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

Ewelina Lukaszyk,Anna Bodzenta-Lukaszyk,Mateusz Lukaszyk,Jolanta Malyszko,Ewa Koc-Zorawska

doi:10.1007/s11255-017-1741-5

Ewelina Lukaszyk, Anna Bodzenta-Lukaszyk + Show 3 more

Open Access

https://doi.org/10.1007/s11255-017-1741-5

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Abstract

Background/aimsZonulin is the only known regulator of intestinal permeability. It is also considered as a potential inflammatory marker in several conditions such as diabetes and inflammatory bowel syndrome. The aim of the study was to investigate zonulin levels in patients with early stages of CKD and its possible correlation with inflammation, anemia and iron status parameters.MethodsEighty-eight patients with early stages of CKD and 23 healthy volunteers were enrolled in the study. Zonulin, hepcidin-25, soluble transferrin receptor, interleukin-6 and high-sensitivity C-reactive protein were measured using commercially available assays.ResultsZonulin was significantly lower among patients with CKD in comparison with healthy volunteers. There were no statistically significant differences in zonulin concentration between patients with and without inflammation. Zonulin was significantly correlated with hepcidin only in patients with inflammation. Zonulin was neither related to iron nor related to ferritin.ConclusionsZonulin cannot be considered as an inflammatory marker in CKD. It does not play a role in the disturbances of iron metabolism in CKD. Its physiological role remains to be elucidated.

Highlights

Inflammation is one of the pathomechanisms responsible for progressive impairment in kidney function and is associated with common complications in chronic kidney disease (CKD) such as anemia
Zonulin was significantly lower in patients with CKD than in healthy volunteers (38.2 ± 16 vs 48.5 ± 6.4 ng/mL; p = 0.003)
There is a trend toward decrease in zonulin levels with the severity of CKD (Fig. 1)

Summary

Introduction

Inflammation is one of the pathomechanisms responsible for progressive impairment in kidney function and is associated with common complications in chronic kidney disease (CKD) such as anemia. Iron absorption takes place in the small intestine, where zonulin is the only known modulator of intracellular tight junction [1]. Intestinal permeability and zonulin disturbances have been reported to be associated with diabetes type 1 [3], type 2 [4, 5], inflammatory bowel syndrome [6] and other conditions with low-grade inflammation [7]. In our previous study on small group of patients in second and third stage of CKD, we observed correlations of zonulin with interleukin-6 (IL-6) and hemojuvelin [8]. We aimed to study zonulin levels in a larger population of patients with early stages of CKD and investigate its possible correlation with inflammation, anemia and iron status

Patients and methods

Results

Discussion

Compliance with ethical standards