Elevated Calprotectin Levels Reveal Loss of Vascular Pattern and Atrophy of Villi in Ileum by Digital Chromoendoscopy and Magnification Colonoscopy in Patients with Spondyloarthritis Without Having Inflammatory Bowel Disease

Objective: This study aimed to establish a correlation between fecal calprotectin levels (FC) and intestinal inflammation in patients with spondyloarthritis without inflammatory bowel disease. Methods: A total of 180 SpA patients were included in the study of them 20.6% required Digital chromoendosc...

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Main Authors: Juliette De Avila, Cristian Flórez-Sarmiento, Viviana Parra-Izquierdo, Wilson Bautista-Molano, Magaly Chamorro-Melo, Adriana Beltrán-Ostos, Diego Alejandro Jaimes, Valery Khoury, Lorena Chila-Moreno, Alejandro Ramos-Casallas, Juan Manuel Bello-Gualtero, Jaiber Gutiérrez, Cesar Pacheco-Tena, Philippe Selim Chalem Choueka, Consuelo Romero-Sánchez
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Language:English
Published: MDPI AG 2024-11-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/14/22/2591
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author Juliette De Avila
Cristian Flórez-Sarmiento
Viviana Parra-Izquierdo
Wilson Bautista-Molano
Magaly Chamorro-Melo
Adriana Beltrán-Ostos
Diego Alejandro Jaimes
Valery Khoury
Lorena Chila-Moreno
Alejandro Ramos-Casallas
Juan Manuel Bello-Gualtero
Jaiber Gutiérrez
Cesar Pacheco-Tena
Philippe Selim Chalem Choueka
Consuelo Romero-Sánchez
author_facet Juliette De Avila
Cristian Flórez-Sarmiento
Viviana Parra-Izquierdo
Wilson Bautista-Molano
Magaly Chamorro-Melo
Adriana Beltrán-Ostos
Diego Alejandro Jaimes
Valery Khoury
Lorena Chila-Moreno
Alejandro Ramos-Casallas
Juan Manuel Bello-Gualtero
Jaiber Gutiérrez
Cesar Pacheco-Tena
Philippe Selim Chalem Choueka
Consuelo Romero-Sánchez
author_sort Juliette De Avila
collection DOAJ
description Objective: This study aimed to establish a correlation between fecal calprotectin levels (FC) and intestinal inflammation in patients with spondyloarthritis without inflammatory bowel disease. Methods: A total of 180 SpA patients were included in the study of them 20.6% required Digital chromoendoscopy (DCE). FC, C-reactive protein (CRP), HLA-B*27 and clinical indices were assessed. Results: Positive fecal calprotectin (PFC) and high fecal calprotectin (HFC) levels were observed in 27.0% and 16.0% of patients, respectively. HFC correlated with a Bath Ankylosing Spondylitis Functional Index (BASFI) score > 4.0 (<i>p</i> = 0.036) and a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score > 4.0 (<i>p</i> = 0.047). Loss of vascular pattern in the ileum (LVPI) was observed in approximately 70.0% of patients (<i>p</i> = 0.005), which was associated with PFC and abdominal bloating (<i>p</i> = 0.020). LVPI was also linked to microscopic inflammation (<i>p</i> = 0.012) and PFC with abdominal pain (<i>p</i> = 0.007). HFC was significantly associated with alterations in the ileal mucosa (<i>p</i> = 0.009) and LVPI (<i>p</i> = 0.001). Additionally, HFC and diarrhea were associated with LVPI in 27.3% of patients (<i>p</i> = 0.037) and with erosions in the ileum (<i>p</i> = 0.031). Chronic ileal inflammation correlated with HFC (<i>p</i> = 0.015), ASDAS-CRP > 2.1 (<i>p</i> = 0.09), LVPI (<i>p</i> = 0.001), and villous atrophy (<i>p</i> = 0.014). Factorial analysis of mixed data (FAMD) identified significant associations between micro/macroscopic changes in chronic inflammation and HFC (CC = 0.837); increased levels of CRP and microscopic acute inflammation (CC = 0.792); and clinical activity scores of ASDAS-CRP and BASDAI (CC = 0.914). Conlusions: FC levels were significantly elevated in patients with SpA, particularly those with LVPI, suggesting their potential as a valuable biomarker for managing SpA when joint manifestations coincide with ileal villous atrophy. This indicates a shared immune pathway linked to chronic gut damage.
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spelling doaj-art-e0b40a18326945ac95d14fbf493667872025-08-20T02:28:12ZengMDPI AGDiagnostics2075-44182024-11-011422259110.3390/diagnostics14222591Elevated Calprotectin Levels Reveal Loss of Vascular Pattern and Atrophy of Villi in Ileum by Digital Chromoendoscopy and Magnification Colonoscopy in Patients with Spondyloarthritis Without Having Inflammatory Bowel DiseaseJuliette De Avila0Cristian Flórez-Sarmiento1Viviana Parra-Izquierdo2Wilson Bautista-Molano3Magaly Chamorro-Melo4Adriana Beltrán-Ostos5Diego Alejandro Jaimes6Valery Khoury7Lorena Chila-Moreno8Alejandro Ramos-Casallas9Juan Manuel Bello-Gualtero10Jaiber Gutiérrez11Cesar Pacheco-Tena12Philippe Selim Chalem Choueka13Consuelo Romero-Sánchez14Cellular and Molecular Immunology Group–InmuBo, School of Dentistry, Universidad El Bosque, Av. Cra 9 No. 131 A–02, Bogotá 110121, ColombiaCellular and Molecular Immunology Group–InmuBo, School of Dentistry, Universidad El Bosque, Av. Cra 9 No. 131 A–02, Bogotá 110121, ColombiaCellular and Molecular Immunology Group–InmuBo, School of Dentistry, Universidad El Bosque, Av. Cra 9 No. 131 A–02, Bogotá 110121, ColombiaCellular and Molecular Immunology Group–InmuBo, School of Dentistry, Universidad El Bosque, Av. Cra 9 No. 131 A–02, Bogotá 110121, ColombiaClinical Immunology Group, Rheumatology and Immunology Department, School of Medicine, Hospital Militar Central, Universidad Militar Nueva Granada, Transversal 3ª # 49-00, Bogotá 110231, ColombiaCellular and Molecular Immunology Group–InmuBo, School of Dentistry, Universidad El Bosque, Av. Cra 9 No. 131 A–02, Bogotá 110121, ColombiaClínicos IPS, Bogotá 110231, ColombiaSchool of Medicine, Universidad El Bosque, Bogotá 110121, ColombiaCellular and Molecular Immunology Group–InmuBo, School of Dentistry, Universidad El Bosque, Av. Cra 9 No. 131 A–02, Bogotá 110121, ColombiaCellular and Molecular Immunology Group–InmuBo, School of Dentistry, Universidad El Bosque, Av. Cra 9 No. 131 A–02, Bogotá 110121, ColombiaClinical Immunology Group, Rheumatology and Immunology Department, School of Medicine, Hospital Militar Central, Universidad Militar Nueva Granada, Transversal 3ª # 49-00, Bogotá 110231, ColombiaClinical Immunology Group, Rheumatology and Immunology Department, School of Medicine, Hospital Militar Central, Universidad Militar Nueva Granada, Transversal 3ª # 49-00, Bogotá 110231, ColombiaInvestigación y Biomedicina de Chihuahua, Chihuahua 31205, MexicoFundación Instituto de Reumatología Fernando Chalem, Bogotá 111211, ColombiaCellular and Molecular Immunology Group–InmuBo, School of Dentistry, Universidad El Bosque, Av. Cra 9 No. 131 A–02, Bogotá 110121, ColombiaObjective: This study aimed to establish a correlation between fecal calprotectin levels (FC) and intestinal inflammation in patients with spondyloarthritis without inflammatory bowel disease. Methods: A total of 180 SpA patients were included in the study of them 20.6% required Digital chromoendoscopy (DCE). FC, C-reactive protein (CRP), HLA-B*27 and clinical indices were assessed. Results: Positive fecal calprotectin (PFC) and high fecal calprotectin (HFC) levels were observed in 27.0% and 16.0% of patients, respectively. HFC correlated with a Bath Ankylosing Spondylitis Functional Index (BASFI) score > 4.0 (<i>p</i> = 0.036) and a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score > 4.0 (<i>p</i> = 0.047). Loss of vascular pattern in the ileum (LVPI) was observed in approximately 70.0% of patients (<i>p</i> = 0.005), which was associated with PFC and abdominal bloating (<i>p</i> = 0.020). LVPI was also linked to microscopic inflammation (<i>p</i> = 0.012) and PFC with abdominal pain (<i>p</i> = 0.007). HFC was significantly associated with alterations in the ileal mucosa (<i>p</i> = 0.009) and LVPI (<i>p</i> = 0.001). Additionally, HFC and diarrhea were associated with LVPI in 27.3% of patients (<i>p</i> = 0.037) and with erosions in the ileum (<i>p</i> = 0.031). Chronic ileal inflammation correlated with HFC (<i>p</i> = 0.015), ASDAS-CRP > 2.1 (<i>p</i> = 0.09), LVPI (<i>p</i> = 0.001), and villous atrophy (<i>p</i> = 0.014). Factorial analysis of mixed data (FAMD) identified significant associations between micro/macroscopic changes in chronic inflammation and HFC (CC = 0.837); increased levels of CRP and microscopic acute inflammation (CC = 0.792); and clinical activity scores of ASDAS-CRP and BASDAI (CC = 0.914). Conlusions: FC levels were significantly elevated in patients with SpA, particularly those with LVPI, suggesting their potential as a valuable biomarker for managing SpA when joint manifestations coincide with ileal villous atrophy. This indicates a shared immune pathway linked to chronic gut damage.https://www.mdpi.com/2075-4418/14/22/2591fecal calprotectinspondyloarthritisdigital chromo-endoscopyinflammatory bowel diseasemicroscopic inflammation
spellingShingle Juliette De Avila
Cristian Flórez-Sarmiento
Viviana Parra-Izquierdo
Wilson Bautista-Molano
Magaly Chamorro-Melo
Adriana Beltrán-Ostos
Diego Alejandro Jaimes
Valery Khoury
Lorena Chila-Moreno
Alejandro Ramos-Casallas
Juan Manuel Bello-Gualtero
Jaiber Gutiérrez
Cesar Pacheco-Tena
Philippe Selim Chalem Choueka
Consuelo Romero-Sánchez
Elevated Calprotectin Levels Reveal Loss of Vascular Pattern and Atrophy of Villi in Ileum by Digital Chromoendoscopy and Magnification Colonoscopy in Patients with Spondyloarthritis Without Having Inflammatory Bowel Disease
Diagnostics
fecal calprotectin
spondyloarthritis
digital chromo-endoscopy
inflammatory bowel disease
microscopic inflammation
title Elevated Calprotectin Levels Reveal Loss of Vascular Pattern and Atrophy of Villi in Ileum by Digital Chromoendoscopy and Magnification Colonoscopy in Patients with Spondyloarthritis Without Having Inflammatory Bowel Disease
title_full Elevated Calprotectin Levels Reveal Loss of Vascular Pattern and Atrophy of Villi in Ileum by Digital Chromoendoscopy and Magnification Colonoscopy in Patients with Spondyloarthritis Without Having Inflammatory Bowel Disease
title_fullStr Elevated Calprotectin Levels Reveal Loss of Vascular Pattern and Atrophy of Villi in Ileum by Digital Chromoendoscopy and Magnification Colonoscopy in Patients with Spondyloarthritis Without Having Inflammatory Bowel Disease
title_full_unstemmed Elevated Calprotectin Levels Reveal Loss of Vascular Pattern and Atrophy of Villi in Ileum by Digital Chromoendoscopy and Magnification Colonoscopy in Patients with Spondyloarthritis Without Having Inflammatory Bowel Disease
title_short Elevated Calprotectin Levels Reveal Loss of Vascular Pattern and Atrophy of Villi in Ileum by Digital Chromoendoscopy and Magnification Colonoscopy in Patients with Spondyloarthritis Without Having Inflammatory Bowel Disease
title_sort elevated calprotectin levels reveal loss of vascular pattern and atrophy of villi in ileum by digital chromoendoscopy and magnification colonoscopy in patients with spondyloarthritis without having inflammatory bowel disease
topic fecal calprotectin
spondyloarthritis
digital chromo-endoscopy
inflammatory bowel disease
microscopic inflammation
url https://www.mdpi.com/2075-4418/14/22/2591
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