Zonulin, inflammation and iron status in patients with early stages of chronic kidney disease

Łukaszyk, Ewelina; Łukaszyk, Mateusz; Koc-Żórawska, Ewa; Bodzenta-Łukaszyk, Anna; Małyszko, Jolanta

doi:10.1007/s11255-017-1741-5

Cited by 18 publications

(19 citation statements)

References 23 publications

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“…However, the plasma zonulin levels documented in the NEPTUNE cohort of children with NS exceeded the mean circulating concentration measured in all of these prior studies including children of comparable age in the autism study (25). Two studies have reported substantially higher plasma zonulin levels in healthy adults and those with obesity, hyperlipidemia and various gastrointestinal disorders excluding celiac disease compared to the other reports and the current patient series (26, 30). This discrepancy may relate to different procedures for sample collection and/or processing and the inherent variability in plasma zonulin levels based on a single determination (27).…”

Section: Discussioncontrasting

confidence: 48%

“…There were no clinical or laboratory values that were significant predictors of the plasma zonulin concentration. In a recent study by Lukaszyk et al (26), plasma zonulin levels were lower in patients with early stage CKD compared to healthy adults, a finding that may account for the lower plasma levels in the children with nephrotic vs. sub-nephrotic proteinuria in the NEPTUNE cohort. The cause of the high plasma zonulin level in children with NS and how it may act on the podocyte to increase proteinuria requires further study.…”

Section: Discussionmentioning

confidence: 86%

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Plasma Zonulin Levels in Childhood Nephrotic Syndrome

et al. 2019

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Objective: We conducted this study to test the hypothesis that plasma zonulin levels are elevated in pediatric patients with nephrotic syndrome compared to healthy controls. Study Design: Plasma zonulin levels were measured by ELISA in 114 children enrolled in the NEPTUNE study. Clinical and laboratory data were retrieved from the NEPTUNE database. Results: The median age of the patients was 10 (IQR = 5 to 14) years, 59 were male, 64 had minimal change disease, 47 focal segmental glomerulosclerosis, median eGFR was 96 (IQR = 80 to 114) ml/min/1.73 m 2 , and median urine protein:creatinine ratio was 0.5 (IQR = 0.1 to 3.4) (g:g). The plasma zonulin level was 14.2 ± 5.0 vs. 10.2 ± 2.5 ng/ml in healthy adults in a report using the same assay kit, P = 0.0025. These findings were confirmed in an independent cohort of children with nephrotic syndrome compared to healthy age-matched controls, P = 0.01. Zonulin concentrations did not differ in children with minimal change disease vs. focal segmental glomerulosclerosis, frequently relapsing vs. steroid-dependent vs. steroid-resistant clinical course, and were not influenced by the immunosuppressive treatment regimen. There was no relationship between plasma zonulin levels and the absolute or percentage change in proteinuria from enrollment until the time of the zonulin assay. Conclusion: Plasma zonulin levels are elevated in childhood nephrotic syndrome regardless of level of proteinuria or specific treatment. The cause of the high plasma zonulin levels and whether zonulin contributes to glomerular injury requires further study.

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Section: Discussioncontrasting

confidence: 48%

Section: Discussionmentioning

confidence: 86%

Plasma Zonulin Levels in Childhood Nephrotic Syndrome

et al. 2019

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“…STROBE evaluation identified that the majority of the included articles provided an inadequate indication of study design, methods of addressing bias, study size calculation or consider the use of a flowchart (Table ). Three articles were recognised as low‐quality . During risk of bias assessment, no articles were identified as high risk of bias; although, 27 of the 47 articles were classified as having a moderate risk of bias.…”

Section: Resultsmentioning

confidence: 99%

“…Twenty‐four studies reported on 29 statistically significant biomarkers and association with altered IP . Two studies reported that fasting glucose had a weak positive correlation with IP (Table ).…”

Section: Resultsmentioning

confidence: 99%

Risk factors associated with intestinal permeability in an adult population: A systematic review

et al. 2019

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Background Increased intestinal permeability (IP) involves the loss of integrity between the cells of the small intestine. IP has been suggested to contribute to the pathogenesis and exacerbation of many chronic diseases. Many potential risk factors for IP are proposed in contemporary literature. The purpose of this review is to identify the most significant risk factors for IP. Methods A systematic search of literature published up until September 2018 in the PubMed, EMBASE, CINAHL, and Scopus databases was conducted. Results A total of 47 articles met the inclusion criteria. Elevated levels of proinflammatory markers, dyslipidaemia, hyperglycaemia, insulin resistance, anthropometric measurements resembling obesity, advanced disease severity, comorbidity and the consumption of a Western‐style diet were identified as the strongest risk factors for altered intestinal integrity. The risk of IP increases when coupled with a multiple disease state or combined with other environmental risk factors. Furthermore, many of the identified risk factors such as anthropometric measurements and biomarkers were external from intestinal health and rather resembled a metabolic‐like condition. Conclusions This review identified a number of potential risk factors for IP, ranging from biomarkers to anthropometric measurements, demographics, dietary intake and chronic diseases. These risk factors warrant the attention of clinicians and other healthcare providers to aid the identification of potential patients at risk of altered IP. Further research needs to examine whether the identified risk factors are homogeneous with the diagnosis of IP or whether the disease state influences the association.

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“…10 Lukaszyk et al also concluded that Zonulin cannot be considered as an inflammatory marker in chronic kidney disease (CKD). 11 It does not play a role in the disturbances of iron metabolism in CKD.…”

Section: Discussionmentioning

confidence: 99%

Low Serum Levels of Zonulin in Patients with HCV-Infected Chronic Liver Diseases

Akao

Morita

Onji

et al. 2018

Euroasian Journal of Hepato-Gastroenterology

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Aim The aim of the study was to assess the implication of Zonulin, a mediator protein synthesized by intestine and the liver,in patients with chronic liver diseases. Materials and methods Twenty-six patients with chronic liver diseases due to hepatitis C virus (HCV) and hepatitis B virus (HBV) were enrolled in this study. Out of total 26 patients, 17 were diagnosed as chronic hepatitis (CH) and 9 were patients with liver cirrhosis (LC). Twenty-four of these patients were infected with hepatitis C virus (HCV) and the rest two by hepatitis B virus (HBV). The study was conducted at Saiseikai-Imabari Hospital, Imabari, Ehime, Japan. Serum levels of Zonulin along with different parameters of liver function test were measured in all patients and comparative analyses were accomplished. Results The serum levels of Zonulin were significantly lower in CH patients compared to controls (p<0.001). Also, the levels of Zonulin were significantly lower in patients with LC compared to CH and normal controls (p<0.001). Further analysis revealed that serum Zonulin was significantly lower in patients with LC having ascites than those without ascites (p <0.05). There was a significant correlation of serum levels of Zonulin with platelet count, cholinesterase, and albumin in patients with chronic liver diseases. Discussion Decreased levels of Zonulin may be related to impaired production of this mediator in the diseased liver. It will be tempting to assess the regulation of Zonulin in the liver, a production site of the mediator. Abbreviations LC: Liver cirrhosis, CH: Chronic hepatitis, HCV: Hepatitis C virus, HBV: Hepatitis B virus, LGS: Leaky gut syndrome How to cite this article: Akao T, Morita A, Onji M, Miyake T, Watanabe R, Uehara T, Kawasaki K, Miyaike J, Oomoto M. Low Serum Levels of Zonulin in Patients with HCV-Infected Chronic Liver Diseases. Euroasian J Hepatogastroenterol, 2018;8(2):112-115.

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Zonulin, inflammation and iron status in patients with early stages of chronic kidney disease

Cited by 18 publications

References 23 publications

Plasma Zonulin Levels in Childhood Nephrotic Syndrome

Plasma Zonulin Levels in Childhood Nephrotic Syndrome

Risk factors associated with intestinal permeability in an adult population: A systematic review

Low Serum Levels of Zonulin in Patients with HCV-Infected Chronic Liver Diseases

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