Intestinal Fatty Acid Binding Protein Concentrations Research Articles

D-Lactate and intestinal fatty acid-binding protein are elevated in serum in patients with acute ischemic stroke.

Experimental studies suggest that the intestinal barrier is affected in ischemic stroke. D-Lactate and intestinal fatty acid-binding protein (IFABP) are markers of intestinal mucosa integrity and barrier function. Our purpose was to evaluate the serum concentrations of these markers in patients with acute ischemic stroke (AIS). We included patients with AIS and used healthy subjects as controls. Clinical, demographic and outcome measures were recorded. Blood was drawn within 24h of symptom onset. Serum concentrations of D-Lactate and IFABP were determined using commercially available colorimetric and ELISA kits, respectively. We included a total of 61 patients (median age of 64years). The majority of patients were male (57.4%). The most common cause of stroke was atherosclerosis (34.4%), followed by small-vessel disease and cardioembolic (32.7% each). Mean admission NIHSS score was 8. Median IFABP and D-Lactate concentrations were significantly higher in patients than in controls. Concentrations were not associated with stroke severity or 3-month outcome. Patients with large-artery atherosclerosis and cardioembolic etiology had higher D-Lactate values than patients with small-vessel disease. D-Lactate and IFABP were significantly elevated in patients with AIS. This suggests that there is disruption of the intestinal barrier in patients with AIS.

The effect of bovine colostrum supplementation on intestinal injury and circulating intestinal bacterial DNA following exercise in the heat

PurposeExercise-induced changes in intestinal permeability are exacerbated in the heat. The aim of this study was to determine the effect of 14 days of bovine colostrum (Col) supplementation on intestinal cell damage (plasma intestinal fatty acid-binding protein, I-FABP) and bacterial translocation (plasma bacterial DNA) following exercise in the heat.MethodsIn a double-blind, placebo-controlled, crossover design, 12 males completed two experimental arms (14 days of 20 g/day supplementation with Col or placebo, Plac) consisting of 60 min treadmill running at 70% maximal aerobic capacity (30 °C, 60% relative humidity). Blood samples were collected pre-exercise (Pre-Ex), post-exercise (Post-Ex) and 1 h post-exercise (1 h Post-Ex) to determine plasma I-FABP concentration, and bacterial DNA (for an abundant gut species, Bacteroides).ResultsTwo-way repeated measures ANOVA revealed an arm × time interaction for I-FABP (P = 0.005, with greater Post-Ex increase in Plac than Col, P = 0.01: Plac 407 ± 194% of Pre-Ex vs Col, 311 ± 134%) and 1 h Post-Ex (P = 0.036: Plac 265 ± 80% of Pre-Ex vs Col, 229 ± 56%). There was no interaction (P = 0.904) but there was a main effect of arm (P = 0.046) for plasma Bacteroides/total bacterial DNA, with lower overall levels evident in Col.ConclusionThis is the first investigation to demonstrate that Col can be effective at reducing intestinal injury following exercise in the heat, but exercise responses (temporal pattern) of bacterial DNA were not influenced by Col (although overall levels may be lower).

The Impact of Mild Heat Stress During Prolonged Running On Gastrointestinal Integrity, Gastrointestinal Symptoms, Systemic Endotoxin and Cytokine Profiles.

The study aimed to determine the effects of mild exertional heat stress on intestinal injury, permeability, gastrointestinal symptoms, and systemic endotoxin and cytokine responses. Ten endurance runners completed 2 h of running at 60% V̇O2max in warm (WARM: 30°C) and temperate (TEMP: 22°C) ambient conditions. Rectal temperature (Tre) and gastrointestinal symptoms were recorded every 10 min during exercise. Blood samples were collected pre- and post-exercise, and during recovery to determine plasma intestinal fatty acid-binding protein (I-FABP) and cortisol concentrations, and systemic endotoxin and inflammatory cytokine profiles. Urinary lactulose:L-rhamnose ratio (L/R) was used to measure small intestine permeability. Compared with TEMP, WARM significantly increased Tre from 50 min onwards (38.1±0.3°C vs. 38.4±0.5°C, respectively; p<0.01), gastrointestinal symptoms (p=0.017), post-exercise plasma cortisol (26% vs. 59%, respectively; p<0.001) and I-FABP (127% vs. 184%, respectively; p<0.001) concentrations. Circulatory anti-endotoxin antibodies increased post-exercise (p<0.001) on WARM (20%) and TEMP (28%). No differences were observed for plasma endotoxin concentration (6% vs. 5% increase, respectively) or small intestine permeability (L/R 0.026±0.010 and 0.025±0.015, respectively). Both pro- and anti-inflammatory cytokines increased post-exercise, with inflammatory response cytokines TNF-α (p=0.015) and IL-8 (p=0.044), and compensatory anti-inflammatory cytokines IL-10 (p=0.065), and IL-1ra higher on WARM than TEMP. Findings suggest that exposure to warm ambient conditions during prolonged submaximal running induces transient intestinal epithelial injury, increases gastrointestinal symptoms, and promotes greater perturbations to the systemic cytokine profile compared to running in temperate conditions.

Establishment of a porcine model of indomethacin-induced intestinal injury.

A useful animal model of intestinal injury is pivotal for studying its pathogenesis and developing nutritional interventions (e.g., amino acid supplementation). Here, we propose the use of indomethacin (IDMT) to induce intestinal inflammation in neonatal pigs. Fourteen-day-old piglets fed a milk replacer diet receive intraperitoneal administration of IDMT (5 mg/kg body weight) for 3 consecutive days. On day 4, blood and intestinal samples are obtained for physiological and biochemical analyses. IDMT increases blood DAO activity, I-FABP concentration, neutrophil and eosinophil numbers; intestinal MMP3 mRNA levels, MPO activity, and MDA concentration; but reduces the plasma concentration of citrulline (synthesized exclusively by enterocytes of the small intestine), intestinal GSH-Px activity, and mRNA levels for villin, I-FABP, TRPV6, AQP10, and KCNJ13. Moreover, extensive hemorrhagic spots, thinned intestinal wall, and ulcers in the distal jejunum and ileum are observed in IDMT-challenged piglets. Furthermore, IDMT decreases intestinal villus height and villus surface area in the piglet jejunum. Collectively, this work establishes a porcine model of intestinal injury for designing novel nutritional means to improve gut function in pigs and humans.

Immunogenicity of rotavirus vaccine (RotarixTM) in infants with environmental enteric dysfunction.

IntroductionDeployment of rotavirus vaccines has contributed to significant declines in diarrheal morbidity and mortality globally. Unfortunately, vaccine performance in low-middle income countries (LMICs) is generally lower than in developed countries. The cause for this has been associated with several host and maternal factors including poor water sanitation and hygiene (WASH) status, which are predominant in LMICs. More recently, environmental enteric dysfunction (EED) has specifically been hypothesized to contribute to poor vaccine uptake and response. The aim of this study was to examine the association between serological biomarkers of EED and seroconversion to rotavirus vaccine in Zambian infants.MethodsThis was a retrospective cohort study of 142 infants who had been fully immunized with Rotarix™, and had known seroconversion status. Seroconversion was defined as 4-fold or more increase in rotavirus-specific IgA titres between pre-vaccination and one month post-dose two vaccination. We performed ELISA assays to assess soluble CD14 (sCD14), Endotoxin Core IgG Antibodies (EndoCAb), intestinal fatty acid binding protein (i-FABP) and Zonulin according to the manufacturers protocols. Generalised linear model with family-poisson, link-log and robust standard error was used to estimate the independent effects of biomarkers on seroconversion adjusting for important cofounders.ResultsThe median concentration of Zonulin, Soluble CD14, EndoCaB, and IFABP were 209.3 (IQR = 39.7, 395.1), 21.5 (IQR = 21.5, 21.5), 0.3 (IQR = 0.3, 0.3), and 107.7 (IQR = 6.4, 1141.4) respectively. In multivariable analyses adjusting for the independent effect of other biomarkers and confounders (i.e. age of child at vaccination, breast-milk anti-rotavirus IgA, infant serum anti-rotavirus IgG, and IgA seropositivity at baseline), there was strong evidence of about 24% increase in seroconversion due to doubling Zonulin concentration (Adjusted risk ratio (aRR) = 1.24; 95% CI = 1.12 to1.37; p<0.0001). Similarly, we found about 7% increase in seroconversion due to doubling IFABP concentration (aRR = 1.07; 95% CI = 1.02 to 1.13; p = 0.006).ConclusionWe found that high levels of zonulin and IFABP played a role in seroconversion. It is plausible that increased gut permeability in EED allows greater uptake of the live virus within the vaccine, but later consequences result in deleterious local structural distortions and malabsorption syndromes.

Intestinal Fatty Acid Binding Protein and Citrulline as Markers of Gut Injury and Prognosis in Patients With Acute Pancreatitis.

Severe acute pancreatitis (AP) is associated with high mortality due to systemic inflammatory response syndrome in the early phase and secondary infection in the later phase. Concomitant intestinal ischemia often results in gut injury. We studied intestinal fatty acid binding protein (IFABP) and citrulline levels as markers of gut injury to predict prognosis in AP. Acute pancreatitis patients at admission and controls were studied. Serum IFABP was measured by enzyme-linked immunosorbent assay and plasma citrulline by high-performance liquid chromatography technique. Ultrastructural changes in duodenal biopsy were also compared between the 2 groups. The IFABP concentration was significantly higher in AP cases (n = 94) compared with controls (n = 100) (mean [standard deviation], 592.5 [753.6] vs 87.8 [67.6] pg/mL; P < 0.001) and in patients with severe AP versus mild AP (738.3 [955.3] vs 404.0 [263.3] pg/ mL, P = 0.03). Citrulline concentration was lower in AP versus controls (29.9 [33.8] vs 83.9 [60.1] μg/L, P < 0.001). We propose a model by which these biomarkers (IFABP >350 pg/mL and citrulline <18 μg/L) are able to predict poor prognosis in 33.9% of patients with AP. The gut injury was also validated via ultrastructural changes. Intestinal fatty acid binding protein is a promising prognostic marker in acute pancreatitis.

Bovine colostrum supplementation does not affect plasma I-FABP concentrations following exercise in a hot and humid environment.

To quantify the impact of a 14-day bovine colostrum (BC) supplementation on intestinal cell damage following exercise in a hot and humid environment. Ten male participants (20 ± 2years, VO2max 55.80 ± 3.79mLkg-1min-1, 11.81 ± 2.71% body fat) ran for 46 ± 7.75min at 95% of ventiliatory threshold in 40°C and 50% RH following a 14-day double-blinded supplementation with either BC or placebo (Plac). Core temperature, skin temperature, heart rate, and rating of perceived exertion were recorded every 5min during exercise. Blood was taken pre, post, 1h, and 4h post exercise. Intestinal cell damage was assessed via intestinal fatty acid binding protein (I-FABP). I-FABP concentrations were similar between conditions at all time points [pre 989.39 ± 490.88pgml-1 (BC) 851.35 ± 450.71 pgml-1 (Plac) post 1505.10 ± 788.63 pgml-1 (BC) 1267.12 ± 521.51 pgml-1 (Plac) 1-h, 1087.77 ± 397.06pgml-1 (BC) 997.25 ± 524.74 pgml-1 (Plac) 4-h, 511.35 ± 243.10 pgml-1 (BC) 501.46 ± 222.54 pgml-1 (Plac)]. I-FABP was elevated pre to post exercise for both BC (162 ± 50%) and Plac (162 ± 56%) (p < 0.05). BC had no effect on mean body temperature [beginning 36.11 ± 0.30°C, ending: 39.52 ± 0.28°C (BC); beginning:35.96 ± 0.43°C, ending:39.42 ± 0.38°C (Plac)]. While BC supplementation may protect against enterocyte damage during exercise in thermonuetral environments, our data suggest that BC supplementation may not be an effective technique for preventing enterocyte damage during exercise when core temperature exceeds 39°C.

Exercise and gastrointestinal symptoms: running-induced changes in intestinal permeability and markers of gastrointestinal function in asymptomatic and symptomatic runners

PurposeAthletes frequently experience gastrointestinal (GI) symptoms during training and competition. Although the prevalence of exercise-induced GI symptoms is high, the mechanisms leading to GI distress during exercise are not fully understood. The aim of this study was to identify running-induced changes in intestinal permeability and markers of GI function and investigate their association with gastrointestinal symptoms.MethodsWe recruited 17 active runners who we allocated as either asymptomatic or symptomatic based on their history of experiencing GI symptoms during running. The participants took part in a running test where they were asked to run for 90 min at 80% of their best 10 km race speed. Intestinal permeability was measured at baseline and after the running test. Levels of serum intestinal fatty acid-binding protein (I-FABP), zonulin, bacterial lipopolysaccharide (LPS), and fecal calprotectin were also measured at baseline and after the running test.ResultsRunning induced a significant increase in intestinal permeability and serum I-FABP concentration but there were no differences between asymptomatic and symptomatic runners. Serum LPS activity did not change from baseline following the running test but the symptomatic group exhibited higher LPS activity at baseline compared to the asymptomatic runners.ConclusionsRunning for 90 min at a challenging pace causes small intestinal damage and increases intestinal permeability. However, these alterations in GI function do not appear to correlate with the development of GI symptoms during running.

Predictive and diagnostic value of serum intestinal fatty acid binding protein in neonatal necrotizing enterocolitis (case series).

ObjectivesIn this study, we aimed to investigate the value of serum intestinal fatty acid binding protein (I-FABP) in early diagnosis and predicting the severity of Necrotizing enterocolitis (NEC).MethodsThis prospective study was performed on 160 preterm neonates ageing less than 35 weeks and weighting less than 2000 gm selected from the Neonatal Intensive Care Units (NICUs) of the Pediatric Department at Benha University hospital and Benha children hospital to evaluate which of them will develop NEC, after follow-up these neonates were divided into two groups: Group one compromised eighteen preterm neonates with symptoms and signs of NEC. Group two compromised ten preterm neonates as a control group. All participants were subjected to full clinical examination, abdominal X-ray and serum I-FABP.ResultsThe 1st values of IFABP taken at birth showed that mean serum IFABP concentrations of the study group were higher than that of the control group. The 2nd values of serum IFABP taken at the start of feeding showed that mean IFABP concentrations of the study group were higher in comparison with IFABP at birth. In the 3rd values of serum, IFABP taken at the time of diagnosing NEC showed that mean serum IFABP concentrations of the study group were higher than the control group. In the 4th values of serum, IFABP taken one week after diagnosing NEC showed that the mean serum IFABP concentrations of the study group became significantly decreased in comparison with IFABP at the time of diagnosis in stage 1 and 2.ConclusionsSerial measurements of serum I-FABP levels may be a useful marker for early diagnosis and prediction of disease severity in NEC.

Gut-training: the impact of two weeks repetitive gut-challenge during exercise on gastrointestinal status, glucose availability, fuel kinetics, and running performance.

Due to gastrointestinal tract adaptability, the study aimed to determine the impact of gut-training protocol over 2 weeks on gastrointestinal status, blood glucose availability, fuel kinetics, and running performance. Endurance runners (n = 25) performed a gut-challenge trial (GC1), consisting of 2 h running exercise at 60% V̇O2max whilst consuming gel-discs containing 30 g carbohydrates (2:1 glucose/fructose, 10% w/v) every 20 min and a 1 h distance test. Participants were then randomly assigned to a carbohydrate gel-disc (CHO-S), carbohydrate food (CHO-F), or placebo (PLA) gut-training group for 2 weeks of repetitive gut-challenge intervention. Participants then repeated a second gut-challenge trial (GC2). Gastrointestinal symptoms reduced in GC2 on CHO-S (60%; p = 0.008) and CHO-F (63%; p = 0.046); reductions were greater than PLA (p < 0.05). H2 peak was lower in GC2 on CHO-S (mean (CI): 6 (4-8) ppm) compared with CHO-F (9 (6-12) ppm) and PLA (12 (2-21) ppm) (trial × time: p < 0.001). Blood glucose concentration was higher in GC2 on CHO-S (7.2 (6.3-8.1) mmol·L-1) compared with CHO-F (6.1 (5.7-6.5) mmol·L-1) and PLA (6.2 (4.9-7.5) mmol·L-1) (trial × time: p = 0.015). No difference in oxidation rates, plasma I-FABP, and cortisol concentrations were observed between groups and trials. Distance test improved on CHO-S (5.2%) and CHO-F (4.3%) in GC2, but not on PLA (-2.1%) (trial × time: p = 0.009). Two weeks of gut-training with CHO-S and CHO-F improved gastrointestinal symptoms and running performance compared with PLA. CHO-S also reduced malabsorption and increased blood glucose availability during endurance running compared with PLA.

An examination of the factors affecting intestinal wall integrity in newborns at birth

Background: An understanding of the factors that influence intestinal wall integrity during the transition from fetal to neonatal life is important to elucidate and minimize potential contributions to the development of intestinal pathologies in vulnerable newborns.Objective: To assess the factors affecting intestinal wall integrity of late preterm and term newborns at birth.Methods: The concentrations of serum intestinal fatty acid-binding protein (I-FABP) as biomarker of intestinal wall injury, superoxide dismutase (SOD), and glutathione peroxidase (Gpx) as parameters of oxidative stress, and blood gas analyses were measured in the arterial cord blood of 80 newborns, delivered by spontaneous vaginal delivery (labor group) or elective cesarean delivery (non-labor group).Results: Compared with the non-labor group, I-FABP, SOD, and Gpx levels were significantly higher in the labor group. I-FABP concentration was inversely correlated with pH and BE and positively correlated with SOD and Gpx concentrations, second stage of labor duration, and active pushing time.Conclusions: This study demonstrates that oxidative stress at birth and prolonged second stage of labor may lead to the intestinal injury, which is reflected in increased serum concentration of I-FABP.

Abstract TP219: D-lactate and Intestinal Fatty-acid Binding Protein Are Elevated in Serum in Patients with Acute Ischemic Stroke

Introduction: Ischemic stroke is associated with gastrointestinal complications such as constipation, dysphagia and fecal incontinence. However, the precise mechanisms involved have not been fully elucidated. D-Lactate and Intestinal Fatty-Acid Binding Protein (IFABP) are markers of intestinal mucosa integrity and barrier function. We evaluated serum concentrations of these markers in patients with acute ischemic stroke. Materials and methods: We included consecutive patients with ischemic stroke, and used healthy, age and sex-matched subjects as controls. We excluded cases determined to be of other or undetermined etiology according to the TOAST classification. Blood was drawn within 24 hours of symptom onset. Serum concentrations of D-Lactate and IFABP were determined using commercially available colorimetric and ELISA kits, respectively. Results: We included a total of 61 patients and 20 controls. The majority of patients were male (57.4%), and had a median age of 64 years. The most common cause of stroke was large-vessel atherosclerosis (34.4%), followed by small-vessel occlusion and cardioembolism (32.7% each). Mean admission NIHSS score was 8. IFABP and D-Lactate concentrations were significantly higher in patients than in controls (0.57±1 ng/ml vs. 1.84±2.7 ng/ml, p=0.04 and 0 nmol/μl vs. 0.38±0.66 nmol/μl, p=0.01, respectively). Concentrations were not associated with stroke severity or outcome. Patients with large-artery atherosclerosis and cardiombolic etiology had significantly higher D-Lactate values than patients with small-vessel disease. Conclusions: D-Lactate and IFABP were significantly elevated in patients with ischemic stroke. This provides, to our knowledge, for the first time in humans, evidence of intestinal barrier disruption. A stroke-associated systemic stress response could be responsible, but the lack of an association with stroke severity does not support this hypothesis. Embolic or atherosclerotic involvement of the mesenteric vasculature is another possibility. Further studies should aim at looking for a plausible mechanism as well as a possible association between intestinal barrier dysfunction and post-stroke gastrointestinal and infectious complications.

Intestinal Oxygenotherapy of Critical Conditions

The latent or mist diagnosed dysfunction of the small intestine is a common disorder in critically ill patients. Intestinal oxygenotherapy is one of the alternative ways to normalize the coordinated activity of the smooth muscles of the digestive tract. Purpose of the study. To determine the effect of intestinal oxygenotherapy in patients with enteropathies of critical conditions on the dynamics of biomarkers of the intestinal wall permeability and ischemia. Materials and methods. An open prospective descriptive study of 12 critically ill patients (7 adults, 5 children) with multiple organ failure and evident or saspected dysfunction of the gastrointestinal tract. Pediatric patients included children with congenital heart disease who underwent open-heart surgery for the purpose of radical or palliative correction. Results. Complications related to the intestinal oxygenotherapy were not observed. On the contrary, its use in children coincided with the positive clinical dynamics: elimination of intestinal paresis, normalization of digestion of enteral nutrition. However, it is difficult to interpret the results unambiguously. Serum citrulline concentration in children is an objective marker of the functional state of the gastrointestinal tract: in the vast majority of the control points its level was 20 μmol/l (up to 80 μmol/l). No correlation between serum citrulline and I-FABP concentrations in adults was found. Conclusion. Intestinal oxygenotherapy is a promising therapeutic technique for prevention and correction of enteropathies. The method may appear especially effective in treatment of anaerobic (i.e. Cl. defficile-assosiated colitis) infection. The diagnostic value of plasma citrulline and I-FABP concentrations needs further confirmation.

Relationship between anesthetic factor and intestinal injury in patients undergoing cardiac surgery with cardiopulmonary bypass: a comparison of propofol- versus sevoflurane-based anesthesia

Objective To investigate the relationship between anesthetic factors and intestinal injury in the patients undergoing elective cardiac surgery with cardiopulmonary bypass (CPB). Methods Ninety American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients of both sexes, aged 18-64 yr, with New York Heart Association grade Ⅱ or Ⅲ, undergoing elective cardiac surgery with CPB, were divided into 2 groups(n=45 each) using a random number table: propofol-based anesthesia group (group P) and sevoflurane-based anesthesia group (group S). CPB was established routinely after anesthesia induction.Before induction (T0), immediately after aortic unclamping (T1), at 30 min after aortic unclamping (T2) and at 2 h after discontinuation of CPB (T3), blood samples were collected from the radial artery for determination of the plasma endotoxin, D-lactic acid, diamine oxidase (DAO) and intestinal fatty acid-binding protein (I-FABP) concentrations (by enzyme-linked immunosorbent assay) and plasma interleukin-6 (IL-6), IL-8 and tumor necrosis factor-alpha (TNF-α) concentrations (using radio-immunity method). Results Compared with the baseline at T0, the concentrations of plasma endotoxin, D-lactic acid, DAO, TNF-α, IL-6, IL-8 and I-FABP were significantly increased at T1-T3 in both groups (P<0.05). Compared with group P, the concentrations of plasma endotoxin, D-lactic acid, DAO, TNF-α, IL-6, IL-8 and I-FABP were significantly decreased at T1-T3 in group S(P<0.05). Conclusion Anesthetic factors are related to intestinal injury in patients undergoing cardiac surgery with CPB.Compared with propofol-based anesthesia, sevoflurane-based anesthesia is helpful in reducing the inflammatory response and in decreasing the degree of intestinal injury and is more suitable for the cardiac surgery with CPB. Key words: Anesthesia, general; Propofol; Cardiopulmonary bypass; Intestinal mucosa; Wounds and injuries; Sevoflurane

Causes of T lymphocyte activation in HIV-infected patients coinfected with hepatitis C virus

To establish the causes of T lymphocyte activation in human immunodeficiency virus (HIV)-infected patients coinfected with hepatitis C (HCV) who are adherent to their antiretroviral therapy regimen and interferon untreated. Examinations were made in 62 people who were HIV+HCV-positive (n=21), HIV+HCV-negative (n=21), and noninfected volunteers (n=20). The activation (CD38+HLA-DR+) and proliferation (Ki-67+) of CD4+ and CD8+ T lymphocytes were estimated. The blood concentration of intestinal fatty acid-binding protein (I-FABP) was determined. The proportion of activated cells among the CD4+ T lymphocytes was equal in the HIV+HCV-positive and HIV+HCV-negative groups. But these indicators were statistically significantly higher than those in the controls (HIV- HCV-). CD8+ T cell activation was greater in the HIV/HCV-coinfected patients than that in the other groups and that was higher in the HIV monoinfected than in the noninfected. The blood I-FABP concentrations were elevated in the HIV+HCV-positive and HIV+HCV groups compared with those in the HIV-HCV-negative group, but these did not differ among themselves. In the HIV+HCV-negative patients, CD4+ and CD8+ T cell activation directly and statistically significantly correlated with blood I-FABP levels. In the HIV+HCV-positive group, this correlation remained only for CD4+ T lymphocytes. CD8+ T cell activation in HIV/HCV-coinfected patients was unrelated to I-FABP concentrations. The increased activation of CD4+ and CD8+ T lymphocytes in HIV monoinfection was found to be associated with intestinal epithelial destruction and unrelated to cell division processes. In HIV/HCV coinfection, the activated state of CD4+ T cells is determined by both the level of proliferative processes and impairment of the intestinal barrier and that of CD8+ T cells is only by proliferation.

Enteric bacterial loads are associated with interleukin-6 levels in systemic inflammatory response syndrome patients

Abstract Background Loss of intestinal integrity is a critical contributor to excessive inflammation following severe trauma or major surgery. In the case of enterocyte damage, intestinal fatty acid-binding protein (IFABP) is released into the extracellular space. Excessive production of interleukin (IL)-6 can induce systemic inflammatory response syndrome (SIRS). However, the correlation of IL-6 with gut barrier failure and bacterial translocation in critically ill patients has not been well characterized. Purposes To define the relationship between enteric bacterial loads and IL-6 levels in patients with SIRS. Methods Variables related to prognosis and treatment were measured in 85 patients with SIRS upon admission to the emergency room. IL-6 and IFABP were measured using an enzyme-linked immunosorbent assay. Enteric bacterial loads in blood were measured through quantitative real-time polymerase chain reaction with primers specific for enteric bacteria. Results Multivariate analysis revealed a positive correlation between enteric bacterial loads and IL-6 levels in blood. Elevated IFABP concentration was associated with low blood pressure, high respiration rate, hyperglycemia, and high Sequential Organ Failure Assessment score. Elevated C-reactive protein concentrations were associated with higher soluble CD14 levels in blood. Conclusion Enterocyte damage is associated with hypotension and tachypnia in patients with SIRS. Gut function failure may permit enteric bacteria to enter the blood, thereby elevating IL-6 levels and inducing a systemic inflammatory response, resulting in multiple organ failure.

Increased intestinal permeability as a risk factor for type 2 diabetes

AimRelationships between the intestinal microbiota, intestinal permeability and inflammation in the context of risk for obesity-associated disease continue to be of interest. The aim of the study was to examine the associations between intestinal permeability and type 2 diabetes (T2D). MethodsA total of 130 individuals with T2D (age: 57.5±6.2 years (mean±SD); BMI: 30.4±3.2; 45% female) and 161 individuals without T2D (age: 37.4±12.5 years; BMI: 25.1±3.9; 65% female) were included in the study. Assessment of intestinal permeability included measurement of circulating lipopolysaccharide (LPS), LPS-binding protein (LBP) and intestinal fatty acid binding protein (iFABP) concentrations, which were used for calculation of a derived permeability risk score (PRS). Associations between permeability measures and T2D status were assessed using logistic regression models. ResultsLBP (∼34%, P<0.001), iFABP (∼46%, P<0.001) and the PRS (∼24% P<0.001) were all significantly higher in the T2D affected individuals. Individuals with a PRS in the upper tertile were 5.07 times more likely (CI: 1.72–14.95; P=0.003) to have T2D when models were adjusted for age, sex and BMI. There was a trend towards improved prediction when including the PRS in models containing age, sex and BMI (AUC: 0.954 versus 0.962; P=0.06). ConclusionThese data demonstrate differences in measures of intestinal permeability between individuals with and without T2D. The utility of using intestinal permeability measures as a tool for predicting T2D risk in at risk individuals should be further investigated.

Application of intestinal fatty acid binding protein and blood procalcitonin for diagnosis of traumatic intestinal rupture in early stage

Objective To investigate the role of intestinal fatty acid binding protein (IFABP) and blood procalcitonin (PCT) in diagnosis of traumatic Intestinal rupture in early stage. Methods The clinical data of 58 patients with abdominal injuries admitted from May 2012 to April 2016 were retrospectively analyzed. All 58 patients were divided into intestinal rupture group (n=21) and non-intestinal rupture group (n=37).The concentrations of IFABP and PCT were detected, analyzed and compared between two groups at different intervals. Results The IFABP and PCT in intestinal rupture group were significantly higher than those in non-intestinal rupture group. The IFABP and PCT in intestinal rupture group significantly decreased after operations. There were significantly differences in IFABP and PCT between two groups at admission, 4 hours after admission, preoperative period, and 24 hours after operation. However, these differences disappeared at 72 hours after operation. At the same time, the accuracy rate 92.4%, sensitivity 96.3%, specificity 72.8% found in combination of these two biomarkers were significantly higher than those of IFABP and PCT measured separately. Conclusions The combination of IFABP and PCT detection can be used as an indicator for the diagnosis of traumatic intestinal rupture in the early stage. Key words: Traumatic intestinal rupture; Intestinal fatty acid binding protein; Blood procalcitonin; Early diagnosis

Enterocyte Damage: A Piece in the Puzzle of Post-Cardiac Arrest Syndrome.

Cardiac arrest is considered to be a cause of small bowel ischemia, but the consequences of cardiac arrest on the human small bowel have been rarely studied. Plasma citrulline concentration is a marker of functional enterocyte mass, and plasma intestinal fatty acid-binding protein (I-FABP) concentration is a marker of enterocyte damage. We aimed to measure enterocyte biomarkers after cardiac arrest and to study the prognostic value of biomarker abnormalities. This is a prospective, observational, single-center study of patients admitted to the intensive care unit (ICU) for cardiac arrest, evaluating plasma citrulline and I-FABP concentrations at admission and after 24 h and variables according to the Utstein criteria. Variables according to 28-day Cerebral Performance Category score of 1 to 2 (good neurological outcome) versus 3 to 5 (poor neurological outcome) were compared. Sixty-nine patients with cardiac arrest of both cardiac and hypoxic origin were included. At ICU admission, plasma citrulline concentration was low in 65% and plasma I-FABP was elevated in 82% of the patients. After 24 h, plasma citrulline was low in 82% and I-FABP was normal in 60% of the patients. Patients with a poor neurological outcome had a lower plasma citrulline concentration and a higher I-FABP concentration at ICU admission. By multivariate analysis, plasma citrulline levels of 13.1 μmol L or less and I-FABP more than 260 pg mL were independently associated with a poor neurological outcome (odds ratio, 21.9 [2.2-215], and odds ratio, 13.6 [1.4-129], respectively). Cardiac arrest resuscitation is associated with evidence of small bowel mucosal damage in most patients, with a short and intense I-FABP elevation at admission and a decrease in citrulline concentration during the first day. In this study, low plasma citrulline and high I-FABP concentrations at ICU admission were predictive of a poor neurological outcome. This study confirms that cardiac arrest is a model of small bowel mucosal ischemia and suggests that enterocyte damage is a piece in the puzzle of post-cardiac arrest syndrome.

Effect of sevoflurane on expression of aquaporin 8 in intestinal mucosa in a pig model of hemorrhagic shock

Objective To evaluate the effect of sevoflurane on the expression of aquaporin 8 (AQP8) in the intestinal mucosa in a pig model of hemorrhagic shock. Methods Twenty-four Bama miniature pigs of both sexes, weighing 22–25 kg, were randomly divided into 3 equal groups using a random number table: sham operation group (group S), hemorrhagic shock group (group HS) and sevoflurane group (group PS). The femoral artery and jugular vein were cannulated for blood pressure monitoring, blood-letting, and blood sampling in anesthetized pigs.Hemorrhagic shock was induced by withdrawing blood from the right femoral artery.Hemorrhagic shock was induced after cannulation in group HS.In group PS, 2% sevoflurane was inhaled for 30 min after the model of hemorrhagic shock was successfully established.Before anesthesia, and at 0.5, 1, 1.5, 2, 3 and 4 h after hemorrhagic shock, blood samples were collected from the jugular vein for determination of serum D-lactic acid and intestinal fatty acid-binding protein (I-FABP) concentrations.The animals were sacrificed at 4 h after hemorrhagic shock, and the intestinal specimens were obtained for microscopic examination and for determination of AQP8 expression in the intestinal mucosa (by enzyme-linked immunosorbent assay). The intestinal water content was calculated. Results Compared with group S, the serum D-lactic acid and I-FABP concentrations, AQP8 expression, and intestinal water content were significantly increased in HS and PS groups (P<0.05). Compared with group HS, the serum D-lactic acid and I-FABP concentrations, AQP8 expression, and intestinal water content were significantly decreased in group PS (P<0.05). The pathological changes of intestinal tissues were significantly reduced in group PS as compared with group HS. Conclusion Sevoflurane can decrease the intestinal mucosal edema through inhibiting AQP8 expression, thus reducing hemorrhagic shock-induced damage to the intestinal mucosa in pigs. Key words: Anesthetics, inhalation; Shock, hemorrhagic; Intestinal mucosa; Aquaporins