Age-related levels of fecal M2-pyruvate kinase in children with cystic fibrosis and healthy children 0 to 10 years old

Abstract Background The pathogenesis of gut inflammation, bacterial dysbiosis and increased rates of malignancy in CF is unclear. Fecal M2-pyruvate kinase (M2-PK) is a biomarker indicative of cellular proliferation that may be raised in intestinal malignancy and inflammation. Biomarkers, including M2-PK, may be useful in assessing effects of novel therapies on the gastrointestinal tract. Methods M2-PK was measured in stools collected from patients with CF and HC (0–10years). Linear mixed model analysis was used. Results M2-PK levels did not significantly change in children with CF (36 patients, 77 samples) ( P =0.998) or HC (45 patients, 45 samples) ( P =0.21), over the age range 0–10years. Patients with CF had elevated M2-PK compared to HC (median [IQR; range]: 10.7 [5.7–28.6; 1.0–239.1] (n=77) vs. 1.0 [1.0–1.0; 1.0–50.0] (n=45) U/mL, respectively; P =0.001). Conclusions Fecal M2-PK was elevated in children with CF compared with HC during infancy and throughout childhood suggesting abnormalities in the CF gut exist in early life.