b'ARTICLECanine and feline chronic inflammatory enteropathy (CIE) refers to a groupFaecal calprotectin in CIEof chronic, relapsing inflammatoryWhat it shows: Non-invasive disorders of the gastrointestinal tract.1biomarker of gastrointestinal CIE can affect the small intestine, largeinflammationintestine, or both and can significantly reduce quality of life. Clinical signs Diagnostic accuracy (GIQuest vary but commonly include vomiting,test, University of Bristol data):diarrhoea, weight loss, flatulence,oDogsScore 3 mg/kg: 96% melaena and alterations in appetite. specificity, 94% sensitivityAlthough the underlying cause is often unclear, multiple contributoryo CatsScore 2.5 mg/kg: 100% factors are thought to be involved.specificity, 92% sensitivityThese include genetic predisposition,Clinical relevance: Supports an inappropriate immune response todiagnosis of CIE; can help monitor dietary components, environmentalresponse to treatment.factors including stress and alterations in the gut microbiome (dysbiosis). 2Advantages: Non-invasive, Diagnostic approach affordable, stable in faeces, easy A definitive diagnosis of CIE requiresto collect, more specific for GI the exclusion of other causes of chronicinflammation than serum markers, gastrointestinal (GI) disease, ideallyfast results.supported by histopathology. However, endoscopic or surgical biopsies carrya cascade of events, culminating in cost, risk, and practical limitations, soneutrophil disintegration. 4-6many clinicians rely on presumptive diagnosis following dietary orBecause calprotectin makes up therapeutic trials. around 60 percent of neutrophil A standard work-up typically includescytosol (the fluid within a cells haematology, serum biochemistry andcytoplasm), this disintegration faecal analysis alongside GI-specificresults in calprotectin release into tests. The GI diagnostic toolbox now alsothe gut lumen and subsequently includes faecal calprotectina specific,into the faeces. Importantly, faecal non-invasive marker of GI inflammation. calprotectin is resistant to degradation by faecal bacteria and stable at What is faecal calprotectin? room temperature for up to a week. Calprotectin is a calcium- and zinc- The amount detected in faeces is binding protein. During GI inflammation,therefore directly proportional to the the innate and adaptive immunedegree of neutrophil infiltration in responses are stimulated, resulting in anthe gastrointestinal mucosa, making influx of phagocytic cells and the releaseit a practical non-invasive marker of of inflammatory cytokines, which in turnintestinal inflammation. This includes chemoattract neutrophils. This triggersinflammation arising from, for example, Figure 1. Distribution of faecal calprotectin scores in histologically verified inflammatory enteropathy vs controlswww.inspiredvet.co.uk21'