Recent Fecal Biomarker for Inflammatory Bowel Disease, Neutrophil Gelatinase Associated Lipocalin

Abstract

Background: In the field of IBD many biomarkers have been studied to find the ideal noninvasive biomarker that best correlates with disease severity and prognosis. NGAL is a biomarker that have been studied and measured either in serum or fecal in different pathological conditions such as AKI, IBD and autoimmune disorders. In our study we aim to evaluate the accuracy of fecal NGAL levels in correlation with endoscopic scoring, and common serum inflammatory markers in patients with IBD. Methods: In this randomized prospective controlled study Fecal NGAL levels were measured using the Elisa technique in 30 patients with ulcerative colitis 10 patients with Crohn’s disease and 20 healthy controls. The results were correlated to colonoscopic severity index and commonly used serum inflammatory markers (highly sensitive CRP, ESR, white blood cell count). Results: Fecal NGAL levels (median and interquartile range) were significantly elevated in patients with active ulcerative colitis (UC) 6.05 (3.6–15.1) mg/kg and Crohn’s disease (CD) 4.9 (1.5– 7.7) mg/kg, compared to healthy controls (HC) 0.3 (0.1–0.4) mg/kg. Sensitivity and specificity were 94.7% and 95.7%, respectively, for distinguishing between active IBD and HC. Conclusions: Fecal NGAL is a noninvasive biomarker that strongly correlate to different parameters of the disease activity in IBD patients. Because most biomarkers are only found in granulocytes, NGAL's epithelial localization could provide additional diagnostic information.