Interesting article on the potential of papaya as a treatment for gut issues -
http://www.nleducation.co.uk/resources/r...-and-gastritis/Calprotectin was one of the markers of gut inflammation measured in one of the small studies of papaya and has also been found to be increased in AS patients:
Calprotectin is a neutrophil-derived protein that can be quantified in the feces and has become established as a marker of whole gut inflammation (Matzkies et al., 2012). A recent meta-analysis reported a sensitivity of 0.95 and a specificity of 0.91 for fCAL to diagnose IBD in adults (Matzkies et al., 2012). In subjects with IBD, levels of fCAL correlate with endoscopic and histological degree of bowel inflammation [27,28]. Furthermore, fCAL has been successfully shown to predict relapses and detect pouchitis in patients with IBD and to consistently differentiate IBD from irritable bowel syndrome. In subjects with IBD the levels of fCAL correlate with the endoscopic and histological degree of gut inflammation in adults and children [27].
Two-thirds of AS patients have elevated levels of fecal calprotectin, without associated gastrointestinal symptoms. Levels of fecal calprotectin are associated with increasing age, disease duration, ESR, CRP, and serum calprotectin, but not with gastrointestinal symptoms. Fecal calprotectin was higher in patients using NSAIDs, salicylates, and proton pump inhibitors, but lower in patients using methotrexate and infliximab (Klingberg, Carlsten, Hilme, Hedberg, & Forsblad-d’Elia, 2012). Calprotectin is also an independent predictor for radiographic spinal progression in AS (Turina et al., 2013). BASFI and BASDAI scores are higher for fCAL-positive patients compared with fCAL-negative AS patients. This finding might suggest more disease activity and functional disability in the group of patients with subclinical inflammation of the gut. Prior studies have found higher BASFI scores in ASCA-positive AS patients, confirming our findings [23]. High calprotectin levels were associated with mSASSS (modified Stoke Ankylosing Spondylitis Spinal Score) worsening over two years in AS, with an Area Under the Curve (AUC) of 0.740 (95% CI 0.614–0.866; P = 0.004) (Turina et al., 2013).
