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Fecal but not serum calprotectin is a potential marker of GVHD after stem cell transplantation

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Abstract

Gastrointestinal graft-versus-host disease (GvHD) represents a life-threatening complication after stem cell transplantation. Differential diagnosis between gut GvHD and other causes of diarrhea after HSCT is still subjected to endoscopy and histological findings. The research for a reliable biomarker for gut GvHD might allow an early diagnosis of this condition and a consequent prompt treatment that could reduce unfavorable outcomes. Recently, fecal calprotectin was reported as reliable marker of gut involvement. We would evaluate if serum instead of fecal calprotectin could be considered a possible biomarker of gut GvHD. Serum calprotectin was measured in a cohort of 54 patients submitted to allogeneic stem cell transplantation using ELISA assay. For a subset of 21 patients, calprotectin serum levels were compared with fecal calprotectin detection. Contrary to fecal calprotectin, we found only a trend to high level of serum calprotectin for GvHD development and gut involvement, but statistical difference was not reached. Fecal but not serum calprotectin could be considered as possible biomarker for gut GvHD.

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References

  1. Levine JE, Braun TM, Harris AC, Holler E, Taylor A, Miller H, Magenau J, Weisdorf DJ, Ho VT, Bolaños-Meade J, Alousi AM, Ferrara JL, Blood and Marrow Transplant Clinical Trials Network (2015) A prognostic score for acute graft-versus-host disease based on biomarkers: a multicentre study. Lancet Haematol 2:e21–e29. doi:10.1016/S2352-3026(14)00035-0

    Article  PubMed  PubMed Central  Google Scholar 

  2. Thompson B, Salzman D, Steinhauer J, Lazenby AJ, Wilcox CM (2006) Prospective endoscopic evaluation for gastrointestinal graft-versus-host disease: determination of the best diagnostic approach. Bone Marrow Transplant 38:371–376

    Article  CAS  PubMed  Google Scholar 

  3. Foell D, Wittkowski H, Vogl T, Roth J (2007) S100 proteins expressed in phagocytes: a novel group of damage-associated molecular pattern molecules. J Leukoc Biol 81:28–37

    Article  CAS  PubMed  Google Scholar 

  4. Lügering N, Stoll R, Schmid KW, Kucharzik T, Stein H, Burmeister G, Sorg C, Domschke W (1995) The myeloic related protein MRP8/14 (27E10 antigen)—usefulness as a potential marker for disease activity in ulcerative colitis and putative biological function. Eur J Clin Investig 25:659–664

    Article  Google Scholar 

  5. Tibble JA, Bjarnason I (2001) Fecal calprotectin as an index of intestinal inflammation. Drugs Today 37:85–96

    Article  CAS  PubMed  Google Scholar 

  6. Cury DB, Mizsputen SJ, Versolato C, Miiji LO, Pereira E, Delboni MA, Schor N, Moss AC (2013) Serum calprotectin levels correlate with biochemical and histological markers of disease activity in TNBS colitis. Cell Immunol 282(1):66–70. doi:10.1016/j.cellimm.2013.04.004

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Kalla R, Kennedy NA, Ventham NT, Boyapati RK, Adams AT, Nimmo ER, Visconti MR, Drummond H, Ho GT, Pattenden RJ, Wilson DC, Satsangi J (2016) Serum calprotectin: a novel diagnostic and prognostic marker in inflammatory bowel diseases. Am J Gastroenterol 111(12):1796–1805. doi. doi:10.1038/ajg.2016.342

  8. O'Meara A, Kapel N, Xhaard A, Sicre de Fontbrune F, Manéné D, Dhedin N, de Latour RP, Socié G, Robin M (2015) Fecal calprotectin and α1-antitrypsin dynamics in gastrointestinal GvHD. Bone Marrow Transplant 50:1105–1109. doi:10.1038/bmt.2015.109

    Article  PubMed  Google Scholar 

  9. Rodriguez-Otero P, Porcher R, Peffault de Latour R, Contreras M, Bouhnik Y, Xhaard A, Andreoli A, Ribaud P, Kapel N, Janin A, Socié G, Robin M (2012) Fecal calprotectin and alpha-1 antitrypsin predict severity and response to corticosteroids in gastrointestinal graft-versus-host disease. Blood 119:5909–5917. doi:10.1182/blood-2011-12-397968

    Article  CAS  PubMed  Google Scholar 

  10. Bastos Oreiro M, Castilla-Llorente C, de la Guía AL, de Paz R, Van Domselaar M, Nieto J, Rodriguez A, Gallardo D, Canales M, GETH (Grupo Español de Trasplantes Hematopoyéticos y Terapia Celular) (2012) Fecal calprotectin in allogeneic stem cell transplantation for the diagnosis of acute intestinal graft versus host disease. Bone Marrow Transplant 47:1241–1242. doi:10.1038/bmt.2011.241

    Article  CAS  PubMed  Google Scholar 

  11. Lorenz F, Marklund S, Werner M, Palmqvist R, Wahlin BE, Wahlin A (2015) Fecal calprotectin as a biomarker of intestinal graft versus host disease after allogeneic hematopoietic stem cell transplantation. Sci Rep 5:7920. doi:10.1038/srep07920

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Chiusolo P, Metafuni E, Giammarco S, Bellesi S, Piccirillo N, Fanali C, Castagnola M, Zuppi C, De Michele T, Leone G, Sica S (2012) Role of fecal calprotectin as biomarker of gastrointestinal GVHD after allogeneic stem cell transplantation. Blood 120:4443–4444. doi:10.1182/blood-2012-08-447326

    Article  CAS  PubMed  Google Scholar 

  13. Glucksberg H, Storb R, Fefer A, Buckner CD, Neiman PE, Clift RA, Lerner KG, Thomas ED (1974) Clinical manifestations of graft-versus-host disease in human recipients of marrow from HLA-A-matched sibling donors. Transplantation 18(4):295–304

    Article  CAS  PubMed  Google Scholar 

  14. Weisdorf D, Haake R, Blazar B, Miller W, McGlave P, Ramsay N, Kersey J, Filipovich A (1990) Treatment of moderate/severe acute graft-versus-host disease after allogeneic bone marrow transplantation: an analysis of clinical risk features and outcome. Blood 75:1024–1030

    CAS  PubMed  Google Scholar 

  15. Deeg HJ (2007) How I treat refractory acute GVHD. Blood 109:4119–4126

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Adam B, Koldehoff M, Ditschkowski M, Gromke T, Hlinka M, Trenschel R, Kordeals L, Steckel NK, Beelen DW, Liebregts T (2016) Endoscopic and histological findings are predicted by fecal calprotectin in acute intestinal graft-versus-host disease. Dig Dis Sci 61(7):2019–2026. doi:10.1007/s10620-016-4112-7

    Article  CAS  PubMed  Google Scholar 

  17. Logan R (2010) Faecal calprotectin for the diagnosis of inflammatory bowel disease. BMJ 341:c3636. doi:10.1136/bmj.c3636

    Article  PubMed  Google Scholar 

  18. Voganatsi A, Panyutich A, Miyasaki KT, Murthy RK (2001) Mechanism of extracellular release of human neutrophil calprotectin complex. J Leukoc Biol 70(1):130–134

    CAS  PubMed  Google Scholar 

  19. Konikoff MR, Denson LA (2006) Role of fecal calprotectin as a biomarker of intestinal inflammation in inflammatory bowel disease. Inflamm Bowel Dis 12(6):524–534 Review

    Article  PubMed  Google Scholar 

  20. Montalto M, Curigliano V, Santoro L, Armuzzi A, Cammarota G, Covino M, Mentella MC, Ancarani F, Manna R, Gasbarrini A, Gasbarrini G (2007) Fecal calprotectin in first-degree relatives of patients with ulcerative colitis. Am J Gastroenterol 102(1):132–136

    Article  CAS  PubMed  Google Scholar 

  21. Røseth AG, Fagerhol MK, Aadland E, Schjønsby H (1992) Assessment of the neutrophil dominating protein calprotectin in feces. A methodologic study. Scand J Gastroenterol 27(9):793–798

    Article  PubMed  Google Scholar 

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Acknowledgements

This study was supported by the Centro di Ricerca sulle Cellule Staminali Emopoietiche e le Terapie Cellulari, Università Cattolica del Sacro Cuore in Rome.

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Authors and Affiliations

  1. Hematology Department, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy

    Elisabetta Metafuni, Sabrina Giammarco, Daniela Giovanna De Ritis, Monica Rossi, Andrea P. Bacigalupo, Simona Sica & Patrizia Chiusolo

  2. Biochemistry Department, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy

    Teresa De Michele & Cecilia Zuppi

  3. Università Cattolica del Sacro Cuore, Largo Gemelli 8, 00168, Rome, Italy

    Elisabetta Metafuni, Sabrina Giammarco, Daniela Giovanna De Ritis, Monica Rossi, Teresa De Michele, Cecilia Zuppi, Andrea P. Bacigalupo, Simona Sica & Patrizia Chiusolo

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  1. Elisabetta Metafuni
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  2. Sabrina Giammarco
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  3. Daniela Giovanna De Ritis
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  4. Monica Rossi
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  5. Teresa De Michele
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  6. Cecilia Zuppi
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  7. Andrea P. Bacigalupo
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  8. Simona Sica
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  9. Patrizia Chiusolo
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Correspondence to Simona Sica.

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For this type of study, formal consent is not required. This article does not contain any studied with animals performed by any of the authors.

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Metafuni, E., Giammarco, S., De Ritis, D.G. et al. Fecal but not serum calprotectin is a potential marker of GVHD after stem cell transplantation. Ann Hematol 96, 929–933 (2017). https://doi.org/10.1007/s00277-017-2974-1

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  • DOI: https://doi.org/10.1007/s00277-017-2974-1

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