Preclinical stages of Crohn's disease defined by faecal calprotectin in asymptomatic first-degree relatives: screening framework for prevention trials.

Persistent elevated faecal calprotectin (>70 µg/g) identified nearly 20% of asymptomatic first-degree relatives as high-risk for presymptomatic Crohn's disease with a predictive calprotectin threshold of >225 µg/g showing 94% specificity.

• Why it matters: Early detection of preclinical Crohn's disease is crucial for prevention efforts, but current methods lack precise tools to identify individuals at imminent risk before symptoms develop.
• What they did: The study measured faecal calprotectin in 950 asymptomatic first-degree relatives aged 6-38 years, offering further endoscopic evaluation to those with persistent elevation, and analyzed the predictive value of calprotectin levels.
• The result: Findings demonstrate that calprotectin effectively distinguishes individuals with presymptomatic Crohn's disease, enabling targeted enrollment in prevention trials and advancing early intervention strategies.