Urine based detection of intestinal mucosal cell damage in neonates with suspected necrotising enterocolitis

Derikx, Joep P. M.; Evennett, Nicholas; Degraeuwe, Pieter; Mulder, Twan; Bijnen, Annemarie A. van; Heurn, L. W. Ernest van; Buurman, Wim A.; Heineman, Erik

doi:10.1136/gut.2007.128934

Cited by 76 publications

(79 citation statements)

References 11 publications

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“…Early diagnosis can be difficult, but is essential for immediate start of adequate treatment. Intestinal fatty acid-binding protein (I-FABP) is a promising diagnostic marker for NEC [2,3,4,5]. This cytosolic protein is primarily located in enterocytes of the small intestine and released into the circulation after enterocyte disruption or cell death [2,6,7].…”

Section: Introductionmentioning

confidence: 99%

Intestinal Fatty Acid-Binding Protein in Neonates with Imminent Necrotizing Enterocolitis

Schurink¹,

Scholten²,

Kooi

et al. 2014

Neonatology

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Background: Intestinal fatty acid-binding protein (I-FABP) is a promising marker for necrotizing enterocolitis (NEC). It can be measured in plasma (I-FABPp) and urine (I-FABPu). Data on the best way to measure I-FABP (in plasma or urine) and the necessity of simultaneous measurement of the urinary creatinine concentration to correct for physiological variations in urine concentration are not available. This holds also true for the reciprocal relation between I-FABPp, I-FABPu and other more conventional laboratory parameters. Objectives: To evaluate the above-mentioned correlations of I-FABP measurements in neonates with suspected NEC. Methods: All neonates with suspected NEC were prospectively included. I-FABPp and I-FABPu were analyzed at regular intervals during the first 24 h after onset of symptoms. Correlation and agreement were assessed between these and other parameters (i.e. IL-6, WBC, platelet count, CRP, pH and lactate). Results: Included were 24 boys, 13 girls [median (range) GA 28 weeks (24-36), median birth weight 1,190 g (570-2,400)]. I-FABPu correlated strongly with I-FABPp (r 0.80, p < 0.001) with an adequate agreement. A very strong correlation between I-FABPu and I-FABPu/urine creatinine ratio (r 0.98, p < 0.001) existed. Correlations between I-FABPp/u and conventional parameters were moderate to strong until 8 h after onset of symptoms. Conclusion: In neonates with suspected NEC, I-FABPu correlates strongly with I-FABPp, offering an opportunity to choose the most appropriate way of measuring I-FABP. Calculating urinary IFABP/creatinine ratio seems redundant. Moderately strong correlations between I-FABPu and IL-6, WBC and lactate were found.

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Section: Introductionmentioning

confidence: 99%

Intestinal Fatty Acid-Binding Protein in Neonates with Imminent Necrotizing Enterocolitis

Schurink¹,

Scholten²,

Kooi

et al. 2014

Neonatology

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“…A good candidate may be intestinal fatty acid-binding protein (I-FABP), which is a sensitive and specific enterocyte marker (5)(6)(7). It is released into the circulation as soon as the enterocyte's cell membrane integrity is compromised, and it can be detected in urine (5,8), making it a suitable marker for intestinal pathologies such as NEC and coeliac disease (9,10).…”

mentioning

confidence: 99%

Intestinal fatty acid–binding protein: a possible marker for gut maturation

et al. 2014

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Background: Gut immaturity is linked with postnatal intestinal disorders. However, biomarkers to assess the intestinal developmental stage around birth are lacking. The aim of this study was to gain more insight on intestinal fatty acid-binding protein (I-FABP) as an indicator of gut maturity. Methods: Antenatal I-FABP distribution and release was investigated in extremely premature, moderately premature, and term lambs, and these findings were verified in human urinary samples. Ileal I-FABP distribution was confirmed in autopsy material within 24 h postnatally. results: Median (range) serum I-FABP levels were lower in extremely premature lambs compared with moderately premature lambs (156 (50.0-427) vs. 385 (100-1,387) pg/ml; P = 0.02). Contrarily, median early postnatal urine I-FABP levels in human infants were higher in extremely premature compared with moderately premature and term neonates (1,219 (203-15,044) vs. 256 (50-1,453) and 328 (96-1,749) pg/ml; P = 0.008 and P = 0.04, respectively). I-FABP expression was most prominent in nonvacuolated enterocytes and increased with rising gestational age (GA) in ovine and human tissue samples. The epithelial distribution pattern changed from a phenotype displaying I-FABP-positive enterocytes merely in the crypts early in gestation into a phenotype with I-FABP expressing cells exclusively present in the villus tips at term in ovine and human tissue. conclusion: In this ovine and human study, increasing GA is accompanied by an increase in I-FABP tissue content. Cord I-FABP levels correlate with gestation in ovine fetuses, identifying I-FABP as a marker for gut maturation. Raised postnatal urine I-FABP levels in preterm human infants may indicate intestinal injury and/or inflammation in utero.

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“…Meghatározása I-FABP-ellenes antitestek használatával, kvantitatív ELISA-(enzyme-linked immunosorbent assay) módszerrel történik. Az alacsony molekulatömegű I-FABP a szisztémás keringésből a vesék glomerularis szűrőjén keresztül kiválasztódik (frakcionált renalis exkréció 28%; felezési idő 11 perc), ily mó-don kimutathatóvá válik a vizeletben is [8].…”

Section: Intestinal Fatty Acid Binding Protein -I-fabpunclassified

“…Előnye, hogy nem jár többletterheléssel a csecsemők számára, és a hólyagban tárolt vizelet lehetővé teszi az I-FABP meghatározását azt követően is, hogy az a vérből már kiürült [8,12,15].…”

Section: Nekrotizáló Enterocolitis Akut Mesenterialis Ischaemiaunclassified

“…A vékonybél ischaemiás toleranciája 6 óra, ezt követően irreverzibilisen károsodik, ezért a korai diagnózis létfon-tosságú. Néhány humán vizsgálat során sikerült igazolni, hogy a szérum-I-FABP szintje megemelkedik az arteria mesenterica superior occlusiója esetén [8,15,[18][19][20][21]. Egy patkányokat használó kísérletes modellben az SE I. Sebészeti Klinika munkacsoportja kimutatta, hogy a szé-rum-I-FABP szintjének emelkedése jól korrelál a szövet-tani minták elemzése során talált intestinalis epithelsejtkárosodás mértékével [22].…”

Section: Nekrotizáló Enterocolitis Akut Mesenterialis Ischaemiaunclassified

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Intestinalis zsírsavkötő fehérje: az enterocytakárosodás markere akut és krónikus gasztroenterológiai kórképekben

et al. 2016

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DebrecenAz intestinalis zsírsavkötő fehérje a zsírsavkötő fehérjék családjába tartozó, a vékony-és vastagbél enterocytáinak citoszoljában termelődő, kis molekulasúlyú fehérje. Az enterocytasejtek membránintegritásának megbomlását köve-tően megjelenik a szisztémás keringésben, és a vesék glomerularis szűrőjén keresztül kiválasztódik a vizeletbe. A szerzők akut és krónikus enterocytakárosodással járó gastrointestinalis kórképekben az intestinalis zsírsavkötő fehérje biomarkerként való használatával kapcsolatos vizsgálatokat tekintik át. Orv. Hetil., 2016, 157(2), 59-64.Kulcsszavak: intestinalis zsírsavkötő fehérje, nekrotizáló enterocolitis, akut mesenterialis ischaemia, coeliakia, gyulladásos bélbetegség, bakteriális transzlokáció Intestinal fatty acid binding protein: marker of enterocyte damage in acute and chronic gastroenterological diseasesIntestinal fatty acid binding protein, a small cytosolic protein abundantly present in mature enterocytes of small and large intestine, has proven to be a sensitive marker for damage to the intestinal epithelium. Upon cellular damage of the enterocyte, intestinal fatty acid binding protein is readily released into the systemic circulation, passes through the glomerular fi lter and can be detected in the urine. In this review, the authors review studies on the application of this protein as a biomarker in acute and chronic gastrointestinal diseases.

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Urine based detection of intestinal mucosal cell damage in neonates with suspected necrotising enterocolitis

Cited by 76 publications

References 11 publications

Intestinal Fatty Acid-Binding Protein in Neonates with Imminent Necrotizing Enterocolitis

Intestinal Fatty Acid-Binding Protein in Neonates with Imminent Necrotizing Enterocolitis

Intestinal fatty acid–binding protein: a possible marker for gut maturation

Intestinalis zsírsavkötő fehérje: az enterocytakárosodás markere akut és krónikus gasztroenterológiai kórképekben

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