Measurement of an intestinal biomarker during poisonings from select toxicants and toxins

Abstract

Introduction Intestinal toxicity can occur following ingestion of various drugs, chemicals, and toxins. Intestinal fatty acid binding protein is a cytosolic protein specific to intestinal epithelial cells released into the systemic circulation following intestinal injury. Understanding intestinal toxicity in poisoning has the potential to explain mechanisms of toxicity and gastrointestinal symptoms. Methods Plasma samples were retrospectively analysed for intestinal fatty acid binding protein in 25 healthy controls and in those poisoned with Gloriosa superba (n = 18), Thevetia peruviana (n = 26), organophosphates (in various solvents) (n = 17), paracetamol (n = 14), glyphosate (n = 20), 2-methyl-4-chlorophenoxyacetic acid (n = 18) and propanil (n = 19). Results Median peak plasma intestinal fatty acid binding protein concentrations were significantly higher in patients poisoned with Gloriosa superba (2,994.1 µg/L; interquartile range 600.0–5,158.2, P < 0.001), Thevetia peruviana (1,292.5 µg/L; interquartile range 760.3 − 2,076.2; P < 0.001), glyphosate (1,803.6 µg/L; interquartile range 225.7–8,927.7; P < 0.001), 2-methyl-4-chlorophenoxyacetic acid (1,236.2 µg/L; interquartile range 192.6 − 1,709.7; P = 0.010), paracetamol (1,066.5 µg/L; interquartile range 512.9 − 1,336.9; P = 0.035), and organophosphate poisoning (729.8 µg/L; interquartile range 431.5 − 1,588.2; P = 0.046) than in healthy controls (221.6 µg/L; interquartile range 134.8 − 460.1). Median intestinal fatty acid binding protein was not statistically significantly increased compared to controls after propanil poisoning (630.0 µg/L; interquartile range 23.5 − 1,390.3; P = 0.423). Conclusions Our pilot study describes intestinal injury assessed by elevated plasma intestinal fatty acid binding protein concentrations following the ingestion of several poisons. This serves as a foundation for further exploration into enterocyte damage in toxicology.