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Original Articles
- Fecal surrogate markers strongly correlate with endoscopic findings in pediatric onset inflammatory bowel disease: a retrospective study in Japan
- Ryoko Yoshimura, Takahiro Kudo, Masanori Toda, Kosuke Kashiwagi, Masumi Nagata, Kaori Aoki, Natsuki Ito, Kazuhide Tokita, Nobuyasu Arai, Reiko Kyodo, Masamichi Sato, Eri Miyata, Keisuke Jimbo, Yoshikazu Ohtsuka, Toshiaki Shimizu, Hiromichi Shoji
- Received January 5, 2025 Accepted April 2, 2025 Published online December 12, 2025
- DOI: https://doi.org/10.5217/ir.2025.00103 [Epub ahead of print]
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Abstract
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ePub - Background/Aims
Endoscopy serves as the gold standard for assessing disease activity in inflammatory bowel disease (IBD). Noninvasive biomarkers have been under exploration as potential alternatives. This study aims to examine the diagnostic effectiveness of fecal immunochemical tests, along with levels of fecal calprotectin (FC) and fecal lactoferrin (FL), in stool samples from patients with early-onset IBD.
Methods
Children with childhood-onset IBD who visited the Department of Pediatrics and Adolescent Medicine at Juntendo University Hospital between August 2019 and July 2023 were included. FC levels, FL levels, and fecal immunochemical test results were measured using a colloidal gold agglutination assay. Fecal biomarker results and endoscopic findings were reviewed retrospectively.
Results
Sixty-five patients had ulcerative colitis (UC), 20 had Crohn’s disease (CD), and 3 had unclassified IBD. The participants, aged 3–27 years (median, 18.0 years), included 56 males and 32 females. Stool samples (n = 1,105) were analyzed, from 803 with UC, 251 with CD, and 51 with IBD. Endoscopic evaluations were conducted in 45 UC patients and 18 CD patients. A significant correlation was found between the FC and FL. These biomarkers were significantly correlated with the endoscopic activity index in both UC and CD patients.
Conclusions
FC is valuable for diagnosing endoscopic inflammation and predicting recurrence. A significant correlation was observed between FC and FL. In patients with UC and CD, both markers strongly correlated with endoscopic activity. Thus, FC and FL can serve as a reliable alternative to endoscopic evaluation in pediatric patients with childhood-onset IBD.
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- Inflammatory bowel diseases
- Tacrolimus for ulcerative colitis in children: a multicenter survey in Japan
- Tadahiro Yanagi, Kosuke Ushijima, Hidenobu Koga, Takeshi Tomomasa, Hitoshi Tajiri, Reiko Kunisaki, Takashi Isihige, Hiroyuki Yamada, Katsuhiro Arai, Atsushi Yoden, Tomoki Aomatsu, Satoru Nagata, Keiichi Uchida, Yoshikazu Ohtsuka, Toshiaki Shimizu
- Intest Res 2019;17(4):476-485. Published online August 31, 2019
- DOI: https://doi.org/10.5217/ir.2019.00027
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Abstract
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Supplementary MaterialPubReaderePub - Background/Aims
Tacrolimus is effective for refractory ulcerative colitis in adults, while data for children is sparse. We aimed to evaluate the effectiveness and safety of tacrolimus for induction and maintenance therapy in Japanese children with ulcerative colitis.
Methods
We retrospectively reviewed the multicenter survey data of 67 patients with ulcerative colitis aged < 17 years treated with tacrolimus between 2000 and 2012. Patients’ characteristics, disease activity, Pediatric Ulcerative Colitis Activity Index (PUCAI) score, initial oral tacrolimus dose, short-term (2-week) and long-term (1-year) outcomes, steroid-sparing effects, and adverse events were evaluated. Clinical remission was defined as a PUCAI score < 10; treatment response was defined as a PUCAI score reduction of ≥ 20 points compared with baseline.
Results
Patients included 35 boys and 32 girls (median [interquartile range] at admission: 13 [11–15] years). Thirty-nine patients were steroid-dependent and 26 were steroidrefractory; 20 had severe colitis and 43 had moderate colitis. The initial tacrolimus dose was 0.09 mg/kg/day (range, 0.05–0.12 mg/kg/day). The short-term clinical remission rate was 47.8%, and the clinical response rate was 37.3%. The mean prednisolone dose was reduced from 19.2 mg/day at tacrolimus initiation to 5.7 mg/day at week 8 (P< 0.001). The adverse event rate was 53.7%; 6 patients required discontinuation of tacrolimus therapy.
Conclusions
Tacrolimus was a safe and effective second-line induction therapy for steroid-dependent and steroid-refractory ulcerative colitis in Japanese children. -
Citations
Citations to this article as recorded by
- Management of paediatric ulcerative colitis, part 2: Acute severe colitis—An updated evidence‐based consensus guideline from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition and the European Crohn's and Colitis Organization
Amit Assa, Marina Aloi, Stephanie Van Biervliet, Jiri Bronsky, Javier M. di Carpi, Marco Gasparetto, Laura Gianolio, Hannah Gordon, Iva Hojsak, Alexandra S. Hudson, Séamus Hussey, Johan Van Limbergen, Erasmo Miele, Lorenzo Norsa, Ola Olén, Gianluca Pellin
Journal of Pediatric Gastroenterology and Nutrition.2025; 81(3): 816. CrossRef - Real‐world effectiveness of ustekinumab and vedolizumab in TNF‐exposed pediatric patients with ulcerative colitis
Perseus V. Patel, Amy Zhang, Balu Bhasuran, Vignesh G. Ravindranath, Melvin B. Heyman, Sofia G. Verstraete, Atul J. Butte, Michael J. Rosen, Vivek A. Rudrapatna
Journal of Pediatric Gastroenterology and Nutrition.2024; 78(5): 1126. CrossRef - CXCR2 Activated JAK3/STAT3 Signaling Pathway Exacerbating Hepatotoxicity Associated with Tacrolimus
Xiao Chen, Ke Hu, Yue Zhang, Su-Mei He, Dong-Dong Wang
Drug Design, Development and Therapy.2024; Volume 18: 6331. CrossRef - Medical management of pediatric inflammatory bowel disease in the Asia‐Pacific region: A position paper by the Asian Pan‐Pacific Society for Pediatric Gastroenterology, Hepatology, and Nutrition (APPSPGHAN) PIBD Working Group
Way Seah Lee, Katsuhiro Arai, George Alex, Suporn Treepongkaruna, Kyung Mo Kim, Chee Liang Choong, Karen S. C. Mercado, Andy Darma, Anshu Srivastava, Marion M. Aw
Journal of Gastroenterology and Hepatology.2023; 38(4): 523. CrossRef - Clinical outcome of ulcerative colitis with severe onset in children: a multicenter prospective cohort study
Ryusuke Nambu, Katsuhiro Arai, Takahiro Kudo, Takatsugu Murakoshi, Reiko Kunisaki, Tatsuki Mizuochi, Sawako Kato, Hideki Kumagai, Mikihiro Inoue, Takashi Ishige, Takeshi Saito, Atsuko Noguchi, Toshifumi Yodoshi, Shin-Ichiro Hagiwara, Naomi Iwata, Shigeo N
Journal of Gastroenterology.2023; 58(5): 472. CrossRef - Oral Tacrolimus in Steroid Refractory and Dependent Pediatric Ulcerative Colitis—A Systematic Review and Meta‐Analysis
Rishi Bolia, Akhil Goel, Pooja Semwal, Anshu Srivastava
Journal of Pediatric Gastroenterology and Nutrition.2023; 77(2): 228. CrossRef - Tacrolimus as an alternative treatment for patients with juvenile idiopathic arthritis
Susumu Yamazaki, Masaki Shimizu, Yuko Akutsu, Asami Shimbo, Masaaki Mori
Modern Rheumatology.2022; 32(4): 783. CrossRef - 3D printed tacrolimus suppositories for the treatment of ulcerative colitis
Iria Seoane-Viaño, Jun Jie Ong, Asteria Luzardo-Álvarez, Miguel González-Barcia, Abdul W. Basit, Francisco J. Otero-Espinar, Alvaro Goyanes
Asian Journal of Pharmaceutical Sciences.2021; 16(1): 110. CrossRef - Does cytomegalovirus load predict the outcome of acute severe ulcerative colitis?
You Sun Kim
Intestinal Research.2021; 19(4): 357. CrossRef - Tacrolimus in pediatric ulcerative colitis: does it have a role?
Seung Kim
Intestinal Research.2019; 17(4): 441. CrossRef
- Management of paediatric ulcerative colitis, part 2: Acute severe colitis—An updated evidence‐based consensus guideline from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition and the European Crohn's and Colitis Organization
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