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However, there is a clear need for non\u2010invasive biomarkers. Constant shedding of mucosal material into the bowel lumen and faeces, together with easy availability of stool, makes it an interesting sample matrix.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To conduct a systematic literature search and summarize the existing evidence for host mucosa\u2010derived faecal biomarkers in evaluating small intestinal damage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched for studies on PubMed (MEDLINE) until 1 March 2024.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 494 studies and included 35 original case\u2013control and cohort studies. These assessed host mucosal transcripts and 14 other markers aiming specifically to reflect inflammation and cell\u2010mediated, innate and gluten\u2010induced immune responses. In coeliac disease, faecal calprotectin and anti\u2010gliadin, tissue transglutaminase, endomysium and deamidated gliadin peptide antibodies were the most studied but with inconsistent results. Single studies reported positive findings about microRNA transcripts, \u03b2\u2010defensin\u20102, lipocalin\u20102, zonulin\u2010related proteins and angiotensin\u2010converting enzyme. In environmental enteropathy, a non\u2010significant association was reported between calprotectin and urine lactulose\/mannitol ratio; there were conflicting results for neopterin, myeloperoxidase and host transcripts. Single studies reported a positive association for lactoferrin, and a negative association for regenerating islet\u2010derived protein 1. Studies comparing faecal markers against small intestinal biopsy findings were not identified in environmental enteropathy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Further studies are needed to determine reliable faecal markers as a proxy for small intestinal mucosal damage.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.18234","type":"journal-article","created":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T07:47:58Z","timestamp":1725522478000},"page":"988-1004","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Review article: Faecal biomarkers for assessing small intestinal damage in coeliac disease and environmental enteropathy"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7959-7628","authenticated-orcid":false,"given":"Laura","family":"Kivel\u00e4","sequence":"first","affiliation":[{"name":"Department of Pediatric Research, Faculty of Medicine University of Oslo  Oslo Norway"},{"name":"Celiac Disease Research Center, Faculty of Medicine and Health Technology Tampere University  Tampere Finland"},{"name":"Children's Hospital, Helsinki University Hospital  Helsinki Finland"},{"name":"Department of Pediatrics Tampere University Hospital, Wellbeing Services County of Pirkanmaa  Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7417-5151","authenticated-orcid":false,"given":"Katri","family":"Lindfors","sequence":"additional","affiliation":[{"name":"Celiac Disease Research Center, Faculty of Medicine and Health Technology Tampere University  Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1713-5545","authenticated-orcid":false,"given":"Knut E. 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