# FECAL CALPROTECTIN AND INTESTINAL METABOLITES: WHAT IS THEIR IMPORTANCE IN THE ACTIVITY AND DIFFERENTIATION OF PATIENTS WITH INFLAMMATORY BOWEL DISEASES?

## TL;DR

This study explores fecal metabolites and calprotectin to better understand and differentiate inflammatory bowel disease subtypes and activity.

## Contribution

The study identifies specific fecal metabolites that distinguish Crohn’s disease from ulcerative colitis and correlate with disease activity.

## Key findings

- Hexadecanoic acid, squalene, and octadecanoic acid help differentiate Crohn’s disease from ulcerative colitis.
- Octadecanoic and hexadecanoic acids correlate with disease activity in ulcerative colitis.
- Metabolomics shows promise as a noninvasive tool for IBD evaluation and diagnosis.

## Abstract

Inflammatory bowel disease (IBD), comprising Crohn’s disease (CD) and ulcerative colitis (UC), lacks a known etiology. Although clinical symptoms, imaging, and colonoscopy are common diagnostic tools, fecal calprotectin (FC) serves as a widely used biomarker to track disease activity. Metabolomics, within the omics sciences, holds promise for identifying disease progression biomarkers. This approach involves studying metabolites in biological media to uncover pathological factors.

The purpose of this study was to explore fecal metabolomics in IBD patients, evaluate its potential in differentiating subtypes, and assess disease activity using FC.

Cross-sectional study including IBD patients, clinical data, and FC measurements (=200 μg/g as an indicator of active disease).

Fecal metabolomics utilized chromatography mass spectrometry/solid phase microextraction with MetaboAnalyst 5.0 software for analysis. Of 52 patients (29 UC, 23 CD), 36 (69.2%) exhibited inflammatory activity. We identified 56 fecal metabolites, with hexadecanoic acid, squalene, and octadecanoic acid notably distinguishing CD from UC. For UC, octadecanoic and hexadecanoic acids correlated with disease activity, whereas octadecanoic acid was most relevant in CD.

These findings highlight the potential of metabolomics as a noninvasive complement for evaluating IBD, aiding diagnosis, and assessing disease activity.