Mo1917 Commensal Fungi and Their Cell Wall Glycans Can Induce Autophagy in Intestinal Epithelial Cells: Implications for Mucosal Homeostasis and Inflammation

Background and Aim: Fecal calprotectin (FC) is a marker of intestinal inflammation enabling clinicians to distinguish between functional and organic bowel diseases as well as evaluate disease activity among patients with inflammatory bowel disease (IBD).For our study, we hypothesized that FC analysis of a single stool sample may be insufficient to aid the clinical decision-making process.Our aim was to assess the FC intra-individual and inter-day variability in patients (pts) with IBD (Crohns disease, ulcerative colitis) as well as constipation and colitis-related manifestations such as abdominal pain and diarrhea.Methods: From a total of 120 patients with IBD or colitis-related manifestations, one (first morning) stool sample was collected per day over a consecutive 3-day period.The time of defecation was self-recorded and each stool sample was delivered to the laboratory directly after sampling.FC was analyzed using a sandwich enzyme-linked immunosorbent assay (Calprotectin ELISA; Bühlmann Laboratories AG, Basel, Switzerland).According to the manufacturer, the normal range of FC is < 50 mg/g.The variability in FC concentration over the 3-day sampling period was assessed as well as the stability of FC concentrations in samples stored at room temperature.Results: Of 120 patients analyzed, we found three consecutive normal FC values in 43 (35%) pts.Notably, 48 (40%) pts showed a day-to-day fluctuation in FC concentration with 25 pts having the last two FC measurements over the cut-off value after normal FC was measured in the first measurement.23 pts had a third FC value lower than 50 mg/g after increased FC over the cut-off value was measured in the first two samples.Only 29 (24%) pts had three consistently abnormal FC levels over the cut-off value.Conclusion: The present study reveals a great day-to-day variability in the FC concentrations measured in stool samples of pts with IBD and colitis-related manifestations.Based on this outcome, it seems most appropriate to analyze three different stool samples, as one may result in a misleading value.It is important to stress that the clinical significance of such variability is strong as the mean value of three different FC concentrations from stool samples taken over three consecutive days could avoid unnecessary colonoscopy intervention.