Association of fecal calprotectin concentrations with disease severity, response to treatment, and other biomarkers in dogs with chronic inflammatory enteropathies

J Vet Intern Med. 2018 Mar;32(2):679-692. doi: 10.1111/jvim.15065. Epub 2018 Feb 20.

Abstract

Background: Calprotectin is a marker of inflammation, but its clinical utility in dogs with chronic inflammatory enteropathies (CIE) is unknown.

Objective: Evaluation of fecal calprotectin in dogs with biopsy-confirmed CIE.

Animals: 127 dogs.

Methods: Prospective case-control study. Dogs were assigned a canine chronic enteropathy clinical activity index (CCECAI) score, and histologic lesions severity was assessed. Fecal calprotectin, fecal S100A12, and serum C-reactive protein (CRP) were measured. Food- or antibiotic-responsive cases (FRE/ARE, n = 13) were distinguished from steroid-/immunosuppressant-responsive or -refractory cases (SRE/IRE, n = 20). Clinical response to treatment in SRE/IRE dogs was classified as complete remission (CR), partial response (PR), or no response (NR).

Results: Fecal calprotectin correlated with CCECAI (ρ = 0.27, P = .0065) and fecal S100A12 (ρ = 0.90, P < .0001), some inflammatory criteria, and cumulative inflammation scores, but not serum CRP (ρ = 0.16, P = .12). Dogs with SRE/IRE had higher fecal calprotectin concentrations (median: 2.0 μg/g) than FRE/ARE dogs (median: 1.4 μg/g), and within the SRE/IRE group, dogs with PR/NR had higher fecal calprotectin (median: 37.0 μg/g) than dogs with CR (median: 1.6 μg/g). However, both differences did not reach statistical significance (both P = .10). A fecal calprotectin ≥15.2 μg/g separated both groups with 80% sensitivity (95% confidence interval [95%CI]: 28%-100%) and 75% specificity (95%CI: 43%-95%).

Conclusions and clinical importance: Fecal calprotectin could be a useful surrogate marker of disease severity in dogs with CIE, but larger longitudinal studies are needed to evaluate its utility in predicting the response to treatment.

Keywords: antibiotic-responsive enteropathy; biomarker; calgranulin; canine; food-responsive enteropathy; inflammatory bowel disease.

MeSH terms

  • Animals
  • Biomarkers / analysis
  • C-Reactive Protein / analysis
  • Case-Control Studies
  • Dog Diseases / diet therapy
  • Dog Diseases / drug therapy
  • Dog Diseases / pathology*
  • Dogs
  • Feces / chemistry
  • Female
  • Inflammatory Bowel Diseases / diet therapy
  • Inflammatory Bowel Diseases / drug therapy
  • Inflammatory Bowel Diseases / pathology
  • Inflammatory Bowel Diseases / veterinary*
  • Leukocyte L1 Antigen Complex / analysis*
  • Male
  • Prospective Studies
  • S100A12 Protein / analysis
  • Sensitivity and Specificity
  • Severity of Illness Index

Substances

  • Biomarkers
  • Leukocyte L1 Antigen Complex
  • S100A12 Protein
  • C-Reactive Protein