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Published on: May 30, 2013
The intestinal fatty acid-binding protein as a marker for intestinal damage in gastroschisis
Alena Kokesova1,2, Stepan Coufal2, Barbora Frybova1
1Department of Pediatric Surgery, Charles University in Prague, 2nd Faculty of Medicine, University Hospital Motol in Prague, Prague, Czech Republic.
Insights
Urinary Intestinal fatty acid-binding protein (I-FABP) levels indicate mucosal damage in newborns with gastroschisis (GS). While a rapid decrease in I-FABP suggests faster recovery, it has limited predictive value for overall patient outcomes.
Area of Science:
- Neonatal surgery
- Gastroenterology
- Biomarker research
Background:
- Gastroschisis (GS) is a congenital condition requiring surgical intervention.
- Assessing the extent of intestinal mucosal injury and predicting recovery in neonates with GS is clinically significant.
Purpose of the Study:
- To evaluate urinary Intestinal fatty acid-binding protein (I-FABP) as a marker for mucosal injury in neonates with gastroschisis (GS).
- To determine the predictive capacity of urinary I-FABP for the speed of clinical recovery in GS patients post-surgery.
Main Methods:
- Prospective collection of urine samples within 48 hours post-surgery from neonates with GS (2012-2015).
- Inclusion of control groups: neonates without gut mucosa surgery (simple GS) and those with intestinal atresia (complex GS).
- Quantification of I-FABP levels using Enzyme-Linked Immunosorbent Assay (ELISA).
Main Results:
- Urinary I-FABP levels were significantly elevated in GS newborns compared to controls.
- Higher I-FABP levels were observed in complex GS cases versus simple GS.
- Urinary I-FABP showed potential in predicting the need for subsequent surgery for ileus in complex GS.
- Abdominal wall closure methods did not significantly impact I-FABP levels.
- Static I-FABP values lacked predictive utility for patient outcomes.
- A rapid decrease in I-FABP post-surgery correlated with faster recovery but did not predict feeding milestones or hospitalization duration.
Conclusions:
- Urinary I-FABP serves as an indicator of mucosal damage in gastroschisis.
- The predictive value of urinary I-FABP for patient outcomes in gastroschisis is limited.
Background/Purpose:
We analyzed the capacity of urinary Intestinal fatty acid-binding protein (I-FABP) to quantify the degree of mucosal injury in neonates with gastroschisis (GS) and to predict the speed of their clinical recovery after surgery.
Methods:
In this prospective study, we collected urine during the first 48h after surgery from neonates operated between 2012 and 2015 for GS. Neonates with surgery that did not include gut mucosa served as controls for simple GS and neonates with surgery for intestinal atresia served as control for complex GS patients. The I-FABP levels were analyzed by ELISA.
Results:
Urinary I-FABP after the surgery is significantly higher in GS newborns than in control group; I-FABP in complex GS is higher than in simple GS. I-FABP can predict subsequent operation for ileus in patients with complex GS. Both ways of abdominal wall closure (i.e. primary closure and stepwise reconstruction) led to similar levels of I-FABP. None of the static I-FABP values was useful for the outcome prediction. The steep decrease in I-FABP after the surgery is associated with faster recovery, but it cannot predict early start of minimal enteral feeding, full enteral feeding or length of hospitalization.
Conclusion:
Urinary I-FABP reflects the mucosal damage in gastroschisis but it has only a limited predictive value for patients' outcome.
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