Elevated fecal calprotectin levels are associated with severity of atopic dermatitis in children.

BACKGROUND Recent data suggested that imbalance in gut microbiota and gastrointestinal inflammation are associated with the childhood allergic disease. Fecal calprotectin has been used for a non-invasive marker of gut inflammation. OBJECTIVE The aim of this study was to investigate the relationships between fecal calprotectin level and the clinical severity of atopic dermatitis (AD) in children. METHODS We enrolled 65 subjects with AD. The concentration of calprotectin was measured in each subject's fecal sample. RESULTS The geometric mean fecal calprotectin level of the total subjects was 33.1(10.1-108.9) μg/g. Among the 65 subjects, 44(67.7%) showed calprotectin levels lower than 50μg/g(Group 1), and 21(32.3%) were higher than 50μg/g(Group 2). The mean SCORAD index was significantly higher in Group 2 than Group 1(31.0±16.0 vs 22.2±15.3, p=0.046). The geometric mean serum total IgE levels was higher in Group 2 compared to Group 1(361.4[31.6-992.3]IU/mL vs 175.9[44.3-699.2]IU/mL, p=0.040). The mean blood eosinophils were significantly higher in Group 2 than in Group 1(497.7[239.8-1032.8]/μL vs 281.5[121.5-652.0]/μL, p=0.034). The incidence of exposure to environmental tobacco smoke was significantly higher in Group 2 compared to Group 1(76.2% vs 47.7%, p=0.036). Geometric mean fecal calprotectin level in severe AD was significantly higher than that of mild-to-moderate AD(66.7[13.5-330.3]μg/g vs 29.4[10.1-85.6]μg/g, p=0.044). The fecal calprotectin level significantly correlated with the SCORAD index(r=0.303, p=0.014). CONCLUSIONS Higher fecal calprotectin levels were observed in subjects with severe AD. Elevated fecal calprotectin level as a gastrointestinal inflammatory marker may associate with childhood AD. Measurement of fecal calprotectin might be useful for assessment of severity of childhood AD.