Intestinal Fatty Acid Binding Protein and Citrulline as Markers of Gut Injury and Prognosis in Patients With Acute Pancreatitis

Goswami, Pooja; Sonika, Ujjwal; Moka, Praneeth; Sreenivas, Vishnubhatla; Saraya, Anoop

doi:10.1097/mpa.0000000000000924

Cited by 17 publications

(10 citation statements)

References 21 publications

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“…The accuracies of D-lactate and I-FABP were high, and the AUCs of both biomarkers were >0.80. Compared with previous studies assessing intestinal ischaemia, these biomarkers exhibit variable accuracies (36)(37)(38)(39)(40)(41). Obviously, single biomarkers were not effective in the evaluation of intestinal mucosal barrier dysfunction given that each biomarker only partially reflects pathophysiological changes in intestinal function.…”

Section: Discussionmentioning

confidence: 98%

Screening and combining serum biomarkers to improve their diagnostic performance in the detection of intestinal barrier dysfunction in patients after major abdominal surgery

Kong

Yang

et al. 2019

Ann. Transl. Med.

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Background: The aim of this prospective study was to screen and combine effective biomarkers to improve their diagnostic performance in detecting intestinal barrier dysfunction in patients after major abdominal surgery. Methods: Patients undergoing major abdominal surgery were enrolled after signing informed consent in this study. The serum concentrations of α-GST, DAO, D-lactate, citrulline and I-FABP were detected 24 hours before and after surgery. The diagnostic performance of five biomarkers on intestinal barrier dysfunction was assessed using logistic regression models and receiver operating characteristic (ROC) curve analyses. Results: Thirty-nine patients with major abdominal surgery were enrolled in and successfully completed this study. ROC analysis revealed that the sensitivities of D-lactate, citrulline and I-FABP were very high (0.91, 0.91 and 1.00, respectively), but the specificities of these biomarkers were less than 0.70. The sensitivity of DAO was very low [0.25; 95% confidence interval (CI), 0.05-0.57], but its specificity was high (0.92; 95% CI, 0.75-0.99). The accuracies of D-lactate and I-FABP were very high, and the areas under the curves (AUCs) of the biomarkers were 0.84 (95% CI, 0.68-0.93) and 0.81 (95% CI, 0.65-0.92), respectively. Different combinations of five biomarkers were also analysed. The sensitivity, specificity and AUC values of the combination of I-FABP, citrulline and D-lactate were 1.00, 0.74 and 0.89, respectively. These results were similar to those derived from the combination of α-GST, DAO, D-lactate, citrulline and I-FABP (P=1.000). Conclusions: The combination of serum D-lactic acid, citrulline and I-FABP greatly improved the diagnostic performance for identifying intestinal barrier dysfunction in patients after major abdominal surgery.

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Section: Discussionmentioning

confidence: 98%

Screening and combining serum biomarkers to improve their diagnostic performance in the detection of intestinal barrier dysfunction in patients after major abdominal surgery

Kong

Yang

et al. 2019

Ann. Transl. Med.

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“…[ 6 , 7 ] IFABP, a novel and objective biomarker of enterocyte injury, has been reported to be able to use for predicting outcomes of critical illness, such as acute decompensated heart failure, [ 3 ] cardiac arrest, [ 11 ] septic shock, [ 13 ] acute pancreatitis. [ 14 ] However, an association between IFABP and postoperative cardiac surgery patients has not been established. In this study, we found that serum IFABP level was well correlated with the AGI grade ( P < .001), and significantly higher in patients with inotropic score more than 10 ( P = .004), or patients who suffered from right ventricular dysfunction ( P = .016).…”

Section: Discussionmentioning

confidence: 99%

“…[ 11 ] Its circulating levels are very low in healthy individuals, but it rapidly releases into the systemic circulation upon enterocyte injury, and it is thus believed to be an early and useful marker for enterocyte injury. [ 12 ] Recently, elevated IFABP levels have been found in patients suffering from acute decompensated heart failure, [ 3 ] septic shock, [ 13 ] acute pancreatitis, [ 14 ] ulcerative colitis, [ 15 ] and have been reported as a promising sensitive marker for predicting clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

Intestinal fatty acid-binding protein as a predictor of prognosis in postoperative cardiac surgery patients

et al. 2018

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During the perioperative period of cardiac disease, as many risk factors exist, such as primary cardiac diseases, the use of vasopressors, ischemia-reperfusion injury during cardiopulmonary bypass (CPB), and surgical stress, the gut suffered from ischemia, anoxia and oxidative stress, which would lead to the enterocyte injury. The aim of this study was to explore whether serum intestinal fatty acid-binding protein (IFABP), which is excreted specifically from damaged intestinal enterocytes, as a predictor of prognosis in postoperative cardiac surgery patients.From January 2017 to December 2017, 40 postoperative cardiac surgery patients were enrolled in this observational study. Serum IFABP levels and prognostic biomarkers were recorded at intensive care unit (ICU) admission.The serum IFABP levels were significantly higher in postoperative cardiac surgery patients who complicated with multiple organ dysfunction syndrome (MODS) (median, 883.20 pg/mL vs 426.10 pg/mL; P < .001), infective complications (median, 917.70 pg/mL vs 409.40 pg/mL; P < .001), or who stayed in ICU beyond 4 days (median, 807.65 pg/mL vs 426.10 pg/mL; P < .001). Moreover, in patients who suffered from right ventricular dysfunction, the serum IFABP levels were significantly higher (median, 737.85 pg/mL vs 445.55 pg/mL; P = .016). The serum IFABP levels also showed great precision for the prediction of MODS (the area under curve, AUC 0.923), infective complications (AUC 0.961) and ICU stay beyond 4 days (AUC 0.853). And it correlated significantly with the acute physiology and chronic health evaluation (APACHE) II score (P < .05), sequential organ failure assessment (SOFA) score (P < .05), and acute gastrointestinal injury (AGI) grade (P < .001).The serum IFABP level at ICU admission is a valuable, convenient, and objective early predictor of prognosis in postoperative cardiac surgery patients.

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“…Intestinal fatty acid binding proteins are increased in serum after intestinal mucosal injury related to a variety of causes, mainly of ischemic and inflammatory type. 8,16,17 Besides I-FABP, L-FABP is a useful plasma marker for the detection of intestinal injury. L-FABP shows a similar pattern of tissue distribution along the duodenal to colonal axis but a >40fold higher content than of I-FABP in each intestinal segment.…”

Section: Discussionmentioning

confidence: 99%

Severe Anemia Is Associated with Intestinal Injury in Preterm Neonates

et al. 2019

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Objective A temporal relationship has been reported between necrotizing enterocolitis, anemia, and red blood cell transfusion (RBCT) in preterm neonates. However, the mechanism underlying this association is not clearly defined. Intestinal (I-) and liver (L-) fatty acid binding proteins (FABPs) have been proposed as plasma markers for the detection of acute intestinal injury. This study aimed to investigate the effect of anemia and RBCT on intestinal injury in preterm neonates by measuring serum I-FABP and L-FABP levels. Study Design A prospective cohort study including preterm neonates with gestational age <32 weeks and/or birth weight <1,500 g and requiring erythrocyte transfusions for anemia after day 15 of life was conducted. Stable growing preterm infants with hemoglobin values ≥ 10 g/dL were taken as controls. I-FABP and L-FABP levels of the neonates with anemia were compared with levels of the control group. In addition, pretransfusion I-FABP and L-FABP levels of the neonates with anemia were compared with posttransfusion levels. Results In total, 39 infants transfused for anemia and 20 controls were enrolled. L-FABP levels were significantly higher in neonates with anemia compared with controls (p < 0.001), whereas I-FABP (p = 0.695) was not different. L-FABP and I-FABP levels were similar before and after transfusion in neonates with anemia. L-FABP levels before transfusion were negatively correlated with pretransfusion hemoglobin levels (p < 0.001). Conclusion Anemia is associated with intestinal injury documented by increased L-FABP levels in preterm infants, and this injury is more severe with lower hemoglobin levels.

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Intestinal Fatty Acid Binding Protein and Citrulline as Markers of Gut Injury and Prognosis in Patients With Acute Pancreatitis

Abstract: Intestinal fatty acid binding protein is a promising prognostic marker in acute pancreatitis.

Cited by 17 publications

References 21 publications

Screening and combining serum biomarkers to improve their diagnostic performance in the detection of intestinal barrier dysfunction in patients after major abdominal surgery

Screening and combining serum biomarkers to improve their diagnostic performance in the detection of intestinal barrier dysfunction in patients after major abdominal surgery

Intestinal fatty acid-binding protein as a predictor of prognosis in postoperative cardiac surgery patients

Severe Anemia Is Associated with Intestinal Injury in Preterm Neonates

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