Predictive and diagnostic value of serum intestinal fatty acid binding protein in neonatal necrotizing enterocolitis (case series)

Abstract

ObjectivesIn this study, we aimed to investigate the value of serum intestinal fatty acid binding protein (I-FABP) in early diagnosis and predicting the severity of Necrotizing enterocolitis (NEC).MethodsThis prospective study was performed on 160 preterm neonates ageing less than 35 weeks and weighting less than 2000 gm selected from the Neonatal Intensive Care Units (NICUs) of the Pediatric Department at Benha University hospital and Benha children hospital to evaluate which of them will develop NEC, after follow-up these neonates were divided into two groups: Group one compromised eighteen preterm neonates with symptoms and signs of NEC. Group two compromised ten preterm neonates as a control group. All participants were subjected to full clinical examination, abdominal X-ray and serum I-FABP.ResultsThe 1st values of IFABP taken at birth showed that mean serum IFABP concentrations of the study group were higher than that of the control group. The 2nd values of serum IFABP taken at the start of feeding showed that mean IFABP concentrations of the study group were higher in comparison with IFABP at birth. In the 3rd values of serum, IFABP taken at the time of diagnosing NEC showed that mean serum IFABP concentrations of the study group were higher than the control group. In the 4th values of serum, IFABP taken one week after diagnosing NEC showed that the mean serum IFABP concentrations of the study group became significantly decreased in comparison with IFABP at the time of diagnosis in stage 1 and 2.ConclusionsSerial measurements of serum I-FABP levels may be a useful marker for early diagnosis and prediction of disease severity in NEC.

Lactate and intestinal fatty acid binding protein as essential biomarkers in neonates with necrotizing enterocolitis: ultrasonographic and surgical considerations

“…15 Our results revealed significantly higher I-FABP levels in NEC neonates than in the control group, which was in line with many investigators. 4,26,27 We also noticed that I-FABPp and I-FABPu levels increased according to Bell's staging at the time of diagnosis of NEC. These data were in accordance with other studies.…”

“…These data were in accordance with other studies. 26,29 Also, there were significant positive correlations between IFABPp and IFABPu and between lactate with both IFABPp and IFABPu. In agreement with our findings, Schurink et al 7 emphasized the importance of such biomarkers as indicators of enterocyte damage and compromised intestinal barrier function (increased permeability) that were induced by ischemia and hypoperfusion.…”

“…Various studies revealed that the levels of IFABP were a helpful marker of evaluating intestinal necrosis. 24,26,33 We plotted a ROC curve for both serum and urinary I-FABP as a marker for diagnosis of NEC, discriminating stage-II from stage-III with equal sensitivity (90% for each), but with higher specificity for I-FABPu (92%) than I-FABPp. The characteristic performances of both assays in the prediction of surgical NEC revealed that I-FABPp (100%) was more specific than I-FABPu (76.19%).…”

The A54T polymorphism in the FABP2 gene and its relationship with obesity

“…In humans, the FABP-2 gene (IFABP) is located in the chromosomal region 4q28-4q31 and it is only expressed in the small intestine. Because of its specific tissue location, the potential of IFABP as a biomarker of intestinal damage has been explored under a variety of conditions, including celiac disease and necrotizing enterocolitis in premature infants (50)(51)(52). Similarly, the IFABP has been associated with higher intestinal permeability in patients with T2DM, along with the lipopolysaccharide (LPS) and the LPS binding protein (52).…”

New insights into necrotizing enterocolitis: From laboratory observation to personalized prevention and treatment

“…This overall lack of an accurate diagnostic test in early stages of NEC has led to a search for novel diagnostic approaches, which often reflect the downstream pathways that are activated in response to the bacterial-enterocyte signaling mechanisms described above. For instance, Abdel-Haie et al have identified that intestinal fatty acid binding protein (iFABP) can be measured in the serum [46] and urine [47] of neonates with NEC, which was found to have a sensitivity of 90% and specificity of 100%, reflective of the fact that enterocyte death is a natural consequence of disease development after TLR4 activation [46]. Fecal calprotectin -a molecule present in both leukocytes and enterocytes -is elevated in NEC, reflective of the inflammatory pathways that are recruited during NEC pathogenesis [48][49][50][51][52][53][54].…”