Human Lactoferrin

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Human Lactoferrin

  1. 1. Human Lactoferrin <ul><li>Lactoferrin is a glycoprotein secreted by mucosal membranes; it is a major protein in the secondary granules of leukocytes </li></ul><ul><li>During intestinal inflammation, activated leukocytes infiltrate the mucosa and lumen, increasing the level of fecal lactoferrin </li></ul><ul><li>Fecal lactoferrin is elevated in patients suffering from active inflammatory bowel disease (IBD) but not in persons with irritable bowel syndrome (IBS) or healthy persons </li></ul>
  2. 2. <ul><li>1200 </li></ul><ul><li>800 </li></ul><ul><li>400 </li></ul><ul><li>0 </li></ul>Lactoferrin levels (ug/g wet weight) Crohn’s Disease N=78 Ulcerative Colitis N=71 Irritable Bowel Syndrome N=31 Healthy Persons N=56 Lactoferrin levels in disease
  3. 3. <ul><li>IBD-CHEK TM – a qualitative ELISA for the clinical lab </li></ul><ul><li>IBD-QUIK CHEK TM – a qualitative lateral flow test for the clinical lab or physician’s office </li></ul>Two new noninvasive tests to detect intestinal inflammation
  4. 4. IBD-CHEK TM Test <ul><li>Qualitative ELISA for detecting elevated fecal lactoferrin as an indicator of intestinal inflammation </li></ul><ul><li>Utilizes a four-step procedure with results in 75 minutes </li></ul><ul><li>A valuable noninvasive diagnostic aid to distinguish active IBD from IBS </li></ul><ul><li>Available by direct order for hospital and reference labs </li></ul>
  5. 5. Performance characteristics of the IBD-CHEK TM Test N=236 Total IBD-CHEK TM IBD-CHEK TM Crohn’s disease Active 52 85% 15% Inactive 26 62% 39% Ulcerative colitis Active 40 88% 13% Inactive 31 52% 48% Active IBS 31 0% 100% Healthy persons 56 0% 100% (+) (-)
  6. 6. Clinical results with the IBD-CHEK TM <ul><li>When distinguishing active IBD from irritable bowel syndrome and healthy persons, the IBD-CHEK TM test exhibited a sensitivity of 86% and specificity of 100% </li></ul><ul><li>When distinguishing active Crohn’s disease from irritable bowel syndrome and healthy persons, the IBD-CHEK TM test exhibited a sensitivity of 85% and specificity of 100% </li></ul>
  7. 7. IBD-QUIK CHEK TM Test <ul><li>Lateral flow test for detecting elevated fecal lactoferrin as an indicator of intestinal inflammation </li></ul><ul><li>Helps to distinguish active IBD from IBS </li></ul><ul><li>Turnaround time in 10 minutes using a single specimen dilution </li></ul><ul><li>Suitable for use in the clinical lab or Physician’s office </li></ul>
  8. 8. Performance characteristics of the IBD-QUIK CHEK TM Test N=137 Total IBD-QUIK IBD-QUIK CHEK TM (+) CHEK TM (-) Crohn’s disease Active 58 100% 0% Inactive 35 6% 94% Ulcerative colitis Active 12 100% 0% Inactive 11 0% 100% Active IBS 17 0% 100% Healthy persons 27 0% 100%
  9. 9. Clinical results with the IBD-QUIK CHEK TM <ul><li>When compared to the IBD-CHEK TM test for distinguishing active IBD from active irritable bowel syndrome and healthy persons, the IBD-QUIK CHEK TM test showed a sensitivity of 100% and specificity of 98% </li></ul><ul><li>When distinguishing active IBD from inactive IBD and active irritable bowel syndrome, the IBD-QUIK CHEK TM test showed a sensitivity of 100% and specificity of 96% </li></ul>
  10. 10. Fecal lactoferrin testing <ul><li>The IBD-CHEK TM and IBD-QUIK CHEK TM tests are sensitive and specific in vitro diagnostic aids for distinguishing active IBD from IBS </li></ul><ul><li>Both assays offer a cost effective method for screening patients </li></ul><ul><li>IBS accounts for 2.4 to 3.4 million office visits annually; fecal lactoferrin testing can help distinguish this condition from more serious IBD </li></ul>
  11. 11. References <ul><li>1. Dwarakanath, A. D., I. A. Finnie, C. M. Beesley, G. M. O’Dowd, J. Nash, H. H. Tsai, N. Parker, and J. Rhodes. 1997. Differential excretion of leucocyte granule components in inflammatory bowel disease: implications for pathogenesis. Clinical Science. 92: 307-313. </li></ul><ul><li>Guerrant, R. L., V. Araujo, E. Soares, K. Kotloff, A. Lima, W. Cooper, and A. Lee. 1992. Measurement of fecal lactoferrin as a marker of fecal leukocytes. J. Clin. Microbiol. 30:1238-1242. </li></ul><ul><li>Kane, S., Sanborn, W. Rufo, P., Zholudev, A., Boone, J., Lyerly, D., Camilleri, M., and S. Hanauer. 2001. Fecal lactoferrin is a sensitive and specific marker for chronic inflammatory bowel disease. Abstract of Digestive Disease Week / American Gastroenterology Association, Atlanta, Georgia. </li></ul><ul><li>Kayazawa, M., O. Saitoh, K. Kojima, K. Nakagawa, S. Tanaka, K. Tabata, R. Maysuse, K. Uchida, M. Hoshimoto, I. Hirata, and K. Katsu. 2002. Lactoferrin in whole gut lavage fluid as a marker for disease activity in inflammatory bowel disease: Comparison with other neutrophil-derived proteins. Am. J. Gastroenterol. 97:360-369. </li></ul><ul><li>Fine, K.D., F. Ogunji, J. George, M. Niehaus, and R. Guerrant. 1998. Utility of a rapid fecal latex agglutination test detecting the neutrophil protein, lactoferrin, for diagnosing inflammatory causes of chronic diarrhea. Am. J. Gastroenterol. 93:1300-1305. </li></ul><ul><li>6. Longstreth, G. F. , A. Wilson, K. Knight, J. Wong, C. Chiou, V. Barghout, F. Frech and J. Ofman. 2003. Irritable bowel syndrome, health care use, and costs: A U.S. managed care perspective. Am. J. Gastroenterol. 98:600-607. </li></ul><ul><li>7. Riley, L. W. 1995. Acute inflammatory diarrhea. In M. Blaser (ed.), P. Smith, J. Ravdin, H. Greenberg, and R. Guerrant, Infections of the Gastrointestinal Tract . Raven Press, New York, NY. </li></ul><ul><li>8. Sugi, K., Saithoh, O., Hirata, I., and K. Katsu. 1996. Fecal lactoferrin as a marker for disease activity in inflammatory bowel disease: Comparison with other neutrophil-derived proteins. Am. J. Gastroenterol. 91:927-934. </li></ul><ul><li>9. Uchida, K., R. Matsuse, S. Tomita, K. Sugi, O. Saitoh, and S. Ohshiba. 1994. Immunochemical detection of human lactoferrin in feces as a new marker for inflammatory gastrointestinal disorders and colon cancer. Clin. Biochem. 27:259-264. </li></ul>

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