Amanda Appleton, Senior Product Manager, Alpha Laboratories Ltd., caught up with Dr Arne Roseth, a pioneer in the adoption of calprotectin testing for diagnosing and monitoring inflammatory bowel diseases.
Dr Arne Roseth, a Norwegian gastroenterologist who is now semi-retired, has more than 25 years’ experience in calprotectin testing and its applications. He was himself diagnosed with Crohn’s disease in 1973, which is why he has always had more than a keen interest in gastroenterology.
“Back in May 1973 I was hospitalised for 77 days to drain an abscess, but this led to the diagnosis of Crohn’s disease in my small bowel – I was 18 years old. Following the diagnosis I had an 8 hour surgery, in November 1973, to deal with the abscess and the fistulas. I was then advised it had all been removed and there was an 80% chance of never having a relapse. However, when I started to study medicine, I discovered
I had an 80% chance of relapse within two years.
I began my career at the University Hospital in Oslo, where I learned all about inflammatory bowel disease (IBD) and the diagnostics available at the time.
My Professor (Prof. Henning Schjønsby) taught that patients are measured against clinical indices: it is active disease if they have abdominal pain and diarrhoea and don’t feel well, and it is in-active disease if they feel OK.
At first, I was very impressed with this, but then I started questioning how could he know how accurate this was? He did get a little bit annoyed at being challenged! A few weeks later he asked me to prepare a talk on IBD and the disease activity. Back then there was no internet for research, it was manual which was cumbersome, but I did it and I presented the data at our internal weekly meeting. The bottom line was the indices were not validated with endoscopy.
During my research I found a group of paediatricians had measured Alpha11 antitrypsin in stools and found a very good correlation with endoscopy. This is useful because paediatricians really don’t like to scope the children, so a noninvasive test is much better. Professor Schjønsby thought this was interesting, so I offered to set up a method to run the assay in stools in our laboratory.
Fortunately, I knew the Norwegian champion in Alpha-1 antitrypsin (Prof Magne Fagerhol) because he sailed the same boats as my dad, so we used to compete together (and he beat us!), so I approached him and asked if he would help.
I collected some stool samples and we made gels for immunodiffusion. Prof
Fagerhol said, “if it is the neutrophils you are really looking for, I have isolated a protein from them, maybe we should look to see if there is any L1 protein present (this is now known as calprotectin).”
