TOPLINE

Fecal eosinophil-derived neurotoxin (fEDN), lipocalin-2 (LCN-2), and calprotectin (FC) were significantly elevated in children with inflammatory bowel disease (IBD) compared with both healthy control children and those with acute diarrhea. Among the three markers, FC demonstrated the strongest overall accuracy for distinguishing IBD from acute diarrhea, while LCN-2 was the only marker that correlated with disease duration.

METHODOLOGY

• Researchers conducted a case-control study over 6 months (January–June 2024) at a pediatric unit in Egypt, to assess the potential of fEDN, LCN-2 and FC as noninvasive fecal biomarkers for screening and evaluating pediatric IBD.
• The group included 30 children with IBD (mean age, 6.8 years; 46.7% girls)—12 diagnosed with Crohn’s disease (CD) and 18 with ulcerative colitis—along with 30 age- and sex-matched children with acute diarrhea, and 30 age- and sex-matched apparently healthy children with no history of chronic gastrointestinal complaints, enrolled as the control group.
• Fecal samples were evaluated for fEDN, LCN-2, and FC levels using enzyme-linked immunosorbent assay, with concentrations expressed as ng/mL of fecal extract.
• Analysis included correlation of biomarker levels with clinical disease activity indices (Crohn's Disease Activity Index [CDAI] and Full Mayo Score) and endoscopic severity scores.
• Diagnostic performance was assessed using receiver operating characteristic curve analysis, with pairwise area under the curve (AUC) comparisons performed using DeLong's test.

TAKEAWAY

• All three biomarkers were significantly elevated in children with IBD compared with both, the acute diarrhea and the control group (P < .001 for all comparisons).
• For distinguishing IBD from the control group, all three markers showed high diagnostic accuracy with no statistically significant difference among them: FC (AUC, 0.98, sensitivity, 96.7%; specificity, 93.3%), fEDN (AUC, 0.95; sensitivity, 100%; specificity, 76.7%), and LCN-2 (AUC, 0.9; sensitivity, 80%; specificity, 96.7%).
• For discriminating IBD from acute diarrhea, FC demonstrated the highest specificity (90%) and overall accuracy (AUC, 0.86), while fEDN performed poorly (AUC, 0.56), significantly below both LCN-2 and FC (DeLong's test, P =.04 for both).
• LCN-2 uniquely correlated with disease duration  and C-reactive protein, while all three markers significantly correlated with CDAI, with LCN-2 showing the strongest correlation.

IN PRACTICE

"These findings suggest that fEDN, LCN-2, and FC may offer complementary information when used as non-invasive supportive tools in the pre-endoscopic evaluation of children with suspected IBD," wrote the authors of the study.

SOURCE

The study was led by Ragaey Ahmad Eid, Department of Gastroenterology, Hepatology, and Infectious Diseases, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt. It was published online on July 17 in BMC Gastroenterology.

LIMITATIONS

This single-center case-control study had a relatively small sample size. Disease activity was assessed using adult-derived scoring systems rather than pediatric-specific indices. Specific treatment regimens at the time of stool sampling were not systematically recorded.

DISCLOSURES

This research did not receive any specific grant from public, commercial, or not-for-profit funding agencies. The authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.