Intestinal Fatty Acid Binding Protein Concentrations Research Articles

Compression Socks Reduce Running-Induced Intestinal Damage.

Zadow, EK, Edwards, KH, Kitic, CM, Fell, JW, Adams, MJ, Singh, I, Kundur, A, Johnstone, ANB, Crilly, J, Bulmer, AC, Halson, SL, and, and Wu, SSX. Compression socks reduce running-induced intestinal damage. J Strength Cond Res 36(9): 2461-2464, 2022-Exercise is associated with a reduction in splanchnic blood flow that leads to the disruption of intestinal epithelium integrity, contributing to exercise-induced gastrointestinal syndrome. Strategies that promote intestinal blood flow during exercise may reduce intestinal damage, which may be advantageous for subsequent recovery and performance. This study aimed to explore if exercise-associated intestinal damage was influenced by wearing compression garments, which may improve central blood flow. Subjects were randomly allocated to wear compression socks ( n = 23) or no compression socks (control, n = 23) during a marathon race. Blood samples were collected 24 hours before and immediately after marathon and analyzed for intestinal fatty acid-binding protein (I-FABP) concentration as a marker of intestinal damage. The magnitude of increase in postmarathon plasma I-FABP concentration was significantly greater in control group (107%; 95% confidence interval [CI], 72-428%) when compared with runners wearing compression socks (38%; 95% CI, 20-120%; p = 0.046; d = 0.59). Wearing compression socks during a marathon run reduced exercise-associated intestinal damage. Compression socks may prove an effective strategy to minimize the intestinal damage component of exercise-induced gastrointestinal syndrome.

Excreta biomarkers in response to different gut barrier dysfunction models and probiotic supplementation in broiler chickens.

Increased intestinal permeability (IP) and inflammation are both linked with functionality of the intestinal barrier and in particular enterocytes. Currently, almost all assessment methods of the intestinal barrier function are invasive. The present study aimed to quantify selected proteins as novel biomarkers in excreta of broiler chickens to facilitate non-invasive assessment of gut barrier function using enzyme-linked immunosorbent assays (ELISA). It was further hypothesised that probiotics as feed additives may counteract gut barrier dysfunction. A 3 × 2 factorial arrangement of treatments was used with the main factors being gut barrier dysfunction models (control, rye-based diet, and dexamethasone–DEX) with and without probiotic supplementation (a three-strain Bacillus) using 72 male Ross 308 day-old chickens. Each of the 6 experimental treatments was replicated 12 times. On d 21 of age, fluorescein isothiocyanate dextran (FITC-d) uptake into serum was examined to test IP. Fresh excreta samples were collected on d 20. The biomarkers included alpha-1 antitrypsin (A1AT), intestinal fatty acid binding protein (I-FABP), lipocalin-2 (LCN2), fibronectin (FN), intestinal alkaline phosphatase (IAP), ovotransferrin (OVT) and superoxide dismutase [Cu-Zn] (SOD1). Only DEX increased (P<0.001) FITC-d passage to the blood on d 21 of age, indicating a greater IP. The excreta concentrations of A1AT, I-FABP and SOD1 were unaltered by the experimental treatments. DEX increased (P<0.05) FN concentration in excreta compared with control birds. Conversely, inclusion of rye in the diet reduced (P<0.05) FN but increased (P<0.001) OVT in excreta. Independently, DEX decreased IAP (P<0.05) in excreta compared with control and rye-fed birds. The excreta concentration of LCN2 tended (P = 0.086) to increase in birds injected by DEX. There was no demonstrable effect of probiotic addition on any of the studied parameters. Among the tested biomarkers, FN, IAP, and LCN2 revealed promise as biomarkers of intestinal barrier function quantified by ELISA kits.

A 16% Carbohydrate-hydrogel Beverage Reduces Gastrointestinal Permeability And Enterocyte Damage After Cycling In Hot-humid Conditions

BACKGROUND: Carbohydrate ingestion during exertional heat stress can reduce enterocyte damage and preserve gastrointestinal permeability. Athletes have begun to use drinks which encapsulate carbohydrate within a pectin-alginate hydrogel, yet little evidence exists to support their preferential use versus traditional carbohydrate-gels and/or beverages with multiple transportable carbohydrates. PURPOSE: To compare the effects of consuming a 16% carbohydrate-hydrogel drink to a nutrient matched maltodextrin-fructose (MF) drink on enterocyte damage and gastrointestinal permeability after cycling in hot and humid conditions. METHODS: Fourteen endurance trained cyclists (7 men, age 27 ± 8 yr, 176 ± 10 cm, 74 ± 11 kg, VO2max: 55.2 ± 9.5 ml.kg-1.min-1) cycled (45% VO2max) for 90 minutes before completing a 15-minute time trial in hot humid conditions (32°C, 70%) on 3 occasions separated by 7 days. During trials participants consumed either water (W), a traditional MF drink, or an encapsulated carbohydrate hydrogel drink (HYDRO) in a randomised order. Each CHO drink provided 90 g CHO.hr (16% w/v). Twenty minutes into exercise a 50 mL drink containing lactulose (L; 5 g) and rhamnose (R; 2 g) was provided and intestinal permeability determined by the percent ratio of lactulose to rhamnose recovered in post exercise urine samples. Venous blood samples were obtained before and 5 minutes after the time trial for assessment of intestinal fatty acid binding protein (IFABP), and data analysed using mixed linear models with fixed effects for condition (W/MF/HYDRO) and time (before and after exercise). RESULTS: L:R was greatest in W, and lower in both HYDRO [by 0.019 (95% CI: 0.010 to 0.027), p = 0.0003], and GF [by 0.014 (95% CI: 0.006 to 0.022), p = 0.0018]. No differences in L:R were found between the H and GF conditions (p = 0.083). Post-exercise IFABP concentrations were greater in W compared to HYDRO [by 349 pg.mL-1 (95% CI: 137 to 561 pg.mL-1), p = 0.007] and GF [by 427 pg.mL-1 (95% CI: 152 to 701 pg.mL-1), p = 0.018]. There was no difference in post exercise IFABP concentrations between H and GF (p = 0.90). CONCLUSION: Both CHO drinks preserved intestinal permeability and reduced the appearance of circulating IFABP compared to W. HYDRO offered no additional benefit beyond those achieved with a traditional MF drink.

Is the gut microbiota bacterial abundance and composition associated with intestinal epithelial injury, systemic inflammatory profile, and gastrointestinal symptoms in response to exertional-heat stress?

ObjectivesThe study aimed to examine if the α-diversity and relative abundance of the gastrointestinal bacterial taxa is associated with the response magnitude of markers characteristic of exercise-induced gastrointestinal syndrome in response to exertional-heat stress. DesignCross-sectional. MethodsTwenty-two endurance-trained athletes completed 2h running at 60% V.O2max in hot ambient conditions (35.2°C, 25% relative humidity). Faecal samples were collected pre-exercise to determine bacterial taxonomy by 16S rRNA amplicon sequencing (Illumina MiSeq platform). Data were processed using the QIIME2 pipeline (v2019.1) establishing taxonomic classification with >95% confidence using SILVA. Pre- and post-exercise blood samples were used to determine plasma I-FABP and cortisol concentrations, and systemic inflammatory response profile. Markers of physiological and thermoregulatory strain, and gastrointestinal symptoms were measured every 10min during exercise. Associations were determined by partial correlation controlled for body mass variables. ResultsPositive associations between Tenericutes (r(18)=0.446, p=0.049) and Verrucomicrobia (r(18)=0.450, p=0.046) phylum, Akkermansiaceae (r(18)=0.486, p=0.030) and Ruminococcaceae (r(18)=0.449, p=0.047) family and aligned genus groups with I-FABP were observed. Whilst, associations between Faecalibacterium (r(12)=0.668, p=0.009) and Ruminoclostridium-9 (r(12)=−0.577, p=0.031) genus with systemic inflammatory profile were observed. Association between bacterial phyla, family, and genus groups were also observed for gastrointestinal symptoms and markers of thermoregulatory strain (r(18) >0.400, p<0.05). ConclusionsThe relative abundance of several commensal bacterial groups showed modest favourable (i.e., low perturbations) or detrimental associations with the magnitude of gastrointestinal integrity perturbations and symptoms, and potentially influences body temperature change, in response to exertional-heat stress.

Normative values for circulating intestinal fatty acid binding protein and calprotectin across gestational ages

BackgroundNecrotizing enterocolitis (NEC) is associated with significant morbidity and mortality. Serum biomarkers to aid diagnosis, such as intestinal fatty acid binding protein (IFABP) and calprotectin, are actively being investigated; however, the normative values of these markers among healthy premature and term infants remains unknown. We sought to identify normative values for the serum concentrations of IFABP and calprotectin across gestational (GA) and post-menstrual age.MethodsWe collected serum from infants (24–40 weeks GA) in the first week of life and at multiple time points in a sub-cohort of premature infants (24–29 weeks GA), excluding sepsis or known intestinal disease. IFABP and calprotectin were measured using ELISA. Groups were compared with descriptive statistics and mixed effects linear regression.ResultsOne hundred twelve infants had specimens in the first week of life, and 19 premature infants had longitudinal specimens. IFABP concentration in the first week of life was low and did not differ across gestational ages. Longitudinally, IFABP increased 4% per day (P < 0.001). Calprotectin concentration in the first week of life was more variable. An inverse relationship between day of life and calprotectin level was found in the longitudinal cohort (P < 0.001).ConclusionsSerum IFABP and calprotectin fluctuate over time. Infants had low levels of IFABP during the first week of life, independent of gestational age, and levels increased longitudinally in premature infants. Calprotectin levels generally declined over time. Normative data for infants is necessary to establish meaningful cut-off levels for clinical use.

Use of intestine-related biomarkers for detecting intestinal epithelial damage in neonatal calves with diarrhea.

To evaluate the usefulness of intestinal biomarkers in determining the presence of intestinal epithelial damage in neonatal calves with diarrhea caused by 4 etiologic agents. 40 neonatal calves that were healthy (n = 10) or had diarrhea (30). The study was a cross-sectional study. Results of hematologic analyses and serum concentrations of intestinal fatty acid-binding protein (I-FABP), liver fatty acid-binding protein (L-FABP), trefoil factor 3 (TFF-3), Claudin-3 (CLDN-3), γ-enteric smooth muscle actin (ACTG2), intestinal alkaline phosphatase (IAP), interleukin-8 (IL-8), platelet-activating factor (PAF), and leptin (LP) were compared among calves grouped according to whether they were healthy (control group; G-1) or had diarrhea caused by K99 Escherichia coli (G-2; n = 10), bovine rota- or coronavirus (G-3; 5 each), or Cryptosporidium spp (G-4; 10). Across the 3 time points at which blood samples were obtained and evaluated, the groups of calves with diarrhea generally had markedly higher mean serum concentrations of L-FABP, TFF-3, IAP, IL-8, and LP, compared with the control group. In addition, G-2 also consistently had markedly higher mean serum concentrations of I-FAB and ACTG2 and lower mean serum concentrations of CLDN-3, compared with the control group. Results indicated that degree of intestinal epithelial damage differed among calves grouped by the etiologic agent of diarrhea and that such damage might have been more severe in calves with diarrhea caused by K99 E coli. Additionally, our results indicated that serum concentrations of I-FABP, L-FABP, TFF-3, IAP, IL-8, ACTG2, LP, and CLDN-3 were useful biomarkers of intestinal epithelial damage in calves of the present study.

Impact of 24-h high and low fermentable oligo-, di-, monosaccharide, and polyol diets on markers of exercise-induced gastrointestinal syndrome in response to exertional heat stress.

The study aimed to determine the effects of 24-h high (HFOD) and low (LFOD) fermentable oligo-, di-, monosaccharide, and polyol (FODMAP) diets before exertional heat stress on gastrointestinal integrity, function, and symptoms. Eighteen endurance runners consumed a HFOD and a LFOD (double-blind crossover design) before completing 2 h of running at 60% maximal oxygen uptake in 35 °C ambient temperature. Blood samples were collected before and after exercise to determine plasma cortisol and intestinal fatty acid binding protein (I-FABP) concentrations, and bacterial endotoxin and cytokine profiles. Breath hydrogen (H2) and gastrointestinal symptoms (GIS) were determined pre-exercise, every 15 min during, and in recovery. No differences were observed for plasma cortisol concentration between diets. Plasma I-FABP concentration was lower on HFOD compared with LFOD (p = 0.033). A trend for lower lipopolysaccharide binding protein (p = 0.088), but not plasma soluble CD14 (p = 0.478) and cytokine profile (p > 0.05), responses on HFOD was observed. A greater area under the curve breath H2 concentration (p = 0.031) was observed throughout HFOD (mean and 95% confidence interval: HFOD 2525 (1452-3597) ppm·4 h-1) compared with LFOD (1505 (1031-1978) ppm·4 h-1). HFOD resulted in greater severity of GIS compared with LFOD (pre-exercise, p = 0.017; during, p = 0.035; and total, p = 0.014). A 24-h HFOD before exertional heat stress ameliorates disturbances to epithelial integrity but exacerbates carbohydrate malabsorption and GIS severity in comparison with a LFOD. Novelty Twenty-four-hour high FODMAP diet ameliorated disturbances to gastrointestinal integrity. Twenty-four-hour high FODMAP diet results in greater carbohydrate malabsorption compared with low FODMAP diet. Incidence of GIS during exertional heat stress were pronounced on both low and high FODMAP diets, but greater GIS severity was observed with high FODMAP diet.

PSVII-19 Potential biomarkers of intestinal injury and inflammation in nursery pigs fed prebiotics

Abstract Prebiotics may alter protein fermentation and reduce biogenic amines that cause intestinal injury and inflammation. Biochemical markers are important in assessing gut integrity and inflammation, especially in evaluating efficacy of interventions for intestinal health at weaning. The objective of this study was to determine the effects of weaning and dietary prebiotics on potential biomarkers of intestinal barrier integrity and immunity. Sixty-four pigs (21 d; BW 6 ± 0.5 kg) of mixed sex were used to test 4 dietary treatments with 4 pens per treatment and 4 pigs per pen. Pens were randomly allocated to 1 of the 4 diets following completely randomized design in a 2-phase 28-d feeding experiment. Dietary treatments were corn-soybean based diet (Control), Control + fructooligosaccharide (FOS), Control + chicory pulp (PC) and Control + sugar beet pulp + (SBP). Prebiotics were incorporated in the diet by partially replacing corn at rate of 0.05 and 0.1% in phase 1 and 2, respectively. Blood samples were collected from 2 pigs per treatment on d 0, 14 and 28 and analyzed for concentrations of tight junction protein 1 (TJP1), intestinal fatty acid binding protein (IFABP), and diamine oxidase (DAO). Dietary treatments had no effect on growth performance. The TJP1 concentration increased with time (P &lt; 0.001). The DAO and IFABP concentrations decreased (P &lt; 0.001) over time. Pigs fed FOS and PC had lower concentrations of DAO (P = 0.034) and IFABP (P = 0.043) than Control and SBP at d 14. Results show that TJP1, DAO, and IFABP serum concentrations vary over the weaning period which may be indicative of intestinal restitution in response to weaning stress. Moreover, inclusion of prebiotics in the diet may affect serum biomarkers which may support the inclusion of prebiotics to improve gut health in weaned pigs.

FATTY-ACID-BINDING PROTEIN AS A MODERN MARKER FOR DIAGNOSIS AND EFFICACY OF INTENSIVE THERAPY OF GASTROINTESTINAL INSUFFICIENCY SYNDROME IN NEWBORNS

I-FABP, a fatty-acid-binding protein, is considered as a highly sensitive and highly specific marker of damage to the intestinal mucosa and could be used as an informative indicator of its affection in gastrointestinal insufficiency syndrome in newborns. Damage to the mucous membrane in patients requiring intensive care will always be accompanied by the basic mechanisms of critical states, ischemia and hypoxia. The aim of the work was to improve the diagnosis and assessment of the effectiveness of intensive care in newborns with gastrointestinal insufficiency syndrome by determining the I-FABP level. A prospective randomized clinical study included 20 newborns with gastrointestinal insufficiency syndrome. The concentration of blood plasma I-FABP in the examined patients was investigated, depending on the severity of the syndrome and the tactics of intensive care. It was established that the I-FABP concentration in 95% of cases was higher than the physiological value. This marker was significantly increased in newborns with clinically significant gastrointestinal insufficiency syndrome and decreased with lowering manifestations of this syndrome and under modified therapy with succinic acid and lactobacillus probiotics. Thus, an increase in the I-FABP concentration in newborns receiving an intensive care in 95% of cases points out the presence of gastrointestinal insufficiency syndrome that confirms a high sensitivity of the indicator. This marker can be used as a criterion for evaluating dynamics and stages of gastrointestinal insufficiency syndrome, accompanied by organic disorders, as well as a criterion for measuring the therapeutic efficacy for this syndrome.

Intestinal Fatty Acid Binding Protein, a Biomarker of Intestinal Barrier, is Associated with Severity of Psoriasis.

Alterations of intestinal microbiota play a significant role in the pathogenesis of psoriasis. Dysbiosis may cause disruption of the intestinal barrier, which contributes to immune activation by translocation of microbial antigens and metabolites. Intestinal fatty acid binding protein (I-FABP) serves as a biomarker of enterocyte damage. The aim of this study was to investigate clinical and metabolic factors affecting plasma concentration of I-FABP in patients with psoriasis. Eighty patients with psoriasis and 40 control subjects were enrolled in the study. Serum I-FABP (243.00 (108.88–787.10) vs. 114.38 (51.60–241.60) pg/ml, p < 0.001) and neutrophil to lymphocyte ratio (NLR; 2.59 (1.96–3.09) vs. 1.72 (1.36–47 2.11), p < 0.01) were significantly increased in patients with psoriasis compared to controls. A significant positive correlation was found between I-FABP and body mass index (BMI) (r = 0.82, p < 0.001), Psoriasis Area Severity Index (PASI) (r = 0.78, p < 0.001) and neutrophil to lymphocyte ratio (NLR) (r = 0.24, p < 0.001). Rising quartiles of I-FABP were associated with increasing values of BMI, PASI and NLR. The results of the logistic regression model confirmed an increased risk of higher disease severity with I-FABP concentration – odds ratio 3.34 per 100 pg/mL I-FABP increase. In conclusion, intestinal integrity in patients with psoriasis is affected by obesity, severity of the disease and systemic inflammation. The modulation of gut barrier may represent a new therapeutic approach for psoriasis.

Impact of the route of nutrition on gut mucosa in ventilated adults with shock: an ancillary of the NUTRIREA-2 trial.

The effects of the route of nutrition on the gut mucosa of patients with shock are unclear. Plasma citrulline concentration is a marker of enterocyte mass, and plasma intestinal fatty acid binding protein (I-FABP) concentration is a marker of enterocyte damage. We aimed to study the effect of the route of nutrition on plasma citrulline concentration measured at day3 of nutrition. Ancillary study of the NUTRIREA-2 trial. Ventilated adults with shock were randomly assigned to receive enteral or parenteral nutrition. Enterocyte biomarkers were measured at baseline, day3, and day8 of nutrition. A total of 165 patients from 13 French ICUs were included in the study: 85 patients in the enteral group and 80 patients in the parenteral group. At baseline, plasma citrulline was low without difference between groups (12.2µmolL-1 vs 13.3µmolL-1). At day3, plasma citrulline concentration was higher in the enteral group than in the parenteral group (18.7µmolL-1 vs 15.3µmolL-1, p = 0.01). Plasma I-FABP concentration was increased at baseline, without difference between groups (245pgmL-1 vs 244pgmL-1). Plasma I-FABP concentration was higher in the enteral group than in the parenteral group at day3 and day8 (158pgmL-1 vs 50pgmL-1, p = 0.005 and 225pgmL-1 vs 50pgmL-1, p = 0.03). Plasma citrulline concentration was higher after 3days of enteral nutrition than after 3days of parenteral nutrition. This result raises the question of the possibility that enteral nutrition is associated with a more rapid restoration of enterocyte mass than parenteral nutrition.

Role of necroptosis in intestinal injury induced by autologous orthotopic liver transplantation in rats

Objective To evaluate the role of necroptosis in intestinal injury induced by autologous orthotopic liver transplantation (AOLT) in rats. Methods Twenty-four SPF adult male Sprague-Dawley rats, aged 10-12 weeks, weighing 250-280 g, were divided into 3 groups (n=8 each) using a random number table method: sham operation group (group S), AOLT group (group T) and necroptosis inhibitor necrostatin-1 group (group N). Necrostatin-1 1.0 mg/kg and the equal volume of dimethyl sulfoxide (DMSO) were intraperitoneally injected at 30 min before surgery in N and T groups, respectively.Blood samples were collected from the inferior vena cava at 6 h after opening the portal vein (at 6 h after the end of surgery in group S) for determination of serum diamine oxidase (DAO), D-lactic acid (D-LA) and intestinal fatty acid binding protein (I-FABP) concentrations by enzyme-linked immunosorbent assay.Rats were sacrificed after blood sampling, and the intestine was removed for examination of the pathological changes (with a light microscope) and for determination of malondialdehyde (MDA) contents and superoxide dismutase (SOD) activities (using a spectrophotometer), and the expression of receptor-interacting protein kinase-1 (RIPK1), RIPK3 and mixed lineage kinase domain-like protein (MLKL) in intestinal tissues (by Western blot). Intestinal damage was assessed and scored using Chiu′s scoring system. Results Compared with group S, the serum DAO, D-LA and I-FABP concentrations, MDA content and Chiu′s score were significantly increased, SOD activity was decreased, and the expression of RIPK1, RIPK3 and MLKL was up-regulated in group T (P<0.05). Compared with group T, the serum DAO, D-LA and I-FABP concentrations, MDA content and Chiu′s score were significantly decreased, the SOD activity was increased, and the expression of RIPK1, RIPK3 and MLKL was down-regulated in group N (P<0.05). Conclusion Necroptosis is involved in the pathophysiological process of intestinal injury induced by AOLT in rats. Key words: Liver transplantation; Intestine; Necrosis

Sucrose but Not Nitrate Ingestion Reduces Strenuous Cycling-induced Intestinal Injury.

Strenuous exercise induces intestinal injury, which is likely related to splanchnic hypoperfusion and may be associated with gastrointestinal complaints commonly reported during certain exercise modalities. Increasing circulating nitric oxide (NO) levels or inducing postprandial hyperemia may improve splanchnic perfusion, thereby attenuating intestinal injury during exercise. Therefore, we investigated the effects of both dietary nitrate ingestion and sucrose ingestion on splanchnic perfusion and intestinal injury induced by prolonged strenuous cycling. In a randomized crossover manner, 16 well-trained male athletes (age, 28 ± 7 yr; Wmax, 5.0 ± 0.3 W·kg) cycled 60 min at 70% Wmax after acute ingestion of sodium nitrate (NIT; 800 mg NO3), sucrose (SUC; 40 g), or a water placebo (PLA). Splanchnic perfusion was assessed by determining the gap between gastric and arterial pCO2 (gapg-apCO2) using gastric air tonometry. Plasma intestinal fatty acid-binding protein (I-FABP) concentrations, reflecting enterocyte damage, were assessed every 20 min during and up to 60 min of postexercise recovery. The exercise protocol resulted in splanchnic hypoperfusion, as gapg-apCO2 levels increased during exercise (P < 0.001), with no differences between treatments (P = 0.47). Although plasma I-FABP concentrations increased during exercise and postexercise recovery for all treatments (P < 0.0001), the increase was different between treatments (P < 0.0001). Post hoc comparisons showed an attenuated increase in I-FABP in SUC versus PLA (P = 0.020). In accordance, I-FABP area under the curve (AUC0-120) was significantly lower in SUC versus PLA (57,270 ± 77,425 vs 114,907 ± 91,527 pg·mL per 120 min, P = 0.002). No differences were observed between NIT and PLA (P = 0.99). Sucrose but not nitrate ingestion lowers intestinal injury evoked during prolonged strenuous cycling. These results suggest that sucrose ingestion, but not nitrate, prevents hypoperfusion-induced gastrointestinal damage during exercise and, as such, may help to lower exercise-related gastrointestinal complaints.

Changes and significance of serum intestinal fatty acid binding protein in children with traumatic brain injury complicated with gastrointestinal dysfunction

Objective To study the changes and significance of serum intestinal fatty acid binding protein (IFABP) in children with traumatic brain injury(TBI) complicaled with acute gastrointestinal injury(AGI). Methods A total of 95 children suffering from TBI hospitalized in the PICU of the First Affiliated Hospital of Zhengzhou University from January 2017 to March 2018 were enrolled in the study.According to the modified Glasgow coma score combined with clinical classification criteria for acute closed head injury, the cases were devided into mild(43 cases), moderate (23 cases), and severe(29 cases). Children were graded according to AGI (AGI Ⅰ42 cases, AGI Ⅱ 30 cases, AGI Ⅲ 13 cases, and AGI Ⅳ 10 cases). Thirty healthy children who underwent physical examination at outpatient service were enrolled as the control group.Blood samples were collected at the time of admission and on the 3rd day after admission.Serum IFABP was detected by ELISA, and the differences of serum IFABP concentrations were compared among groups.The correlations between IFABP with TBI classification and AGI grade were analyzed.The receiver operating characteristic (ROC) curve was drawn, and the predictive values of IFABP for the diagnosis of children with TBI complicated with AGI were evaluated. Results On the day of admission, the serum levels of IFABP in mild, moderate and severe brain injury group were significantly higher than that in control group (all P<0.01). And serum IFABP concentration gradually increased with the increase of brain injury (all P<0.01). Serum IFABP levels in children with AGI grade Ⅰto Ⅳ were significantly higher than those in control group (all P<0.01). The levels of serum IFABP also increased with the increase of AGI level (all P<0.01). The concentration of serum IFABP was positively correlated with the grade of TBI and AGI (rs=0.82, P<0.01; rs=0.70, P<0.01). In each group, the levels of serum IFABP on the 3rd day after admission were lower than those on admission (all P<0.01). The ROC curve analysis showed that serum IFABP was of high diagnostic value in children with TBI complicated with AGI, and the area under the ROC curve was 0.88.When the cutoff value of IFABP was 431.36 ng/L, the sensitivity and specificity were 71.61% and 90.00%, respectively. Conclusion Serum IFABP can be used as a sensitive indicator for the early diagnosis and disease assessment in children with TBI complicated with gastrointestinal dysfunction. Key words: Intestinal fatty acid binding protein; Traumatic brain injury; Gastrointestinal dysfunction; Children

Effect of transcutaneous electrical acupoint stimulation on intestinal mucosal injury in patients undergoing laparoscopic radical resection of colorectal cancer

Objective To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on intestinal mucosal injury in patients undergoing laparoscopic radical resection of colorectal cancer. Methods Fifty-six American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients, aged 35-64 yr, with body mass index of 18-25 kg/m2, scheduled for elective laparoscopic radical resection of colorectal cancer, were selected and divided into 2 groups (n=28 each) using a random number table method: general anesthesia group (group G) and TEAS combined with general anesthesia group (group TG). In group TG, patients received continuous TEAS at bilateral Neiguan, Hegu, Zusanli, Shangjuxu and Xiajuxu acupoints from 30 min before anesthesia induction until the end of surgery, with a frequency 2/100 HZ, disperse dense waves, intensity the maximum current that could be tolerated (3-8 mA). After induction of anesthesia, the patients were endotracheally intubated and mechanically ventilated, and combined intravenous-inhalational anesthesia was used to maintain anesthesia in both groups.Peripheral venous blood samples were collected when entering the operating room (T1), at the end of operation (T2), and at 24 and 72 h after operation (T3, 4) for determination of intestinal fatty acid binding protein (I-FABP) and diamine oxidase (DAO) in palsma using enzyme-linked immunosorbent assay.Quality of Recovery-9 (QoR-9) was used to assess the postoperative quality of recovery at 24 h before surgery (T0), T3 and T4. Results The concentrations of plasma I-FABP and DAO were significantly higher at T2 and T3 than at T1 in G and TG groups (P<0.05). Compared with the baseline at T0, QoR-9 scores were significantly decreased at T3 and T4 in G and TG groups (P<0.05). Compared with group G, the concentrations of plasma I-FABP at T2 - T4 and DAO at T2 and T3 were significantly decreased, and QoR-9 scores were increased at T3 and T4 in group TG (P<0.05). Conclusion TEAS can attenuate intestinal mucosal injury in patients undergoing laparoscopic radical resection of colorectal cancer. Key words: Electric stimulation therapy; Anesthesia, general; Laparoscopy; Intestinal mucosa

Evaluation of Intestinal Damage Biomarkers in Calves with Atresia Coli.

IntroductionIntestinal obstruction such as atresia coli causes pathophysiological changes in gastrointestinal tissue due to the rise of intra-abdominal pressure. The aim of this study is to determine the intestinal damage with intestinal biomarkers in calves with atresia coli.Material and MethodsThe study was conducted on 40 Holstein calves diagnosed with atresia coli with mild to moderate abdominal distention and 10 healthy Holstein calves which served as the control. Blood samples were collected from all calves, and then serum concentrations of intestinal biomarkers were estimated, namely intestinal fatty acid binding protein (IFABP), liver fatty acid binding protein (LFABP), trefoil factor 3 (TFF3), and intestinal alkaline phosphatase (IAP), using commercially available specific bovine ELISA kits. An automatic blood gas analyser was employed for determining the lactate concentration.ResultsThe concentrations of serum LFABP (P < 0.01), IFABP, TFF3, IAP, and blood lactate (P < 0.001) were significantly higher in calves with atresia coli than in healthy calves.ConclusionThe calves affected with atresia coli exhibited severe intestinal damage, and IFABP, LFABP, and TFF3 have significant diagnostic importance and play a useful role in determining the intestinal damage due to intestinal obstruction. High levels of IAP and lactate may serve as a signal for the development of intestinal injury.

Non-invasive Point-of-Care Device To Diagnose Acute Mesenteric Ischemia

Inadequate blood supply to the intestine can lead to acute mesenteric ischemia (AMI), with a mortality rate ranging from 60% to 90%. This high mortality rate is partially due to late detection and the lack of efficient early diagnostic tests. There is an urgent need for a point-of-care tool for immediate bedside diagnosis. Here we present for the first time a rapid and non-invasive electrochemical biosensor device based on non-faradic impedance spectroscopy to detect intestinal fatty-acid binding protein (I-FABP) as an indication of AMI. The electrochemical biosensors consist of gold interdigitated electrodes that were fabricated using photolithographic techniques on top of silicon dioxide substrates. The electrode surfaces were functionalized with an I-FABP capture antibody (CAnB) to entice the target protein, while gold nanoparticles (GNPs) functionalized with detection antibodies (DAnB-GNPs) were utilized as a novel mechanism to enhance the detection signal. Quantification of the I-FABP concentration in the medium depended on its attachment to CAnB and DAnB-GNPs in a sandwich manner, where the latter boosts the impedance signal through its binding to the I-FABP. This non-invasive non-faradic electric biosensor device demonstrates the potential for bench-to-bedside translation with the goal of decreasing morbidity and mortality from AMI.

Preexercise breakfast ingestion versus extended overnight fasting increases postprandial glucose flux after exercise in healthy men.

The aim of this study was to characterize postprandial glucose flux after exercise in the fed versus overnight fasted state and to investigate the potential underlying mechanisms. In a randomized order, twelve men underwent breakfast-rest [(BR) 3 h semirecumbent], breakfast-exercise [(BE) 2 h semirecumbent before 60 min of cycling (50% peak power output)], and overnight fasted exercise [(FE) as per BE omitting breakfast] trials. An oral glucose tolerance test (OGTT) was completed after exercise (after rest on BR). Dual stable isotope tracers ([U-13C] glucose ingestion and [6,6-2H2] glucose infusion) and muscle biopsies were combined to assess postprandial plasma glucose kinetics and intramuscular signaling, respectively. Plasma intestinal fatty acid binding (I-FABP) concentrations were determined as a marker of intestinal damage. Breakfast before exercise increased postexercise plasma glucose disposal rates during the OGTT, from 44 g/120 min in FE {35 to 53 g/120 min [mean (normalized 95% confidence interval)] to 73 g/120 min in BE [55 to 90 g/120 min; P = 0.01]}. This higher plasma glucose disposal rate was, however, offset by increased plasma glucose appearance rates (principally OGTT-derived), resulting in a glycemic response that did not differ between BE and FE ( P = 0.11). Plasma I-FABP concentrations during exercise were 264 pg/ml (196 to 332 pg/ml) lower in BE versus FE ( P = 0.01). Breakfast before exercise increases postexercise postprandial plasma glucose disposal, which is offset (primarily) by increased appearance rates of orally ingested glucose. Therefore, metabolic responses to fed-state exercise cannot be readily inferred from studies conducted in a fasted state.

Prematurity reduces citrulline-arginine-nitric oxide production and precedes the onset of necrotizing enterocolitis in piglets.

Necrotizing enterocolitis (NEC) is associated with low plasma arginine and vascular dysfunction. It is not clear whether low intestinal citrulline production, the precursor for arginine synthesis, occurs before and thus predisposes to NEC or if it results from tissue damage. This study was designed to test the hypothesis that whole body rates of citrulline, arginine, and nitric oxide synthesis are low in premature pigs and that they precede NEC. Piglets delivered by cesarean section at 103 days [preterm (PT)], 110 days [near-term (NT)], or 114 days [full-term (FT)] of gestation were given total parenteral nutrition and after 2 days orogastrically fed infant formula for 42 h to induce NEC. Citrulline and arginine fluxes were determined before and during the feeding protocol. Gross macroscopic and histological NEC scores and plasma fatty acid binding protein (iFABP) concentration were determined as indicators of NEC. Intestinal gene expression for enzymes of the arginine pathway were quantitated. A lower ( P < 0.05) survival rate was observed for PT (8/27) than for NT (9/9) and FT pigs (11/11). PT pigs had higher macroscopic gross ( P < 0.05) and histological NEC ( P < 0.05) scores and iFABP concentration ( P < 0.05) than pigs of more advanced gestational age. PT pigs had lower citrulline production and arginine fluxes ( P < 0.05) throughout and a reduced gene expression in genes of the citrulline-arginine pathway. In summary, intestinal enzyme expression and whole body citrulline and arginine fluxes were reduced in PT pigs compared with animals of more advance gestational age and preceded the development of NEC. NEW & NOTEWORTHY Arginine supplementation prevents necrotizing enterocolitis (NEC), the most common gastrointestinal emergency of prematurity. Citrulline (precursor for arginine) production is reduced during NEC, and this is believed to be a consequence of intestinal damage. In a swine model of NEC, we show that intestinal gene expression of the enzymes for citrulline production and whole body citrulline and arginine fluxes are reduced and precede the onset of NEC in premature pigs. Reduced citrulline production during prematurity may be a predisposition to NEC.

Intestinal damage following short-duration exercise at the same relative intensity is similar in temperate and hot environments.

Increasing temperature and exercise disrupt tight junctions of the gastrointestinal tract although the contribution of environmental temperature to intestinal damage when exercising is unknown. This study investigated the effect of 2 different environmental temperatures on intestinal damage when exercising at the same relative intensity. Twelve men (mean ± SD; body mass, 81.98 ± 7.95 kg; height, 182.6 ± 7.4 cm) completed randomised cycling trials (45 min, 70% maximal oxygen uptake) in 30 °C/40% relative humidity (RH) and 20 °C/40%RH. A subset of participants (n = 5) also completed a seated passive trial (30 °C/40%RH). Rectal temperature and thermal sensation (TSS) were recorded during each trial and venous blood samples collected at pre- and post-trial for the analysis of intestinal fatty acid-binding protein (I-FABP) level as a marker of intestinal damage. Oxygen uptake was similar between 30 °C and 20 °C exercise trials, as intended (p = 0.94). I-FABP increased after exercise at 30 °C (pre-exercise: 585 ± 188 pg·mL-1; postexercise: 954 ± 411 pg·mL-1) and 20 °C (pre-exercise: 571 ± 175 pg·mL-1; postexercise: 852 ± 317 pg·mL-1) (p < 0.0001) but the magnitude of damage was similar between temperatures (p = 0.58). There was no significant increase in I-FABP concentration following passive heat exposure (p = 0.59). Rectal temperature increased during exercise trials (p < 0.001), but not the passive trial (p = 0.084). TSS increased more when exercising in 30 °C compared with 20 °C (p < 0.001). There was an increase in TSS during the passive heat trial (p = 0.03). Intestinal damage, as measured by I-FABP, following exercise in the heat was similar to when exercising in a cooler environment at the same relative intensity. Passive heat exposure did not increase I-FABP. It is suggested that when exercising in conditions of compensable heat stress, the increase in intestinal damage is predominantly attributable to the exercise component, rather than environmental conditions.