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Intestinal barrier integrity and function in infants with cholestasis
Nagla H Abu Faddan1, Tahra M K Sherif2, Omnia A Mohammed2
1Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt.
Insights
Infants with cholestasis show impaired intestinal barrier integrity, indicated by elevated intestinal fatty acid binding protein (I-FABP) and ileal bile acid binding protein (I-BABP) levels. Gut wall permeability, however, remained unchanged in these infants.
Area of Science:
- Pediatric Gastroenterology
- Neonatal Research
- Intestinal Barrier Function
Background:
- The intestinal barrier is crucial for protecting the body from harmful compounds.
- Cholestasis and bile absence can compromise intestinal barrier function.
- Infant cholestasis may lead to impaired gut barrier integrity.
Purpose of the Study:
- To assess gut barrier integrity in infants with cholestasis.
- To evaluate intestinal fatty acid binding protein (I-FABP) and ileal bile acid binding protein (I-BABP) as markers of epithelial damage.
- To measure plasma D-lactate as a marker of gut wall permeability.
Main Methods:
- A case-control study involving 53 infants with cholestasis and 29 controls.
- Serum levels of I-FABP, I-BABP, and D-lactate were measured.
- Comparison of marker levels between cholestatic infants and healthy controls.
Main Results:
- Infants with neonatal hepatitis and biliary atresia had significantly higher I-FABP and I-BABP levels than controls.
- No significant differences in serum D-lactate levels were observed between groups.
- No correlations were found between I-FABP, I-BABP, or D-lactate and bilirubin levels.
Conclusions:
- Intestinal epithelial barrier integrity is compromised in infants with cholestasis.
- Further research is needed to understand the clinical implications for infant management.
- The link between physical barrier damage and functional failure requires further investigation.
Background/Aims:
The safety of the human body is maintained by effective monitoring of the mucosal surface integrity and protection against potentially harmful compounds. This function of the gut called intestinal barrier function can be affected by cholestasis and the absence of bile in the intestinal lumen. We aimed to determine whether the gut barrier integrity is impaired in infants with cholestasis by evaluation of the intestinal fatty acid binding proteins (I-FABP) and ileal bile acid binding protein (I-BABP) as markers of intestinal epithelial cell damage and plasma D-lactate level as a marker of gut wall permeability.
Methods:
This case-control study included 53 infants with cholestasis and 29 controls. Serum levels of I-FABP, I-BABP, and D-lactate were measured in all subjects.
Results:
Both groups of patients with neonatal hepatitis and biliary atresia showed significantly higher levels of I-FABP and I-BABP than the controls. There were no differences in the serum D-lactate level between the cases and controls. There was no difference between the two groups of patients (I and II) regarding any of the parameters studied. No significant correlations between serum levels of I-FABP, I-BABP, or D-lactate and total or direct bilirubin levels were found in the cholestatic infants.
Conclusions:
The intestinal epithelial barrier integrity is breached nearly in all parts of the intestine in infants with cholestasis. Further research is recommended to determine the impact of this finding on the management of these infants. The relationship between physical intestinal barrier damage and its functional failure remains subject for further research.
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