Development and validation of an improved test for the measurement of human faecal elastase-1

This version was published on 1 January 2009

Ann Clin Biochem 2009;46:33-37
© 2009 Association for Clinical Biochemistry


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Original Articles

Petros Kampanis,
Loretta Ford and
Jonathan Berg

Department of Clinical Biochemistry, City Hospital, Dudley Road, Birmingham B18 7QH, UK

Corresponding author: Dr Petros Kampanis. Email: Petros.Kampanis{at}

Background: Human faecal elastase-1 (FE-1) is an established biochemicaltest for the investigation of pancreatic exocrine insufficiency.Conventional extraction methods for FE-1 analysis can give false-positiveresults with watery stools. This is a major limitation as patientsinvestigated for pancreatic disease commonly produce such stools.We have developed an improved FE-1 test that overcomes waterinterference by measuring the enzyme in dried faeces.

Methods: A novel collection device for FE-1 analysis that involves dryingand weighing the stool sample was developed in our laboratoryand compared with a conventional wet method, E1 Quick-Prep (Schebo,Biotech AG, Germany). The concentration of faecal FE-1 was determinedusing a commercially available enzyme-linked immunosorbent assaymethod (Schebo).

Results: FE-1 values obtained using the new dry extraction procedure (mean 1777 µg/g dry stool) were higher when compared with the conventional wet analysis (mean 402 µg/g stool). A1:2 dilution in water, mimicking a loose stool, was found toaffect FE-1 results obtained using the conventional wet extractionprocedure. The new dry extraction method gave consistent resultswhen water content was varied in the original stool sample.

Conclusion: We have demonstrated that our new device overcomes water interference,allowing results to be obtained from stool samples that wouldotherwise be unsuitable for FE-1 analysis.

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