Elevated fecal M2‐pyruvate kinase in children with cystic fibrosis: A clue to the increased risk of intestinal malignancy in adulthood?. Issue 5 (May 2015)

• Record Type: Journal Article
• Authors: Pang, Tamara; Leach, Steven T; Katz, Tamarah; Jaffe, Adam; Day, Andrew S; Ooi, Chee Y
• Is Part Of: Journal of gastroenterology and hepatology. Volume 30:Issue 5(2015:May)
• Page Start: 866
• Page End: 871
• Publication Date: 2015-05
• Subjects: Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/jgh.12842
• Languages: English
• ISSNs: 0815-9319

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jgh12842-sec-0001" sec-type="section"> <title>Background and Aim</title> <p>Adult patients with cystic fibrosis (CF) have an increased risk of gastrointestinal malignancies. We hypothesized that increased intestinal cell turnover beginning in childhood may explain the increased risk of malignancy in early adulthood. Therefore, we aimed to measure fecal M2‐pyruvate kinase (M2‐PK), a biomarker of intestinal cell turnover, in children with CF. To assess whether the increased cell turnover is secondary to intestinal inflammation, the secondary aims were to measure fecal calprotectin and evaluate its association with fecal M2‐PK.</p> </sec> <sec id="jgh12842-sec-0002" sec-type="section"> <title>Methods</title> <p>Fecal samples, for M2‐PK and calprotectin measurements, were prospectively collected from children with CF and healthy controls (HC).</p> </sec> <sec id="jgh12842-sec-0003" sec-type="section"> <title>Results</title> <p>Thirty‐three children with CF (mean [standard deviation] 7.3 [3.8] years old; 29 pancreatic insufficient [PI]) were enrolled and compared with 33 age‐matched HC. Fecal M2‐PK in CF patients (median [interquartile range, IQR]: 4.7 [1.5–9.7]) was greater than HC (1.0 [1.0–1.0] U/mL; <italic>P</italic> < 0.0001), and higher in PI (median [IQR]: 5.1 [1.8–13.7]) than pancreatic sufficient patients (1.0 [1.0–1.0] U/mL; <italic>P</italic> = 0.002). Fecal calprotectin was significantly elevated in CF than HC (median [IQR] 61.3 [43.8–143.8] <italic>vs</italic> 19.5 [19.5–35.1] mg/kg; <italic>P</italic> < 0.0001). However, there was no correlation between fecal M2‐PK and fecal calprotectin levels among subjects with CF (<italic>r</italic> = 0.29; <italic>P</italic> = 0.1).</p> </sec> <sec id="jgh12842-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Increased intestinal cell turnover is present in children with PI CF. The lack of relationship between fecal M2‐PK and calprotectin suggests that contributing factor(s) other than inflammation may be present.</p> </sec> </abstract>