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World J Gastrointest Pharmacol Ther. Feb 6, 2017; 8(1): 39-46
Published online Feb 6, 2017. doi: 10.4292/wjgpt.v8.i1.39
Update on clinical and research application of fecal biomarkers for gastrointestinal diseases
Imran Siddiqui, Hafsa Majid, Shahab Abid
Imran Siddiqui, Hafsa Majid, Section of Chemical Pathology, Department of Pathology and Laboratory Medicine, Karachi 74800, Pakistan
Shahab Abid, Section of Gastroenterology, Department of Medicine, Aga Khan University, Karachi 74800, Pakistan
Author contributions: Siddiqui I and Majid H contributed to literature research and wrote the manuscript; Abid S made critical revisions related to important intellectual content of the manuscript; all authors read and approved the final version of the article.
Conflict-of-interest statement: All Authors have no conflict-of-interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Shahab Abid, MBBS, PhD, FCPS, FRCP, FACG, Section of Gastroenterology, Department of Medicine, Aga Khan University, Stadium Road, P.O. Box 3500. Karachi 74800, Pakistan. shahb.abid@aku.edu
Telephone: +92-21-34864656 Fax: +92-21-34934294
Received: October 18, 2016
Peer-review started: October 22, 2016
First decision: December 1, 2016
Revised: December 13, 2016
Accepted: January 2, 2017
Article in press: January 3, 2017
Published online: February 6, 2017
Abstract

Gastrointestinal (GI) diseases comprise a large spectrum of clinical conditions ranging from indigestion to inflammatory bowel diseases (IBDs) and carcinomas. Endoscopy is the usual method employed to diagnose these condition. Another noninvasive way to assess and diagnose GI conditions are fecal biomarkers. Fecal biomarkers provide information regarding a specific disease process and are perhaps more acceptable to clinicians and patients alike because of their non-invasivity compared to endoscopy. Aim of this review was to evaluate the current status of the fecal biomarkers in clinical and research for in GI diseases. Multiple types of fecal biomarkers are discussed in this review including; markers to assess IBD, which are released as a results of an inflammatory insults to intestinal epithelia such as antimicrobial peptides (lactoferrin) or inflammation related proteins (calprotectin). While markers related to function of digestion are primarily related to partially digested food or mucosal proteins such as abnormal amount of fecal fat α1-antitrypsin, elastase and secretary IgA. The upcoming fecal biomarker like M2 pyruvate kinase and neutrophil gelatinase associated lipocalin are discussed as well. Apart from above mention, the fecal biomarkers under exploration for possible clinical use in future are also discussed. These include cathelicidins, osteoprotegerin, β-glucuronidase, Eosinophil proteins, etc.

Keywords: Biomarkers, Gastrointestinal diseases, Inflammation, Lactoferrin, Calprotectin

Core tip: There is a general inclination of clinicians as well as pathologists’ to consider fecal biomarkers due to its non-invasivity. There are multiple types of fecal biomarkers in clinical use and under exploration for potential clinical use in future. It includes biomarkers for evaluating inflammatory bowel disease (e.g., calprotectin, lactoferrin), for evaluating colorectal cancer, malabsorption and eosinophilic protein for allergic gastrointestinal diseases. In this review we have analyzed the current status in terms of their practical utilization of fecal biomarkers with established indications and those which are under various stages of investigation.