Dynamics of changes in plasma fatty acid binding proteins and intestinal zonulin in patients with generalized intra-abdominal infection and abdominal sepsis depending on the severity of patients

Abstract

Objective. Determine the levels of plasma intestinal fatty acid binding proteins levels in combination with zonulin in patients with generalized intra-abdominal infection and abdominal sepsis, and define the clinical usefulness them to assess the severity of patients.
 Materials ad methods. This study was based on an analysis of 59 patients of both sexes aged 18 to 70 years with generalized intra-abdominal infection (gIAI) and abdominal sepsis (AS).
 Results. According to the aims and objectives of the study the patients were divided into three groups: the 1st group - 26 patients with generalized peritonitis without sepsis according to the «Sepsis-3» criterion; the 2nd group - 24 patients with sepsis, and the 3rd group - 9 patients with septic shock. We found statistically significant higher levels of I-FABP in the all groups of patients (P = 0.000). The same tendency was observed in all periods of the study, and the most significant levels of I-FABP were by the tenth day after surgery in patients with septic shock: IQR 1567.3- 3876.1 (P = 0.000). Patients with abdominal sepsis did not have a statistically significant change in zonulin levels compared to patients with gIAI without sepsis (P = 0.560) and a similar trend was observed on the 3rd day after surgery (P = 0.135). Only by the 7th and 10th days after surgery changes in zonulin levels were significant in intra-abdominal infection patients without sepsis, with abdominal sepsis and septic shock (P = 0.000 and P = 0.004, respectively).
 Conclusions. Serum I-FABP levels were valuable and objectively early predictors of the severity of gastrointestinal injuries in gIAI. We also presented evidence of increased plasma zonulin levels in generalized intra-abdominal infection compared with the control group. Elevated zonulin levels were an additional indicator of the observed increase in intestinal permeability during gIAI, but zonulin was not an early biomarker of the severity of gastrointestinal damage like I-FABP.