Analiza rezultata fekalne elastaze i fekalnog kalprotektina kod pacijenata s i bez upalne bolesti crijeva

master's thesis

• Title (english): Analysis of fecal elastase and fecal calprotectin results in patients with and without inflammatory bowel disease
• Author: Ana Rukavina
• Mentor: Anita Somborac Bačura (mentor)
• Mentor: Lovorka Đerek (mentor)
• Committee member: Anita Somborac Bačura (predsjednik povjerenstva)
• Committee member: Lidija Bach-Rojecky (član povjerenstva)
• Committee member: Lovorka Đerek (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Department of medical biochemistry and haematology); Zagreb
• Defense date and country: 2023-07-04, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Medical Biochemistry

Abstract

Upalne bolesti crijeva (IBD), ulcerozni kolitis i Crohnova bolest, složeni su kronični upalni poremećaji koji zahvaćaju različite
dijelove sluznice gastrointestinalnog trakta, uz kontinuirane izmjene stanja remisije i relapsa. Većina kliničkih simptoma nije
specifična za IBD i mogu se javiti kod drugih upalnih bolesti. Egzokrina insuficijencija pankreasa može je javiti kao posljedica
brojnih poremećaja, a često se javlja kao ekstraintestinalna manifestacija upalnih bolesti crijeva. Fekalna elastaza je enzim pankreasa
koji se ne razgrađuje prolaskom kroz crijeva i korelira s egzokrinom funkcijom pankreasa. Fekalni kalprotektin je protein koji
sudjeluje u stimulaciji upalnog odgovora, a njegova koncentracija u fecesu neizravna je mjera infiltrata neutrofila u sluznici crijeva.
Cilj ovog rada je bio analizirati rezultate fekalne elastaze i fekalnog kalprotektina kako bi se ispitao njihov potencijal u razlikovanju
gastrointestinalnih poremećaja ovisno o prisutnosti odnosno odsustvu IBD. Ispitanici su podijeljeni u dvije skupine (prva uključuje
pacijente s dijagnozom IBD-a, a druga gastrointestinalna oboljenja uz isključenu dijagnozu IBD). Iz ostatnih ekstrahiranih uzoraka
stolice 59 ispitanika određene su koncentracije fekalne elastaze i fekalnog kalprotektina imunoturbidimetrijskim metodama na
analitičkom sustavu Beckman Coulter AU 5800 (Beckman Coulter, Brea, SAD). Rezultati istraživanja su pokazali da nema razlika
u koncentraciji fekalne elastaze između pacijenata s dijagnozom IBD-a i pacijenata s ostalim gastrointestinalnim poremećajima.
Bolesnici s dijagnozom IBD-a imali su visoke koncentracije fekalnog kalprotektina u odnosu na skupinu bolesnika koji nemaju
navedeni poremećaj. Snižene koncentracije fekalne elastaze pokazale su slabu korelaciju s povišenim koncentracijama fekalnog
kalprotektina kod pacijenata s dijagnozom aktivnog IBD-a. Fekalni kalprotektin ima značajan dijagnostički potencijal te može s
visokom dijagnostičkom osjetljivošću (87,88 %) i specifičnošću (88,46 %) odvojiti pacijente s IBD-om od pacijenata s drugim
gastrointestinalnim poremećajima. Na temelju dobivenih rezultata zaključuje se da fekalna elastaza nema dodatnu vrijednost u
diferencijalno dijagnostičkom pristupu IBD-a, dok fekalni kaprotektin ima izvrsnu dijagnostičku točnost u otkrivanju IBD-a.

Abstract (english)

Inflammatory bowel disease (IBD), ulcerative colitis and Crohn's disease, are complex chronic inflammatory disorders that affect
different parts of the gastrointestinal tract mucosa, with continuous changes in the state of remission and relapse. Most of the clinical
symptoms are not specific to IBD and can occur in other inflammatory diseases. Pancreatic exocrine insufficiency can appear as a
result of numerous disorders, and often as an extraintestinal manifestation of inflammatory bowel diseases. Fecal elastase is a
pancreatic enzyme that is not degraded when passing through the intestines and correlates with the exocrine function of the pancreas.
Fecal calprotectin is a protein that participates in the stimulation of the inflammatory response, and its concentrations in feces are an
indirect measure of the neutrophil infiltrate in the intestinal mucosa. The aim of this work was to analyze the results of fecal elastase
and fecal calprotectin in order to examine their potential in differentiating gastrointestinal disorders depending on the presence or
absence of IBD. Subjects were divided into two groups (the first included patients with a diagnosis of IBD, and the second included
patients with gastrointestinal diseases without IBD). From the remaining extracted stool samples of 59 subjects, the concentrations
of fecal elastase and fecal calprotectin were determined by immunoturbidimetric methods on the analytical system Beckman Coulter
AU 5800 (Beckman Coulter, Brea, USA). The research results showed that there were no differences in fecal elastase concentrations
between patients with a diagnosis of IBD and patients with other gastrointestinal disorders. Patients with a diagnosis of IBD had high
concentrations of fecal calprotectin compared to the group of patients without the mentioned disorder. Decreased fecal elastase
concentrations showed a weak correlation with elevated fecal calprotectin concentrations in patients diagnosed with active IBD.
Fecal calprotectin has significant diagnostic potential and can distinguish patients with IBD from patients with other gastrointestinal
disorders with high sensitivity (87.88%) and specificity (88.46%). Based on the obtained results, it is concluded that fecal elastase
has no additional value in the differential diagnostic approach of IBD, while fecal calprotectin has excellent diagnostic accuracy in
detecting IBD.

• Keywords: upalne bolesti crijeva; fekalna elastaza; fekalni kalprotektin; insuficijencija pankreasa
• Keywords (english): inflammatory bowel disease; fecal elastase; fecal calprotectin; pancreatic insuficiency
• Language: croatian
• URN:NBN: urn:nbn:hr:163:520489
• Study programme: Title: Medical biochemistry; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: magistar/magistra medicinske biokemije (magistar/magistra medicinske biokemije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-11-17 14:05:28