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Lactoferrin Test to Differentiate IBD from IBS, Schemes and Mind Maps of Epidemiology

The Royal Central School of Speech and DramaEpidemiology

The use of lactoferrin testing as a non-invasive method for distinguishing inflammatory bowel disease (ibd) from irritable bowel syndrome (ibs). Lactoferrin is a glycoprotein that indicates intestinal inflammation, which is a key characteristic of ibd but not ibs. How lactoferrin testing can help in the diagnosis and management of ibd and ibs, and also compares it with other technologies for detecting intestinal inflammation.

Typology: Schemes and Mind Maps

2021/2022

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TECHLAB LACTOFERRIN TESTING 2015
Overview
Millions of people in the U.S. suffer from Inflamma-
tory Bowel Disease (IBD), and, less seriously, from
Irritable Bowel Syndrome (IBS). Chronic abdominal
pain and diarrhea are symptoms common to both
IBS and IBD, making differentiation between the
two disorders difficult, and often resulting in un-
necessary testing and delayed treatment.
The glycoprotein lactoferrin is a FDA-cleared bio-
marker of intestinal inflammation that can be used
to distinguish IBD from IBS. Lactoferrin is a primary
component of activated neutrophils and is found
in high levels when intestinal inflammation is pres-
ent. Fecal lactoferrin testing is a non-invasive lab-
oratory assay that quickly and accurately detects
intestinal inflammation using a patient’s stool sam-
ple. Knowing if inflammation is present is crucial
information for physicians to avoid unnecessary
endoscopies, guide treatment decisions, and im-
prove patient outcomes.
Inflammatory Bowel Disease
IBD affects an estimated 2 to 3 million people in
the United States (1). Ulcerative colitis and Crohn’s
disease are the primary subgroups of IBD and both
involve chronic inflammation of a noninfectious eti-
ology. In cases of chronic intestinal illnesses, infec-
tious diarrhea that may involve intestinal inflamma-
tion must be ruled out to confirm a diagnosis or a
flare of IBD, such as Shigella, Campylobacter, and
Clostridium difficile (9). Although ulcerative colitis
and Crohn’s disease differ in disease location and
complications, both involve disease states that os-
cillate between flare and remission. During active
disease, leukocytes infiltrate the intestinal mucosa
and increase the level of fecal lactoferrin (2-10).
Irritable Bowel Syndrome
Unlike IBD, IBS is a noninflammatory condition and
is relatively more prevalent in the U.S.—affecting at
least 30 million people. In persons with IBS, the
intestine appears normal upon endoscopic exam-
ination, leukocytes are not present in the mucosa,
and fecal lactoferrin levels are at baseline (6).
Distinguishing IBD from IBS
IBD patients with active disease may present with
symptoms similar to IBS, making it difficult to diag-
nose in the early stages of disease (1). In suspect-
ed cases of ulcerative colitis and Crohn’s disease,
colonoscopy and barium x-ray examinations are
the most commonly used techniques for confirma-
tion of intestinal inflammation and ulceration (2).
Lactoferrin testing is not intended as a replacement
for these methods, but rather as a first step to help
physicians screen out IBS patients, quickly identify
likely IBD patients for further testing, and assess
inflammation levels in diagnosed IBD patients.
Distinguishing inflammatory bowel disease (IBD) from irritable
bowel syndrome (IBS)—more reliable than ever with fecal
lactoferrin testing for gut inflammation
REFERENCES
1. Everhart, J. E. 1994. Digestive diseases in the United States: epidemiology and impact. U.S. Department of Health and Human Services, National
Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. U.S. Government Printing Office, NIH Publication no. 94-1447.
2. Fine., K.D., F. Ogunji, J. George, M. Niehaus, and R.L. 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.
3. 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 leuko-
cytes. J. Clin. Microbiol. 30:1238-1242.
4. Harris, J. C., H. L. DuPont, and B. R. Hornick. 1971. Fecal leukocytes in diarrheal illness. Ann. Intern. Med. 76:697-703.
5. Huicho L., V. Garaycochea, N. Uchima, R. Zerpa, and R.L. Guerrant. 1997. Fecal lactoferrin, fecal leukocytes and occult blood in the diagnostic
approach to childhood invasive diarrhea. Pediatr. Infect. Dis. J. 16(7):644-647.
6. Kane, S., W. Sandborn, P. Rufo, A. Zholudev, J. Boone, D. Lyerly, M. Camilleri, and S. Hanauer. 2003. Fecal lactoferrin is a sensitive and specific
marker in identifying intestinal inflammation. Am. J. Gastroenterol. 98:1309-1314.
7. Kayazawa, M., O. Saitoh, K. Kojima, K. Nakagawa, S. Tanaka, K. Tabata, R. Maysuse, K. Uchida, M. Hoshimoto, I. Hirata, and K. Katsu. 2002. Lac-
toferrin 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.
8. Parsi, M., B. Shen, J. Achkar, F. Remzi, J. Goldblum, J. Boone, D. Lin, J. Connor, V. Fazio, and B. Lashner. 2004. Fecal lactoferrin for the diagnosis
of symptomatic patients with ileal pouch-anal anasotmosis. Gastroenterology 126:1280-1286.
9. Sartor, R. B. 1995. Microbial agents in pathogenesis, differential diagnosis, and complications of inflammatory bowel disease. In M. Blaser, P.
Smith, J. Ravdin, H. Greenberg, and R. Guerrant (ed.), Infections of the Gastrointestinal Tract. Raven Press, New York, NY.
10. Sugi, K., O. I. Saitoh, and K. Katsu. 1996. Fecal lactoferrin as a marker for disease activity in inflammatory bowel disease: Comparison with other
neutrophil-derived proteins. Am. J. Gastoenterol. 91:927-934.
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Download Lactoferrin Test to Differentiate IBD from IBS and more Schemes and Mind Maps Epidemiology in PDF only on Docsity!

Overview Millions of people in the U.S. suffer from Inflamma tory Bowel Disease (IBD), and, less seriously, from Irritable Bowel Syndrome (IBS). Chronic abdominal pain and diarrhea are symptoms common to both-

IBS and IBD, making differentiation between the two disorders difficult, and often resulting in un necessary testing and delayed treatment. The glycoprotein lactoferrin is a FDA-cleared bio marker of intestinal inflammation that can be used-- to distinguish IBD from IBS. Lactoferrin is a primary component of activated neutrophils and is found in high levels when intestinal inflammation is pres ent. Fecal lactoferrin testing is a non-invasive lab oratory assay that quickly and accurately detects-- intestinal inflammation using a patient’s stool sam ple. Knowing if inflammation is present is crucial information for physicians to avoid unnecessary endoscopies, guide treatment decisions, and im prove patient outcomes. --

Inflammatory Bowel Disease IBD affects an estimated 2 to 3 million people in the United States (1). Ulcerative colitis and Crohn’s disease are the primary subgroups of IBD and both involve chronic inflammation of a noninfectious eti-

ology. In cases of chronic intestinal illnesses, infec tious diarrhea that may involve intestinal inflamma tion must be ruled out to confirm a diagnosis or a--

flare of IBD, such as Clostridium difficile and Crohn’s disease differ in disease location and complications, both involve disease states that os cillate between flare and remission. During active (9). Although ulcerative colitis Shigella, Campylobacter, and-

disease, leukocytes infiltrate the intestinal mucosa and increase the level of fecal lactoferrin (2-10). Irritable Bowel Syndrome Unlike IBD, IBS is a noninflammatory condition and

is relatively more prevalent in the U.S.—affecting at least 30 million people. In persons with IBS, the intestine appears normal upon endoscopic exam ination, leukocytes are not present in the mucosa, and fecal lactoferrin levels are at baseline (6). -

Distinguishing IBD from IBS IBD patients with active disease may present with symptoms similar to IBS, making it difficult to diag nose in the early stages of disease (1). In suspect ed cases of ulcerative colitis and Crohn’s disease,--

colonoscopy and barium x-ray examinations are the most commonly used techniques for confirma tion of intestinal inflammation and ulceration (2). Lactoferrin testing is not intended as a replacement for these methods, but rather as a first step to help- physicians screen out IBS patients, quickly identify likely IBD patients for further testing, and assess inflammation levels in diagnosed IBD patients.

Distinguishing inflammatory bowel disease (IBD) from irritable bowel syndrome (IBS)—more reliable than ever with fecal lactoferrin testing for gut inflammation

REFERENCES 1. Everhart, J. E. 1994. Digestive diseases in the United States: epidemiology and impact. U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. U.S. Government Printing Office, NIH Publication no. 94-1447. 2. Fine., K.D., F. Ogunji, J. George, M. Niehaus, and R.L. 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. 3. 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 leuko cytes. J. Clin. Microbiol. 30:1238-1242. -

  1. Harris, J. C., H. L. DuPont, and B. R. Hornick. 1971. Fecal leukocytes in diarrheal illness. Ann. Intern. Med. 76:697-703. 5. Huicho L., V. Garaycochea, N. Uchima, R. Zerpa, and R.L. Guerrant. 1997. Fecal lactoferrin, fecal leukocytes and occult blood in the diagnostic approach to childhood invasive diarrhea. Pediatr. Infect. Dis. J. 16(7):644-647. 6. Kane, S., W. Sandborn, P. Rufo, A. Zholudev, J. Boone, D. Lyerly, M. Camilleri, and S. Hanauer. 2003. Fecal lactoferrin is a sensitive and specific marker in identifying intestinal inflammation. Am. J. Gastroenterol. 98:1309-1314. 7. Kayazawa, M., O. Saitoh, K. Kojima, K. Nakagawa, S. Tanaka, K. Tabata, R. Maysuse, K. Uchida, M. Hoshimoto, I. Hirata, and K. Katsu. 2002. Lac toferrin 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. 8. Parsi, M., B. Shen, J. Achkar, F. Remzi, J. Goldblum, J. Boone, D. Lin, J. Connor, V. Fazio, and B. Lashner. 2004. Fecal lactoferrin for the diagnosis of symptomatic patients with ileal pouch-anal anasotmosis. Gastroenterology 126:1280-1286. 9. Sartor, R. B. 1995. Microbial agents in pathogenesis, differential diagnosis, and complications of inflammatory bowel disease. In M. Blaser, P. Smith, J. Ravdin, H. Greenberg, and R. Guerrant (ed.), Infections of the Gastrointestinal Tract. Raven Press, New York, NY. 10. Sugi, K., O. I. Saitoh, and K. Katsu. 1996. Fecal lactoferrin as a marker for disease activity in inflammatory bowel disease: Comparison with other neutrophil-derived proteins. Am. J. Gastoenterol. 91:927-934.

What is lactoferrin? TECHLAB LACTOFERRIN TESTING 2 015

Lactoferrin is a protein found in activated neutro phils – a type of white blood cell. When there is in flammation in the intestines, activated neutrophils will be shed into the stool. Lactoferrin is a biomark er for the presence of neutrophils; therefore it is--- a reliable indication of inflammation when neutro phils are present. It is resistant to degradation and is stable in feces for 2 weeks at room temperature or refrigerated at 2 to 8°C. -

Why should I choose lactoferrin testing? Lactoferrin is the basis of the most widely estab lished and accepted assays in the U.S. for differen tiating IBS from IBD. It has been the focus of many--

publications and well documented clinical studies, making it an ideal test for a clinical routine. Diag nosing a patient with IBD or IBS can take years due to the similarity of symptoms and clinical findings. Lactoferrin testing can aid in the diagnosis of these-

disorders. Results of a quantitative lactoferrin test can help determine the effectiveness of therapy, predict relapse, and guide treatment decisions. What lactoferrin tests are available?

There are three distinct formats of lactoferrin tests: LACTOFERRIN VUE™ TOFERRIN CHEK™ be used in high volume clinical laboratories and, and LACTOFERRIN SCAN™ CHEK™ test is a qualitative ELISA to, LACTOFERRIN. The LAC EZ- testing facilities. The test is a lateral flow rapid membrane test for small er clinical laboratories. Both tests are in vitro qual itative assays that measure elevated levels of fecal lactoferrin in stool specimens and provide a yes/no LACTOFERRIN EZ VUE™-- result for the presence of intestinal inflammation. The ELISA that accurately and quantitatively measures the levels of fecal lactoferrin in a stool sample. The test result can be used to help distinguish persons LACTOFERRIN SCAN™ test is a quantitative

with IBD, who will have elevated levels of fecal lac toferrin, from those with IBS, who will have base line lactoferrin levels. How can lactoferrin testing help diagnose--

and manage intestinal inflammation? Intestinal inflammation is caused by many different conditions. IBD is an autoimmune disease and is the primary cause of noninfectious intestinal in-

flammation. IBD can be difficult to distinguish from other intestinal disorders, especially IBS. A positive

test result in persons who have tested negative for infectious etiologies should alert the physician to possible IBD. A negative result, on the other hand, may signal a functional disorder like IBS, which is noninflammatory and less serious.

How does lactoferrin testing compare with other technologies? Other markers of fecal leukocytes are being evalu ated as markers of intestinal inflammation. In gen--

eral, however, other markers show higher levels of fluctuation than fecal lactoferrin and are affected by factors such as smoking, excessive weight, lifestyle modifications, time of testing, and some types of medication, such as proton pump inhib- itors. Lactoferrin is also highly stable in stool with levels remaining unchanged for up to 2 weeks when samples are stored either at room tempera ture or at 2 to 8°C. Lactoferrin’s stability exceeds all other FDA-cleared fecal biomarker assays. -

Why should I incorporate lactoferrin testing into my practice? If your daily practice includes patients with ul cerative colitis, Crohn’s disease, irritable bowel-

syndrome, or chronic bowel problems, lactoferrin testing can be part of a more accurate and cost-ef fective route to diagnosing the problem and pre scribing treatment. Lactoferrin testing is not intend ed as a replacement for endoscopy, but rather as a--- first step to assist you in determining if endoscopy is necessary, or to confirm endoscopic findings. By far, IBD and IBS are more responsible for visits to the gastroenterologist than any other condition. The lactoferrin assays are non-invasive adjunct as-

says to accompany your current regimen of tests. Who are candidates for lactoferrin testing? Anyone with chronic bowel problems should be

considered a candidate for lactoferrin testing. In particular, however, you should strongly consider lactoferrin testing for a patient suspected of IBD or IBS or an IBD patient suspected of active disease.

What are the specimen requirements? A stool specimen collected in a cup can be test ed. Specimens can be stored at 2-8°C or at room temperature for up to 2 weeks before being tested.-

The ing concentrations of fecal lactoferrin, a marker of fecal leukocytes. An elevated level is an indicator of intestinal inflammation. The test can be used as an in vitro diagnostic aid to help distinguish patients with active inflammatory bowel disease (IBD) from those with nonin LACTOFERRIN SCAN™ test is a quantitative ELISA for measur-- flammatory irritable bowel syndrome (IBS). In addition, the test can be used to assess when an IBD patient is in confirmed remission and has responded to treatment. The LACTOFERRIN CHEK™ test is an ELISA for the qualitative de- tection of elevated levels of lactoferrin, a marker for fecal leukocytes and an indicator of intestinal inflammation. The test can be used as an in vitro diagnostic aid to identify patients with active inflammato ry bowel disease (IBD) and rule out those with active irritable bowel syndrome (IBS), which is noninflammatory. IBD, which is a condition- of chronic inflammation, consists of ulcerative colitis and Crohn’s dis ease. Both of these diseases result in elevated fecal lactoferrin. As a result, patients with these diseases test positive in the RIN CHEK™ normal upon endoscopic examination and there is no indication of test. In patients with active IBS, the intestine appears LACTOFER-- inflammation. As a result, IBS patients test negative in the FERRIN CHEK™ to-use microwell format that has a turnaround time of an hour and fifteen minutes. test. The LACTOFERRIN CHEK™ test is a simple- LACTO- The test for the qualitative detection of elevated levels of lactoferrin, a marker for fecal leukocytes and an indicator of intestinal inflamma tion. The test can be used as an in vitro diagnostic aid to identify patients with an active inflammatory bowel disease (IBD) and rule out LACTOFERRIN EZ VUE™ test is an immunochromatographic- those with active noninflammatory irritable bowel syndrome (IBS). IBD, a condition of chronic inflammation, primarily includes ulcerative colitis and Crohn’s disease. Both of these diseases result in elevated fecal lactoferrin. As a result, patients with these diseases test positive in the LACTOFERRIN EZ VUE™ test. In patients with active IBS, the intestine appears normal upon endoscopic examination and there is no indication of inflammation. As a result, IBS patients test negative in the test is in a simple-to-use lateral flow format which provides results in 10 minutes. LACTOFERRIN EZ VUE™ test. The LACTOFERRIN EZ VUE™

Three formats are available for lactoferrin testing. All help to distinguish IBD from IBS.

Patents for Lactoferrin Testing and Intestinal Inflammation • • • Method For Differentiating Irritable Bowel Syndrome From Inflammatory Bowel Disease (IBD) And For Monitoring Persons With IBD Using Total Endogenous Lactoferrin As A Marker. U.S. Patent 7,192,724Inflammatory Bowel Disease And Irritable Bowel Syndrome IBD-First Chek Diagnostic Panel. U.S. Patent 7,785,818Method For Diagnosing Irritable Bowel Syndrome And Monitoring Inflammatory Bowel Disease. U.S. Patent 7,

  • For more information Fecal Lactoferrin As A Biomarker For Determining Disease Severity And For Monitoring Infection In Patients With Clostridium difficile Disease (patent pending) Please have a sales representative contact me I would like to receive additional information about the Lactoferrin tests.