Association between serum zonulin level and severity of house dust mite allergic asthma

Abstract

Background Increased intestinal permeability, either due to the exposure to antigens in asthmatic patients or due to a barrier defect, plays a critical role in susceptibility to environmental allergens. House dust mite allergy occurs more commonly than any other type of allergy among Egyptian asthmatic patients. Aim To assess the relation between serum zonulin level as a marker of increased intestinal permeability and the severity of house dust mite allergic asthma. Methods A case–control study which included 48 patients with house dust mite allergic asthma and 48 healthy control subjects attending the Allergy and Immunology Unit, Microbiology and Immunology Department, Faculty of Medicine, Zagazig University. Results A statistically significant difference was detected between the two studied groups with respect to serum IgE and serum zonulin levels (p ˂ 0.001 and ˂ 0.001, respectively). The mean serum zonulin was equal to 258.3 ± 153.01 ng/ml in the asthmatic group and 80 ± 13 ng/ml in the control group. Serum zonulin level significantly increased with the increase of asthma severity (p ˂ 0.001). The cut off value of serum zonulin was ≥ 198 ng/ml, and the area under the curve was 0.76. It displayed sensitivity equal to 80% and specificity equal to 71.4%. Its negative predictive value was equal to 83.3%. Conclusion Intestinal barrier dysfunction contributes to the pathogenesis of allergic asthma. Serum zonulin level reflects an increase in intestinal permeability. Zonulin acts as prognostic factor of severity in asthma. Correction of the gut barrier defect may have a potential positive prognostic effect in asthma.

Heat-killed Akkermansia muciniphila ameliorates allergic airway inflammation in mice

“…SCFAs can play crucial roles in promoting goblet cell differentiation, mucus production, and tight junction protein expression in colon crypts, which in turn stabilizes epithelial integrity and improves intestinal barrier function ( Rooks and Garrett, 2016 ; Martin-Gallausiaux et al, 2021 ). Notably, intestinal barrier dysfunction contributes to the onset of symptoms in patients with HDM AA ( Baioumy et al, 2021 ). Moreover, the relative abundance of the Lachnospiraceae_NK4A136_group is negatively correlated with intestinal barrier dysfunction and inflammation in a mouse model of dextran sodium sulfate-induced colitis ( Li et al, 2020 ).…”

Short chain fatty acids: key regulators of the local and systemic immune response in inflammatory diseases and infections

“…Impairment of the intestinal barrier is also linked to the onset of cystic fibrosis [ 79 , 80 ], allergic asthma [ 81 ], non-alcoholic fatty liver disease (NAFLD) [ 82 , 83 ] and multiple sclerosis (MS) [ 84 ]. In the following sections, we will discuss the role of intestinal-derived SCFAs as regulators of the inflammatory response in the liver, the lung and the central nervous system (CNS) and the potential therapeutic options of SCFA supplementation in ameliorating disease-associated inflammation in these organs.…”

Zonulin as a Potential Therapeutic Target in Microbiota-Gut-Brain Axis Disorders: Encouraging Results and Emerging Questions

“…These studies suggest that the integrity of intestinal barrier may determine the severity of systemic inflammation due to the migration of immune cells from the gut into the joints [ 153 ]. In addition, a possible role of zonulin in the pathomechanism of other disorders has been suggested, including but not limited to cardiac [ 68 , 156 ], pulmonary [ 12 , 13 , 157 , 158 ], or renal diseases [ 15 , 159 , 160 , 161 ].…”