Comparisons between myeloperoxidase, lactoferrin, calprotectin and lipocalin-2, as fecal biomarkers of intestinal inflammation in malnourished children

Mara de Moura Gondim Prata, A Havt, D T Bolick, R Pinkerton, Aam Lima, R L Guerrant, Mara de Moura Gondim Prata, A Havt, D T Bolick, R Pinkerton, Aam Lima, R L Guerrant

Abstract

Fecal biomarkers have emerged as important tools to assess intestinal inflammation and enteropathy. The aim of this study was to investigate the correlations between the fecal markers, myeloperoxidase (MPO), lactoferrin (FL), calprotectin (FC) and lipocalin-2 (Lcn-2), and to compare differences by breastfeeding status as well as normalization by fecal protein or by fecal weight. Simultaneous, quantitative MPO, FL, FC and Lcn-2, levels were determined in frozen fecal specimens collected from 78 children (mean age 15.2 ± 5.3 months) in a case-control study of childhood malnutrition in Brazil. The biomarker concentrations were measured by enzymelinked immunosorbent assay. The correlations among all biomarkers were significant (P<0.01). There were stronger correlations of fecal MPO with fecal lactoferrin and calprotectin, with lower, but still highly significant correlations of all 3 inflammatory biomarkers with Lcn-2 likely because the latter may also reflect enterocyte damage as well as neutrophil presence. Furthermore, the biomarker results with protein normalized compared to simple fecal weight normalized values showed only a slightly better correlation suggesting that the added cost and time for protein normalization added little to carefully measured fecal weights as denominators. In conclusion, fecal MPO correlates tightly with fecal lactoferrin and calprotectin irrespective of breastfeeding status and provides a common, available biomarker for comparison of human and animal model studies.

Keywords: biomarkers; calprotectin; enteropathy; inflammation; lactoferrin; lipocalin; malnutrition; myeloperoxidase.

Conflict of interest statement

All authors have read the journal’s authorship agreement and policy on conflicts of interest and declare no conflicts.

Figures

Figure 1
Figure 1
Pearson correlations of the natural log transformed (LN) between fecal MPO and the other biomarker with stool weight normalized and protein normalized in samples from malnutrition children. Stool weight normalized: (a) FL (P

Figure 2

Pearson correlations of the natural…

Figure 2

Pearson correlations of the natural log transformed (LN) between FL vs Lcn-2 and…

Figure 2
Pearson correlations of the natural log transformed (LN) between FL vs Lcn-2 and FC and Lcn-2 vs FC with stool weight normalized and protein normalized in samples from malnutrition children. Stool weight normalized: (a) FL vs FC (P

Figure 3

Graph of mean fecal lactoferrin…

Figure 3

Graph of mean fecal lactoferrin (FL) based on breastfeeding status (p=0.051).

Figure 3
Graph of mean fecal lactoferrin (FL) based on breastfeeding status (p=0.051).

Figure 4

Correlation of Ln fecal lactoferrin…

Figure 4

Correlation of Ln fecal lactoferrin with fecal myeloperoxidse (MPO) measurements, showing the linear…

Figure 4
Correlation of Ln fecal lactoferrin with fecal myeloperoxidse (MPO) measurements, showing the linear regression line +s.e.mean (y = −1.04+1.02*x; n = 78; p
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References
    1. Lehmann FS, Burri E, Beglinger C. The role and utility of faecal markers in inflammatory bowel disease. Therap Adv Gastroenterol. 2015;8:23–36. - PMC - PubMed
    1. Guerrant RL, Araujo V, Soares E, Kotloff K, Lima AA, et al. Measurement of fecal lactoferrin as a marker of fecal leukocytes. J Clin Microbiol. 1992;30:1238–1242. - PMC - PubMed
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    1. Assche GV. Fecal biomarkers for the diagnosis and management of inflammatory bowel disease. Gastroenterol Hepatol (N Y) 2011;7:396–398. - PMC - PubMed
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Figure 2
Figure 2
Pearson correlations of the natural log transformed (LN) between FL vs Lcn-2 and FC and Lcn-2 vs FC with stool weight normalized and protein normalized in samples from malnutrition children. Stool weight normalized: (a) FL vs FC (P

Figure 3

Graph of mean fecal lactoferrin…

Figure 3

Graph of mean fecal lactoferrin (FL) based on breastfeeding status (p=0.051).

Figure 3
Graph of mean fecal lactoferrin (FL) based on breastfeeding status (p=0.051).

Figure 4

Correlation of Ln fecal lactoferrin…

Figure 4

Correlation of Ln fecal lactoferrin with fecal myeloperoxidse (MPO) measurements, showing the linear…

Figure 4
Correlation of Ln fecal lactoferrin with fecal myeloperoxidse (MPO) measurements, showing the linear regression line +s.e.mean (y = −1.04+1.02*x; n = 78; p
Similar articles
Cited by
References
    1. Lehmann FS, Burri E, Beglinger C. The role and utility of faecal markers in inflammatory bowel disease. Therap Adv Gastroenterol. 2015;8:23–36. - PMC - PubMed
    1. Guerrant RL, Araujo V, Soares E, Kotloff K, Lima AA, et al. Measurement of fecal lactoferrin as a marker of fecal leukocytes. J Clin Microbiol. 1992;30:1238–1242. - PMC - PubMed
    1. Archbald-Pannone L, Sevilleja JE, Guerrant R. Diarrhea, clostridium difficile, and intestinal inflammation in residents of a long-term care facility. J Am Med Dir Assoc. 2010;11:263–267. - PMC - PubMed
    1. Wright EK. Calprotectin or Lactoferrin: Do They Help. Dig Dis. 2016;34:98–104. - PubMed
    1. Assche GV. Fecal biomarkers for the diagnosis and management of inflammatory bowel disease. Gastroenterol Hepatol (N Y) 2011;7:396–398. - PMC - PubMed
Show all 47 references
Related information
LinkOut - more resources
Full text links [x]
[x]
Cite
Copy Download .nbib
Format: AMA APA MLA NLM
Figure 3
Figure 3
Graph of mean fecal lactoferrin (FL) based on breastfeeding status (p=0.051).
Figure 4
Figure 4
Correlation of Ln fecal lactoferrin with fecal myeloperoxidse (MPO) measurements, showing the linear regression line +s.e.mean (y = −1.04+1.02*x; n = 78; p

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