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Analysis of Faecal Zonulin and Calprotectin Concentrations in Healthy Children During the First Two Years of Life. An
Beata Łoniewska1, Karolina Adamek1, Dagmara Węgrzyn1
1Department of Neonatal Diseases, Pomeranian Medical University, Szczecin 70-111, Poland.
Insights
Intestinal permeability in newborns, a measure of gut health, develops over the first year. Factors like maternal antibiotic use and higher BMI increase this permeability in early childhood.
Area of Science:
- Pediatric Gastroenterology
- Neonatal Health
- Gut Microbiome Research
Background:
- Intestinal barrier permeability is crucial for infant health.
- Factors like maternal body mass index (BMI), nutrition, and antibiotic exposure are hypothesized to influence infant gut permeability.
- Understanding the developmental trajectory of gut permeability is essential for identifying potential health risks.
Purpose of the Study:
- To assess the development of intestinal-barrier permeability in healthy newborns up to 24 months of age.
- To identify factors influencing gut permeability during the first two years of life.
- To evaluate the utility of fecal zonulin and calprotectin as markers of intestinal permeability.
Main Methods:
- A longitudinal study of 100 healthy, full-term newborns from birth to 24 months.
- Measurement of fecal zonulin and calprotectin concentrations at 1, 6, 12, and 24 months.
- Correlation analysis to assess the relationship between early and later gut permeability markers and influencing factors.
Main Results:
- Fecal zonulin concentrations increased from 1 to 12 months, while calprotectin decreased from 1 to 6 months, then stabilized.
- High gut permeability markers at one month correlated with higher levels at older ages.
- Maternal antibiotic use during pregnancy, vaginal birth, and a pregnancy BMI increase > 5.7 were associated with increased intestinal permeability markers.
Conclusions:
- The 'intestinal closure' process is gradual, occurring between 6 and 12 months of age.
- Antibiotic therapy, elevated maternal BMI gain, and vaginal birth are linked to heightened intestinal permeability in early childhood.
- Further validation and clinical interpretation are needed for elevated stool zonulin and calprotectin levels observed in this cohort.
Abstract:
Factors affecting the intestinal-barrier permeability of newborns, such as body mass index (BMI), nutrition and antibiotics, are assumed to affect intestinal-barrier permeability in the first two years of life. This study assessed 100 healthy, full-term newborns to 24 months old. Faecal zonulin/calprotectin concentrations were measured at 1, 6, 12, 24 months as gut-permeability markers. Zonulin concentrations increased between 1 and 12 months (medians: 114.41, 223.7 ng/mL; respectively), whereas calprotectin concentrations decreased between one and six months (medians: 149. 29, 109.28 µg/mL); both then stabilized (24 months: 256.9 ng/mL zonulin; 59.5 µg/mL calprotectin). In individual children, high levels at one month gave high levels at older ages (correlations: calprotectin: between 1 and 6 or 12 months: correlation coefficient (R) = 0.33, statistical significance (p) = 0.0095; R = 0.28, p = 0.032; zonulin: between 1 and 24 months: R = 0.32; p = 0.022, respectively). Parameters which gave marker increases: antibiotics during pregnancy (calprotectin; six months: by 80%, p = 0.038; 12 months: by 48%, p = 0.028); vaginal birth (calprotectin: 6 months: by 140%, p = 0.005); and > 5.7 pregnancy-BMI increase (zonulin: 12 months: by 74%, p = 0.049). Conclusions: "Closure of the intestines" is spread over time and begins between the sixth and twelfth month of life. Antibiotic therapy, BMI increase > 5.7 during pregnancy and vaginal birth are associated with increased intestinal permeability during the first two years of life. Stool zonulin and calprotectin concentrations were much higher compared with previous measurements at older ages; clinical interpretation and validation are needed (no health associations found).
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