Diagnosis biomarkers in acute intestinal ischemic injury: so close, yet so far

Peoc’h, Katell; Nuzzo, Alexandre; Guedj, Kévin; Paugam, Catherine; Corcos, Olivier

doi:10.1515/cclm-2017-0291

Cited by 56 publications

(48 citation statements)

References 81 publications

(84 reference statements)

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“…However, as a consequence, and as a limitation of the current study, plasma I-FABP levels during exercise may have been slightly overestimated, and direct comparisons between studies should be performed with caution. Furthermore, in light of the relatively high I-FABP values reported here, it is important to note that baseline I-FABP concentrations tend to vary substantially between individuals and even within individuals between subsequent test days, and I-FABP values are highly variable between different ELISA kits (32). Therefore, we also report I-FABP values as a percentage change from baseline.…”

Section: Discussionmentioning

confidence: 93%

Sucrose but Not Nitrate Ingestion Reduces Strenuous Cycling–induced Intestinal Injury

Jonvik

Lenaerts

Smeets

et al. 2019

Medicine &Amp; Science in Sports &Amp; Exercise

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Strenuous exercise induces intestinal injury, which is likely related to splanchnic hypoperfusion and may be associated with gastrointestinal complaints commonly reported during certain exercise modalities. Increasing circulating nitric oxide (NO) levels or inducing postprandial hyperemia may improve splanchnic perfusion, thereby attenuating intestinal injury during exercise. Therefore, we investigated the effects of both dietary nitrate ingestion and sucrose ingestion on splanchnic perfusion and intestinal injury induced by prolonged strenuous cycling. Methods: In a randomized crossover manner, 16 well-trained male athletes (age, 28 T 7 yr; W max , 5.0 T 0.3 WIkg j1) cycled 60 min at 70% W max after acute ingestion of sodium nitrate (NIT; 800 mg NO 3), sucrose (SUC; 40 g), or a water placebo (PLA). Splanchnic perfusion was assessed by determining the gap between gastric and arterial pCO 2 (gap g-a pCO 2) using gastric air tonometry. Plasma intestinal fatty acidbinding protein (I-FABP) concentrations, reflecting enterocyte damage, were assessed every 20 min during and up to 60 min of postexercise recovery. Results: The exercise protocol resulted in splanchnic hypoperfusion, as gap g-a pCO 2 levels increased during exercise (P G 0.001), with no differences between treatments (P = 0.47). Although plasma I-FABP concentrations increased during exercise and postexercise recovery for all treatments (P G 0.0001), the increase was different between treatments (P G 0.0001). Post hoc comparisons showed an attenuated increase in I-FABP in SUC versus PLA (P = 0.020). In accordance, I-FABP area under the curve (AUC 0-120) was significantly lower in SUC versus PLA (57,270 T 77,425 vs 114,907 T 91,527 pgImL j1 per 120 min, P = 0.002). No differences were observed between NIT and PLA (P = 0.99). Conclusion: Sucrose but not nitrate ingestion lowers intestinal injury evoked during prolonged strenuous cycling. These results suggest that sucrose ingestion, but not nitrate, prevents hypoperfusion-induced gastrointestinal damage during exercise and, as such, may help to lower exercise-related gastrointestinal complaints.

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Section: Discussionmentioning

confidence: 93%

Sucrose but Not Nitrate Ingestion Reduces Strenuous Cycling–induced Intestinal Injury

Jonvik

Lenaerts

Smeets

et al. 2019

Medicine &Amp; Science in Sports &Amp; Exercise

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“…Intestinal fatty acid binding protein (I-FABP) is an intracellular protein that acts on the metabolism of long chain fatty acids and is abundantly expressed in the cytosol of epithelial cells in the small intestinal mucosa. Increased plasma levels of I-FABP have been associated with intestine-specific injury in several diseases [12]; however, studies of I-FABP in giardiasis are lacking.…”

Section: Introductionmentioning

confidence: 99%

Giardiasis Alters Intestinal Fatty Acid Binding Protein (I-FABP) and Plasma Cytokines Levels in Children in Brazil

et al. 2019

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Giardiasis is an intestinal infection caused by ingestion of water or food contaminated with cysts of Giardia lamblia. Susceptibility is higher in children and overall prevalence can reach up to 90% in low-income areas, although outbreaks are also reported in developed countries. Both parasite and immune-mediated epithelial damage has been observed in vitro and in animal models. However, whether enterocytes are directly damaged during infection is not entirely known. Our goal was to identify whether plasma levels of intestinal fatty acid binding protein (I-FABP), a marker of enterocyte damage, are related to the immune response in giardiasis. Blood plasma was collected from 31 children (19 Giardia-positive) from a public day care in Rio de Janeiro, Brazil. The levels of I-FABP were increased in Giardia-infected children compared to children without detectable infection. There was no difference in I-FABP levels in giardiasis caused by different genetic assemblages of Giardia. Levels of IL-8 were decreased, while there was a trend to elevated IL-17 in the Giardia-positive children. A positive correlation was observed between I-FABP and IL-17 levels as well as TNF, suggesting that epithelial damage can be related to cytokine production during giardiasis. These results help elucidate the relationship between the disruption of the intestinal mucosal barrier and immune responses to G. lamblia in children.

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“…En la medida en la que el período de tiempo entre el momento de la estrangulación y el tratamiento se prolonga, se produce un fallo progresivo de la microcirculación [23][24][25] . Como consecuencia la isquemia continúa hasta que a las 24 h más del 50% de los órganos isquémicos se encuentran necróticos [24][25][26] . Este proceso que se inicia con la insuficiencia vascular, afecta inicialmente la mucosa y submucosa, en la medida que va progresando, compromete toda la pared del órgano produciéndose la necrosis del mismo lo cual constituye la fase final e irreversible 25,26 .…”

Section: Tabla 5 Resultados De Las Pruebas Diagnósticasunclassified

“…Como consecuencia la isquemia continúa hasta que a las 24 h más del 50% de los órganos isquémicos se encuentran necróticos [24][25][26] . Este proceso que se inicia con la insuficiencia vascular, afecta inicialmente la mucosa y submucosa, en la medida que va progresando, compromete toda la pared del órgano produciéndose la necrosis del mismo lo cual constituye la fase final e irreversible 25,26 . En aquellos casos en los que el proceso continúa por falta de resolución, se llega al compromiso sistémico del paciente 26 .…”

Section: Tabla 5 Resultados De Las Pruebas Diagnósticasunclassified

“…Este proceso que se inicia con la insuficiencia vascular, afecta inicialmente la mucosa y submucosa, en la medida que va progresando, compromete toda la pared del órgano produciéndose la necrosis del mismo lo cual constituye la fase final e irreversible 25,26 . En aquellos casos en los que el proceso continúa por falta de resolución, se llega al compromiso sistémico del paciente 26 . El análisis de nuestra pequeña serie de casos nos permite sugerir que en aquellos pacientes que se presentan 12 o más horas después del inicio de la sintomatología, el riesgo de sufrir necrosis y resección de los órganos comprometidos es elevado comparado con aquellos pacientes que se presentan antes de las 12 h. Seguramente, un universo mayor de pacientes, nos permitiría establecer un punto de corte más específico para la ventana de tiempo entre la isquemia reversible y la necrosis irreversible.…”

Section: Tabla 5 Resultados De Las Pruebas Diagnósticasunclassified

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Hernia diafragmática secundaria a trauma: presentación tardía

et al. 2018

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Introduction: Late presentation of traumatic diaphragmatic hernia constitutes a true surgical emergency. The purposes of this study were to describe the diagnostic characteristics, treatment and outcomes of late presentation diaphragmatic hernias and to identify a cutoff point from the onset of symptoms to necrosis development. Patients and Methods: A retrospective series of cases constituted by all patients subjected to emergency diaphragmatic hernia repair form 2006 to 2016 was studied. Categorical and continuous variables were measured and analyzed with descriptive statistics. Receiver Operating Characteristics (ROC) curves at 6 and 12 hours from the onset of symptoms were used to determine the cutoff point for organ resection. Once stablished the cutoff point, sensitivity, specificity, positive and negative predictive values and prevalence were calculated. Results: Clinical presentation, diagnostic study and surgical treatment were similar to what has been already described. The cutoff point was defined at 12 hours from the onset of symptoms with 80% sensitivity and 83% sensibility. Conclusions: The diagnosis and treatment of these cases should be carried on before the first 6 hours after the onset of symptoms. Even though the universe of this study was small, we may suggest that after 12 hours form the onset of symptoms, the implicated organs would be found necrotic requiring surgical resection.

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Diagnosis biomarkers in acute intestinal ischemic injury: so close, yet so far

Cited by 56 publications

References 81 publications

Sucrose but Not Nitrate Ingestion Reduces Strenuous Cycling–induced Intestinal Injury

Sucrose but Not Nitrate Ingestion Reduces Strenuous Cycling–induced Intestinal Injury

Giardiasis Alters Intestinal Fatty Acid Binding Protein (I-FABP) and Plasma Cytokines Levels in Children in Brazil

Hernia diafragmática secundaria a trauma: presentación tardía

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