Increased expression of cyclooxygenase-2 in first-degree relatives of gastric cancer patients

AIM: To study the expression of cydooxygenase-2 (COX-2) in human gastric cancer tissues and their paired adjacent mucosa, as well as mucosa from gastric antrum and corpus of the first-degree relatives of the recruited cancer patients. METHODS: The expression of COX-2 mRNA in 38 patients with gastric cancer and their 29 first-degree relatives and 18 healthy controls was assessed by the real time RT-PCR. The expression of COX-2 protein was determined by Western blot. RESULTS: A marked increase in COX-2 mRNA expression was found in 20 of 37 (54%) cancerous tissues compared to their respective paired normal mucosa (P<0.001). Interestingly, increased COX-2 mRNA expression was also found in mucosa of the corpus (6/29) and antrum (13/29) of their first-degree relatives. Increased COX-2 mRNA expression was more frequently observed in the antrum biopsies from cancer patients than in the antrum biopsies from healthy controls (P<0.05). In addition, 3 of 23 (13%) patients with atrophic mucosa and 6 of 35 (17%) patients with intestinal metaplasia showed increased COX-2 mRNA expression. Furthermore, COX-2 expression increased in H pylori-positive tissues, especially in antrum mucosa. CONCLUSION: Increased COX-2 expression is involved in gastric carcinogenesis, and may be necessary for maintenance of the malignant phenotype and contribute to Helicobacter pylori-associated malignant transformation.     

Association between gastric acid and mucin secretion in dyspeptic patients

BACKGROUND AND AIMS: The maintenance of an intact gastric mucosa implies a balance between aggressive, such as acid, and protective factors such as mucin. We examined gastric aspirates to determine a possible correlation between gastric acid and mucin contents. METHODS: Gastric contents were aspirated at gastroscopy in 14 patients. Acid content was evaluated by titration, and mucin content by gel filtration. In 4 other patients these measurements were also performed for 1-hour basal gastric secretion, and after pentagastrin stimulation. Western blot and dot blot for mucin protein were performed with polyclonal antibodies to the protein of MUC 5AC and MUC 6. RESULTS: A positive correlation was demonstrated between acid and mucin content in 14 patients, r = 0.77. In 4 other patients mucin secretion, after pentagastrin injection, increased by 3-46 fold in comparison with basal secretion. A positive correlation was demonstrated between basal acid and mucin secretion, and stimulated acid and mucin secretion. In dot blot experiments, MUC 5AC had a significant higher dot blot intensity than MUC 6. CONCLUSIONS: There is a correlation between acid and mucin secretion rates. Secretagogue that causes acid secretion may also cause secretion of protective mucin.     

Higher frequency of cagA EPIYA-C Phosphorylation Sites in H. pylori strains from first-degree relatives of gastric cancer patients

ABSTRACT: BACKGROUND: To evaluate the prevalence of more virulent H. pylori genotypes in relatives of gastric cancer patients and in patients without family histories of gastric cancer. METHODS: We evaluated prospectively the prevalence of the infection by more virulent H. pylori strains in 60 relatives of gastric cancer patients comparing the results with those obtained from 49 patients without family histories of gastric cancer. H. pylori status was determined by the urease test, histology and presence of H. pylori ureA. The cytotoxin associated gene (cagA), the cagA-EPIYA and vacuolating cytotoxin gene (vacA) were typed by PCR and the cagA EPIYA typing was confirmed by sequencing. RESULTS: The gastric cancer relatives were significant and independently more frequently colonized by H. pylori strains with higher numbers of CagA-EPIYA-C segments (OR = 4.23, 95%CI = 1.53--11.69) and with the most virulent s1m1 vacA genotype (OR = 2.80, 95%CI = 1.04--7.51). Higher numbers of EPIYA-C segments were associated with increased gastric corpus inflammation, foveolar hyperplasia and atrophy. Infection by s1m1 vacA genotype was associated with increased antral and corpus gastritis. CONCLUSIONS: We demonstrated that relatives of gastric cancer patients are more frequently colonized by the most virulent H. pylori cagA and vacA genotypes, which may contribute to increase the risk of gastric cancer.     

'Serological biopsy' in first-degree relatives of patients with gastric cancer affected by Helicobacter pylori infection

BACKGROUND: Relatives of patients with gastric cancer are at increased risk of developing this disease, especially if they are infected by Helicobacter pylori. Moreover, H. pylori-related atrophic gastritis and hypochlorhydria are well-documented risk factors for noncardia gastric cancer. Serum pepsinogen I (sPGI) and II (sPGII) levels are low in this condition. The aim of our study was to assess by means of a 'Gastropanel' blood test, including sPGI, sPGII, gastrin-17 (G-17) and antibodies anti-H. pylori (IgG-Hp). both functional and morphological features of gastric mucosa in Hp + ve subjects with a family history of gastric cancer. MATERIALS AND METHODS: Twenty-five Hp + ve subjects consecutively referred to our department for gastrointestinal complaints, selected as first-degree relatives of patients suffering from gastric cancer, were enrolled in the study and then matched for sex and age with 25 dyspeptic and Hp + ve subjects with no family history of gastric neoplasia. Blood samples were taken for determination of gastropanel in all patients; in addition, antibodies against CagA were analysed. RESULTS: No statistically significant differences were detected between the two groups as regards alcohol consumption, coffee intake and smoking habits. Mean sPGI levels in Group A (83.4 +/- 58.4 microg/L) were significantly lower than those in Group B (sPGI 159.5 +/- 80.6 microg/L; P < 0.0001) as well as sPGII (12.5 microg/L = 6.24 versus 20.6 +/- 58 microg/L; P < 0.006). No statistical difference was found between the two groups in relation to G-17 levels, IgG-Hp titres and antibodies against CagA. CONCLUSION: First-degree relatives of patients with noncardia gastric cancer affected by H. pylori infection present lower sPGI and sPGII levels, possibly due to the increased frequency of atrophic lesions in these patients.     

Expression of G1 phase cyclins in human gastric cancer and gastric mucosa of first-degree relatives

The aim of this study was to investigate the expression of D-type cyclins and cyclin E in gastric cancer patients (N = 34), in healthy first-degree relatives of gastric cancer patients (N = 29), and in control subjects (N = 18). Expression of cyclins D1, D2, D3, and E was determined by RT-PCR. Localization of cyclin expression was determined by immunohistochemistry. Expression of cyclins D2, D3, and E was more frequently detected in tumor tissue compared with tumor-free gastric mucosa (P < 0.05) and was associated with the presence of intestinal metaplasia. In contrast, cyclin D1 was frequently expressed in both tumor- and tumor-free tissue. Cyclin D3 expression was more frequently detected in the antrum mucosa of first-degree relatives compared to controls (P < 0.01) and was associated with the presence of Helicobacter pylori. Our data suggest that deregulation of G₁ phase cyclins may play a role in gastric carcinogenesis, and may point to the presence of molecular alterations in individuals at an increased risk for gastric cancer.     

Lower beta-cell secretion in physically active first-degree relatives of type 2 diabetes patients

Regular physical activity may prevent or postpone type 2 diabetes, and is thought to be related to an increase of insulin sensitivity. We studied whether physically active, glucose-tolerant first-degree relatives of type 2 diabetes patients differ in glucose tolerance (oral glucose tolerance test [OGTT]) and insulin secretion (hyperglycemic glucose clamp) from less active first-degree relatives. A group of 37 relatives was split into 2 subgroups according to the sex-specific median of the sports index, assessed by a questionnaire, as the cutoff point. Blood glucose levels during the OGTT were lower in the highly active subgroup versus the less active counterparts (multivariate ANOVA [MANOVA], P = .011), but the plasma insulin levels were similar. First-phase secretion was not different in the highly active group versus the less active group, but second-phase secretion (average plasma insulin in the third hour) was significantly lower (P = .016). As expected, the insulin sensitivity index (ISI) was higher in the highly active subgroup (P= .011). Subdivision into subgroups with high or low maximal O2 consumption (VO2max) resulted in similar differences, but these were not significant. In a group of 21 controls, the results resembled the values in the relatives but were less often statistically significant. In conclusion, regular physical activity not only is associated with increased insulin sensitivity but also downregulates the pancreatic beta cell. This downregulation may provide an extra mechanism by which physical activity diminishes the development of type 2 diabetes.     

Colorectal cancer risk in first-degree relatives of patients with colorectal adenomatous polyp

BACKGROUND/AIMS: To evaluate any risk of colorectal cancer in first-degree relatives of patients with colorectal adenomatous polyp. METHODOLOGY: In a screening program-based cross-sectional study, 44821 subjects received an immunochemical fecal occult blood test using a 2-consecutive-day method. They were divided into two groups, according to the results of a self-completed questionnaire on family history of colorectal adenomatous polyps, and the positivity rate of an immunochemical fecal occult blood test as well as the positive predictive value for colorectal cancer were determined in these two groups. RESULTS: The fecal occult blood test was positive in 8.5% of subjects with family history and in 4.8% of subjects without family history, and the positive predictive value for colorectal cancer was 6.8% and 2.4% in subjects with and without family history of colorectal adenomatous polyps, respectively, indicating a significant difference in the positivity rate of the fecal occult blood test (P < 0.01) as well as the positive predictive value for colorectal cancer (P < 0.05) between these two groups. CONCLUSIONS: These results show that first-degree relatives of patients with colorectal adenomatous polyp have an increased risk for colorectal cancer, and that the subjects with family history of colorectal adenomatous polyps as well as cancers should be considered as a priority group for prevention of colorectal cancer.     

Colonoscopic screening for neoplasms in asymptomatic first-degree relatives of colon cancer patients

Individuals with a family history of colorectal cancer are believed to be at an increased risk of developing colorectal neoplasia. To estimate this risk and the potential yield of screening colonoscopy in this population, we recruited and prospectively colonoscoped 181 asymptomatic first-degree relatives (FDR) of colorectal cancer patients and 83 asymptomatic controls (without a family history of colorectal cancer). The mean ages for the FDR and control groups were 48.2 ± 12.5 and 54.8 ± 11.0, respectively. Adenomatous polyps were detected in 14.4 percent of FDRs and 8.4 percent of controls. Although 92 percent of our FDRs had only one FDR afflicted with colon cancer, those subjects with two or more afflicted FDRs had an even higher risk of developing colonic adenomas (23.8 percent) than those with only one afflicted FDR (13.1 percent). A greater proportion of adenomas was found to be beyond the reach of flexible sigmoidoscopy in the FDR group than in the controls (48 percent vs.25 percent, respectively). Logistic regression analysis revealed that age, male sex, and FDR status were independent risk factors for the presence of colonic adenomatous polyps (RR=2.32, 2.86, and 3.49, respectively;P <0.001). Those at greatest risk for harboring an asymptomatic colonic adenoma are male FDRs over the age of 50 (40 percent ts.20 percent for age-matched male controls). Based on probability curves, males with one FDR afflicted with colon cancer appear to have an increased risk of developing a colonic adenoma beginning at 40 years of age. Our results document, for the first time, an increased prevalence of colonoscopically detectable adenomas in asymptomatic first-degree relatives of colon cancer patients, as compared with asymptomatic controls, and support the use of colonoscopy as a routine screening tool in this high-risk group.Read at the meeting of The American Society of Colon and Rectal Surgeons, San Francisco, California, June 7 to 12, 1992.Funded in part by the Aaron Diamond Foundation Colon Cancer Program of Columbia University and the Jean and Louis Dreyfus Foundation.     

Detection of early abnormalities in gastric function in first-degree relatives of patients with pernicious anemia

BACKGROUND: Pernicious anemia (PA), as many other autoimmune disorders, has a trend to appear in other members of the family of the affected patients. Although this fact has been recognized since some decades ago, less is known about the frequency with which the abnormalities detected in the patients appear also in their relatives, the correlations that exist among these abnormalities and to what extent these markers of the disease relate to serum cobalamin concentration. SUBJECTS AND RESULTS: For these reasons we studied the values of some markers of PA in a group of 79 first-degree relatives and we detected that the most frequent abnormalities are a decrease in serum pepsinogen I (22.7% of cases), an increase in serum gastrin (16.5% of cases) and in parietal cell antibody at a titer >or=40 (23.4% of cases). From a functional point of view, a decrease in hydrogen excretion in a magnesium breath test, indicative of achlorhydria, is also frequent (29.1%). The fall in cobalamin concentration runs in parallel with these abnormalities. The concentration of this vitamin was below normal levels in as much as 15.2% of cases. CONCLUSION: These findings emphasize the need for searching for the presence of occult or latent PA in relatives of patients with this diagnosis, not only to prevent the development of anemia but also to avoid other undesirable consequences of cobalamin deficiency.     

2型糖尿病患者一级亲属胰岛素抵抗与胰岛B细胞功能缺陷的临床研究

目的探讨胰岛素抵抗与胰岛B细胞功能缺陷在2型糖尿病(T2DM)发生中的作用。方法收集2004年4月至2005年6月解放军总医院门诊及住院T2DM患者的既往无糖耐量异常史的一级亲属,其中糖耐量正常(NGT)组174例、空腹血糖受损(IFG)或糖耐量低减(IGT)组55例,以及12例新发T2DM与同期收集的59例新发T2DM合并为新发糖尿病(T2DM)组;以其无糖尿病家族史的配偶或无血缘关系亲友中糖耐量正常者114名作为正常对照(NC)组。酶联免疫法测定血清真胰岛素(trueinsulin,TI)、胰岛素原(proinsulin,PI)。用胰岛素抵抗指数(Homa-IR)评价胰岛素抵抗。用空腹胰岛素原与空腹胰岛素比值(PI/TI)及B细胞功能指数(Homa-B),评估胰岛B细胞功能状态,并做对比分析。结果一级亲属中NGT组与NC组相比,Homa-IR显著高于NC组,PI/TI及Homa-B显著低于NC组。而且从NC至NGT至IGT或IFG至DM组,胰岛素抵抗进行性加重。胰岛B细胞分泌缺陷进行性加重,PI/TI逐渐升高,但LnHoma-B下降直至T2DM组才具显著意义(NC组为4.40±0.60,T2DM组为3.38±0.96)。结论T2DM患者一级亲属作为糖尿病的高危人群,在发生糖代谢异常前就存在胰岛素抵抗和胰岛分泌功能缺陷,且胰岛素抵抗和胰岛分泌功能缺陷与T2DM的发病相关;胰岛素原比例增加以及胰岛素原与真胰岛素比值升高是反映胰岛分泌功能缺陷的早期标志。     

Gastric epithelial cell proliferation and ras oncogene p21 expression in first-degree relatives of gastric cancer patients: a case-control study

OBJECTIVES: Individuals with a family history of gastric cancer have an increased risk of developing such neoplasia. This study aimed to assess epithelial cell proliferation and ras oncogene mutation in such individuals. METHODS: Twenty dyspeptic, first-degree relatives of patients with gastric cancer and 20 matched controls were enrolled. Endoscopy with biopsies was performed in all cases. Gastric specimens were used to look for Helicobacter pylori infection and to assess both epithelial cell proliferation and ras oncogene expression by immunohistochemistry. RESULTS: Cell proliferation values were not significantly different between the patient and control groups (18.1 +/- 7.1 versus 18.9 +/- 7.4; P = 0.7). Overall, ras mutation was detected in five out of 40 cases, and its distribution was similar between patients and controls (20 versus 10%; P = 0.9), as well as between H. pylori-positive and negative patients (22 versus 9%; P = 0.2). Cell proliferation values tended to be higher in cases with ras mutation than in those without (25.2 +/- 9.4 versus 16.8 +/- 5.8; P = 0.08). Cell proliferation values were significantly higher in H. pylori-positive cases compared with uninfected cases, in both patient (24.7 +/- 4.7 versus 12.5 +/- 2.4; P = 0.0003) and control (25.9 +/- 4.8 versus 13.3 +/- 2.8; P = 0.0003) groups. CONCLUSIONS: Both gastric cell proliferation values and ras mutation prevalence did not differ between first-degree relatives of gastric cancer patients and controls. H. pylori infection similarly increased the proliferation index of gastric mucosa in both groups.     

Regulation of canine gastric mucin synthesis and phospholipid secretion by acid secretagogues.

Key components of the mucous gel include the glycoprotein mucin and surface-active phospholipids. In the present study, mucin production and release of the surface-active phospholipid phosphatidylcholine (PC) into the medium were measured with an isolated canine mucous cell culture system. Stimulation of glycoprotein synthesis in response to 10(-4) mol/L histamine (160% +/- 9% of control, P < 0.01), 10(-6) mol/L gastrin (129% +/- 7%, P < 0.01), and 10(-6) mol/L carbamylcholine (129% +/- 7%, P < 0.01) was observed by metabolic labeling, whereas prostaglandin E2 (PGE2) had no effect. The effect of histamine was blocked by the H2 receptor antagonist cimetidine but not the H1 receptor antagonist diphenhydramine (P < 0.01). Activators of adenylate cyclase and cyclic adenosine monophosphate analogs significantly stimulated mucin synthesis (P < 0.05). A 7.8% +/- 1.7% increase in mucin above basal levels after 24 hours was observed with a solid-phase immunoassay in control wells, whereas histamine, gastrin, and carbamylcholine increased total mucin by 14% +/- 0.7%, 17% +/- 4.3%, and 20.4% +/- 4%, respectively (all P < 0.01), and PGE2 had no significant effect. PC release was stimulated by the administration of histamine, carbamylcholine, gastrin (108%-110% of control, P < or = 0.05), and PGE2 (120% of control, P < 0.01). The acid secretagogues histamine, gastrin, and carbamylcholine stimulated mucin synthesis and PC release. PGE2 has no direct role in the synthesis of canine gastric mucin but stimulates release of surface-active phospholipids. The mechanisms responsible for acid secretion provide for the coordinated production of the primary layer of defense against the injurious effects of low pH.     

Stomach cancer screening and preventive behaviors in relatives of gastric cancer patients

AIM:To investigate gastric cancer screening and preventive behaviors among the relatives of patients with gastric cancer[i.e.,gastric cancer relatives(GCRs)].METHODS:We examined the Korean National Health and Nutrition Examination Survey 2005(KNHANESⅢ) database and compared the gastric cancer screening and preventive behaviors of GCRs(n=261)with those of non-GCRs(n=454)and controls without a family history of cancer(n=2842).RESULTS:The GCRs were more likely to undergo gastric cancer screening compared with ...     

2型糖尿病患者一级亲属第一时相胰岛素分泌及其组分的变化

目的　探讨 2型糖尿病糖耐量正常的一级亲属胰岛素分泌第一时相和组分的变化 ,及其与2型糖尿病的关系。方法　以口服糖耐量正常的糖尿病一级亲属 (B组 ,3 5例 ) ,新诊断的 2型糖尿病患者(C组 ,3 5例 )及健康人群对照 (A组 ,2 1例 )为研究对象 ,放免法测定各组空腹及静脉葡萄糖耐量试验后血清免疫活性胰岛素 (IRI) ,ELISA法测定胰岛素原 (PI)、真胰岛素 (TI)水平。结果　 (1)空腹血清IRI、PI水平 :B组与A组间差异存在显著性 (均P <0 .0 5 ) ;TI水平 :B组与A组间差异无显著性 ;空腹血清IRI、TI水平 :B组与C组间差异无显著性 ;空腹PI :B组与C组间差异存在显著性 (P <0 .0 1)。 (2 )糖负荷后胰岛素分泌第一时相 :IRI及TI水平在B组与A组间差异无显著性 ;在B组与C组间差异有显著性 (P <0 .0 5 ) ;PI水平在B组与A组 ,A组与C组 ,B组与C组间均差异无显著性。结论　 2型糖尿病糖耐量正常的一级亲属可能存在 :(1)空腹高IRI血症及胰岛素抵抗 ;(2 )空腹胰岛素分泌组分存在异常 ,表现为空腹高PI血症 ;(3 )胰岛素分泌第一时相的IRI、TI、PI与正常人群相近 ;(4 )空腹血清PI可以作为 2型糖尿病的早期预测指标。     

Low adherence to colonoscopy in the screening of first-degree relatives of patients with colorectal cancer

Background

Colonoscopy is one of the methods of choice for screening relatives of patients with colorectal cancer.

Objective

To evaluate the rate of adherence to colonoscopy in first‐degree relatives of patients with colorectal cancer and describe the lesions found.

Methods

A prospective, cross‐sectional, multicentre, nationwide study was conducted. The study population was composed of first‐degree relatives of patients with colorectal cancer selected randomly from the EPICOLON study. Seventy‐four index patients were included. These had 342 living first‐degree relatives (parents, siblings and children), of whom 281 were interviewed.

Results

The adherence rate was 38% (107/281). Adherence was greater in families with a higher degree of familial aggregation for colorectal cancer (88.9% for Amsterdam vs 33.3% for Bethesda and sporadic cancer; p<0.05), an index patient aged under 65 years (60% for patients <65 years vs 32.9% for patients ⩾65 years; p<0.05) and an index patient who was female (46.2% for women vs 31% for men; p = 0.28). Adherence was also greater in relatives under 65 years (54% in patients <65 years vs 18% in patients ⩾65 years; p = 0.05), in female relatives (49% in female relatives vs 27.3% in male relatives; p<0.05) and in siblings and children (40% in siblings and children vs 13% in parents; p<0.05). Lesions were found in 26% (28/107) of the study population. Nine (8.4%) individuals had a total of 18 advanced lesions.

Conclusions

These results indicate that adherence to colonoscopy in our population of first‐degree relatives was low. The adherence was more frequently associated with a higher degree of familial aggregation, a relative age of under 65 years, a sibling or offspring relationship, and female sex.Colorectal cancer is the second most common form of cancer and the second leading cause of death from cancer in both men and women in the majority of developed countries. Death from colorectal cancer is also very high in Spain, where it is the second leading cause of death from cancer in men and women. Mortality has increased by an annual average of 2.6% for men and 0.8% for women since 1975, without variations.¹ It is estimated that colorectal cancer caused 11 900 deaths in Spain in 2000, which represents 11% of the total deaths from cancer in men and 15% of those in women.¹One of the main risk factors for colorectal cancer is a family history of the disease. First‐degree relatives (parents, siblings and children) of patients with colorectal cancer have a two‐ to threefold increased risk of developing the disease compared with the general population. Risk also depends on the age at which the neoplasm is detected, the number of relatives affected and the degree of kinship. Screening for colorectal cancer in first‐degree relatives serves to detect neoplastic lesions in their early stages. Although the majority of international organisations recommend screening for colorectal cancer in first‐degree relatives of affected patients,^2,3,4,5 this practice is not widespread in the majority of regions in Spain.Four strategies are currently used to screen for colorectal cancer in people at average risk or people with one first‐degree relative affected at age ⩾60 years: faecal occult blood testing; sigmoidoscopy; faecal occult blood testing combined with sigmoidoscopy; and colonoscopy. People with two or more first‐degree relatives affected or one first‐degree relative affected at age <60 years should be advised to have screening colonoscopy.^2,3,4,5 Potential adherence rates, however, need to be evaluated before a new strategy is added to a screening programme targeting at‐risk groups.The purpose of this study was to test the rate of adherence to colonoscopy in first‐degree relatives of patients with colorectal cancer, to identify associated factors and to study the characteristics associated with lesion detection.     

Incidence and recurrence rates of colorectal adenomas in first-degree asymptomatic relatives of patients with colon cancer

OBJECTIVES: Subjects with one first-degree relative affected with colorectal cancer are considered to be at increased risk of colorectal adenomas. We compared the recurrence and incidence rates of colorectal adenomas among subjects with one first-degree relative with colorectal cancer and those without family history. METHODS: A series of consecutive asymptomatic subjects successfully underwent a colonoscopy, were found to have either normal results or at least one adenoma, provided a detailed family history, and were offered a second colonoscopy 3 yr later; 190 out of 436 subjects accepted, 134/172 with one or more adenomas and 56/264 with no abnormalities at the initial examination. A first-degree family history was reported by 43/134 and 26/56, respectively. RESULTS: By multivariate analysis, the presence of adenomas at follow-up examination was significantly associated with a positive family history of colorectal cancer in both subgroups, those with a previously resected adenoma (odds ratio = 2.23, 95% CI = 1.04-4.79) and those without (odds ratio = 8.95, CI = 1.29-62.22). CONCLUSION: A history of one first-degree relative with colorectal cancer is associated with a significant increase in 3-yr cumulative incidence and recurrence rates of adenomas.     

Fecal calprotectin in first-degree relatives of patients with ulcerative colitis

OBJECTIVES: The pathogenesis of inflammatory bowel disease seems to depend on the combination of genetic and environmental factors. To evaluate genetic susceptibility, one approach is to search for specific markers in apparently unaffected family members of patients. Our aim was to evaluate fecal calprotectin concentrations (FCCs) in first-degree relatives of patients with ulcerative colitis (UC). PATIENTS: Fifty-five patients with UC and 167 healthy first-degree relatives were recruited; 38 of the patients' spouses were also enrolled. One hundred fifty healthy subjects participated as the control group. METHODS: FCCs were determined by ELISA. FCCs were compared among the groups by Kruskal-Wallis analysis of variance (ANOVA) test followed by Mann-Whitney U test. RESULTS: Significantly greater FCCs were found in first-degree relatives of patients with UC (76.0 [34.7-129.6] microg/g) as compared with controls (31.6 [17.0-45.0]) (P < 0.0001). Fecal calprotectin levels in patients with UC (256.0 [153.0-356.0] microg/g) were significantly higher as compared with first-degree relatives, spouses (43.8 [18.6-89.0] microg/g), and controls (P < 0.0001 for all comparisons). FCC of relatives was significantly higher than FCC of spouses (P = 0.01). FCC of spouses had a significantly higher FCC with respect to controls (P = 0.01). CONCLUSIONS: First-degree relatives of patients with UC had greater FCC values and could have a subclinical intestinal inflammation. It needs to be clarified if this finding is the consequence of genetic predisposition, of environmental factors, or the interaction of both, and if relatives with high FCC have a greater risk of developing the disease.