DISCLAIMER

For physicians only

 
Intestinal Inflammation
Index
Calprotectin, the assay for detecting patients with possible bowel inflammation: discover the available tests and their procedures.
 
Calprest
WHAT IS CALPREST?
Calprest is the new enzyme immunoassay developed by Eurospital to assess bowel inflammation with an accurate and non-invasive method.
Calprest is very helpful to differentiate organic Inflammatory Bowel Disease (IBD) and functional disorders like Irritable Bowel Syndrome (IBS). A negative Calprest results allows to exclude almost certainly bowel inflammation.

A SIMPLE AND ACCURATE ASSAY
Till now, invasive tests were needed to assess inflammation of the intestinal mucosa (colonoscopy and subsequent histology). Recently, however, the use of non-invasive markers has become more and more popular. Among them calprotectin is one of the most reliable and safest methods to determine faecal concentration of calprotectin, an antimicrobial protein found in neutrophils, which is released in the intestinal lumen when inflammatory processes are active in the bowel.
The diagnostic application of Calprest is based on the quantitative measurement of calprotectin in stools: in patients with Inflammatory Bowel Disease the level of calprotectin in generally very high. Patients with Irritable Bowel Syndrome show substantially lower levels of calprotectin than in IBD; sometimes higher than the cut-off but always higher than in healthy subjects.
Calprest can therefore be used to select patients with inflammation to be submitted to further investigations in a more accurate way than the usual biochemical tests (ESR, CPR).

SPECIFICITY AND SENSITIVITY
The determination of fecal calprotectin is useful to differentiate patients with an organic disease (IBD) from those with a functional disorder (IBS) due to its elevated negative predictive value which allows to rule out a possible organic disease. All available studies allow to confirm that sensitivity and specificity are above 90%.

DIAGNOSTIC SENSITIVITY
DIAGNOSTIC SPECIFICITY
NEGATIVE PREDICTIVE VALUE
95%
93%
98%

INTERPRETATION OF RESULTS
Samples with a concentration of calprotectin exceeding 50 mg/kg should be considered positive. The average value of calprotectin in healthy adults is approximately 25 mg/kg. A positive Calprest result indicates intestinal inflammation and allows to safely submit patients to further diagnostic investigations.

Samples giving values above 50 mg/kg are regarded as having a positive Calprest test. In healthy adults the median value is about 25 mg/kg.

VALUE
INTERPRETATION
< 50 mg/kg of stool
Negative
50 - 100 mg/kg of stool
Borderline area. The patients
should be retested within a short period of time
> 100 mg/kg of stool
Positive

SCREENING AND FOLLOW UP
Calprest performances, its ease-of-use and the non-invasive ELISA method do not limit the use of Calprest to diagnosis only, but make it useful for screening procedures also to detect, for instance, the inflammatory causes of chronic diarrhoea. Moreover, Calprest can also be applied in the follow up of IBD, diverticulitis and in the monitoring of the treatment. Despite a clinical improvement of patients as wells as the presence of negative inflammation indexes, the inflammatory process persists to affect the intestinal mucosa: this is the main cause of relapses that often occur in these diseases. The longer the time interval between clinical remission and relapse, the more favourable the prognosis of the disease.
Until a short time ago, the histological remission, i.e. the complete functional recovery of the mucosa, could only be assessed with invasive methods. It was recently demonstrated that in ulcerative colitis (UC) patients, a negative calprotectin result indicates not only clinical but also histological remission.
The availability of a non-invasive method like Calprest is a breakthrough not only for the diagnosis of bowel inflammation, but also for the monitoring and optimization of medical therapy.
Calprest tests can be repeated over time to help evaluate clinical status with a view to preventing possible relapses and adjust therapy.

CALPREST - 96 tests - code 9031
CALPREST - Device to collect stool-100 pc- code 9062

 

 
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