Intestinal fatty acid-binding protein levels in Necrotizing Enterocolitis correlate with extent of necrotic bowel: results from a multicenter study

Heida, Fardou H.; Hulscher, Jan B F; Schurink, Maarten; Timmer, Albertus; Kooi, Elisabeth M. W.; Bos, Arie; Bruggink, Janneke L M; Kasper, David C.; Pones, Matthias; Benkoe, Thomas

doi:10.1016/j.jpedsurg.2014.11.037

Cited by 51 publications

(37 citation statements)

References 13 publications

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“…Recent studies have demonstrated that I-FABP levels in urine, not serum, were useful as a marker of intestinal mucosal damage in the early diagnosis of necrotic enterocolitis. 23 Further investigations into the prognostic value of urinary I-FABP are therefore warranted.…”

Section: Discussionmentioning

confidence: 99%

Circulating intestinal fatty acid-binding protein (I-FABP) levels in acute decompensated heart failure

Kitai

Kim

Kiefer

et al. 2017

Clinical Biochemistry

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Background Venous congestion has become increasingly recognized as a potential contributor to end-organ dysfunction in heart failure. Elevated I-FABP, which is excreted specifically from damaged intestinal epithelial cells, has been found in patients with abdominal hypertension and intestinal ischemia. We hypothesize that elevated intestinal fatty acid-binding protein (I-FABP) levels would identify patients with more advanced heart failure who have venous and intestinal congestion. Methods Baseline serum I-FABP levels were measured in 69 acute decompensated heart failure (ADHF) patients admitted to the intensive care unit for invasive hemodynamic monitoring and tailored medical therapy. Comprehensive echocardiography examinations were performed in all study patients, and clinical outcomes (death, cardiac transplant or left ventricular assist device placement) were assessed. Results The median circulating I-FABP level was 853 pg/ml (interquartile range: 533 to 1448 pg/ml). Age, gender, race, and baseline comorbidities were comparable between patients with low and high I-FABP levels. Although there were no significant correlations between I-FABP levels and invasively-measured hemodynamic parameters nor echocardiographic parameters, patients with higher I-FABP levels (≥853 g/ml) had significantly worse clinical outcomes compared to those with lower I-FABP levels (<853 pg/ml, P=0.025). Conclusion Circulating I-FABP levels had no association with invasively-measured hemodynamic parameters, but were associated with adverse clinical outcomes in patients with ADHF with systolic dysfunction.

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Section: Discussionmentioning

confidence: 99%

Circulating intestinal fatty acid-binding protein (I-FABP) levels in acute decompensated heart failure

Kitai

Kim

Kiefer

et al. 2017

Clinical Biochemistry

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“…I-FABP can be elevated in other types of bowel disease, such as small bowel obstruction, mesenteric ischemia, acute enterocolitis, Crohn disease, ulcerative colitis, and necrotizing enterocolitis. [7,11,12,25–27] Besides these factors, I-FABP can increase the false-positive rate in trauma patients. First, hemorrhagic shock and systemic inflammatory response are known to cause intestinal mucosal damage.…”

Section: Discussionmentioning

confidence: 99%

Early diagnosis of hollow viscus injury using intestinal fatty acid–binding protein in blunt trauma patients

Matsumoto

Sekine

Funaoka³

et al. 2017

Medicine

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A delay in diagnosing hollow viscus injury (HVI) causes an increase in mortality and morbidity. HVI remains a challenge to diagnose, and there is no specific diagnostic biomarker for HVI. We evaluated the utility of intestinal fatty acid–binding protein (I-FABP) in diagnosing HVI in blunt trauma patients. Within a 5-year period, 93 consecutive patients with clinically suspected HVI at our trauma center were prospectively enrolled. The diagnostic performance of I-FABP for HVI was compared with that of other various parameters (physical, laboratory, and radiographic findings). HVI was diagnosed in 13 patients (14%), and non-HVI was diagnosed in 80 patients (86%). The level of I-FABP was significantly higher in patients with HVI than in those with non-HVI (P = 0.014; area under the curve, 0.71). The sensitivity, specificity, positive predictive value, and negative predictive value were 76.9%, 70.0%, 29.4%, and 94.9%, respectively (P = 0.003). However, all other biomarkers were not significantly different between the groups. Presence of extraluminal air, bowel wall thickening on computed tomography (CT), and peritonitis signs were significantly higher in patients with HVI (P < 0.05). Of 49 patients (52.7%) who had a negative I-FABP and negative peritonitis signs, none developed HVI (sensitivity, 100%; negative predictive value, 100%). This is the first study that demonstrated the diagnostic value of a biomarker for HVI. I-FABP has a higher negative predictive value compared to traditional diagnostic tests. Although the accuracy of I-FABP alone was insufficient, the combination of I-FABP and other findings can enhance diagnostic ability.

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“…However, I-FABP concentrations in healthy preterm infants are somewhat variable and the half-life of I-FABP in plasma is short, so that use of the I-FABP concentration in plasma or urine to diagnose early NEC is limited. Similarly, although I-FABP can usefully distinguish those infants who have more extensive disease and thus require more extensive resection [15], the short half-life means that unless there is ongoing enterocyte damage, some infants with very extensive disease can have paradoxically low I-FABP levels (as all the enterocytes have been lost).…”

Section: Improved Diagnostic Methodsmentioning

confidence: 99%

Current Research on the Epidemiology, Pathogenesis, and Management of Necrotizing Enterocolitis

2017

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Despite decades of research on necrotizing enterocolitis, we still do not fully understand the pathogenesis of the disease, or how to prevent or how to treat it. However, as a result of recent significant advances in the microbiology, molecular biology, and cell biology of the intestine of preterm infants and infants with necrotizing enterocolitis, there is some hope that research into this devastating disease will yield some important translation into effective prevention, more rapid diagnosis, and novel therapies.

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Intestinal fatty acid-binding protein levels in Necrotizing Enterocolitis correlate with extent of necrotic bowel: results from a multicenter study

Cited by 51 publications

References 13 publications

Circulating intestinal fatty acid-binding protein (I-FABP) levels in acute decompensated heart failure

Circulating intestinal fatty acid-binding protein (I-FABP) levels in acute decompensated heart failure

Early diagnosis of hollow viscus injury using intestinal fatty acid–binding protein in blunt trauma patients

Current Research on the Epidemiology, Pathogenesis, and Management of Necrotizing Enterocolitis

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