: 10.17305/bjbms.2016.752
43. Fauny M., D'Amico F., Bonovas S., Netter P., Danese S., Loeuille D., Peyrin-Biroulet L. Faecal Calprotectin for the Diagnosis of Bowel Inflammation in Patients With Rheumatological Diseases: A Systematic Review. J Crohns Colitis. 2020 Jun 19; 14 (5): 688–693. DOI: 10.1093/ecco-jcc/jjz205
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Kulakova P.I., Lukina G.V., Alexandrova E.A., Novikov A.A., Borisova M.A. Evaluation of the possibility of using fecal calprotectin for the diagnosis of inflammatory bowel diseases in patients with ankylosing spondylitis. Medical alphabet. 2026;(12):44-48. (In Russ.) https://doi.org/10.33667/2078-5631-2026-12-44-48
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