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LBP and iFABP mismatch in the evaluation of intestinal barrier dysfunction due to SARS-CoV-2 infection

  • 0Laboratório de Investigação Médica da Disciplina de Emergências Clínicas, Departamento de Clínica Médica, Faculdade de Medicina da Universidade de São Paulo São Paulo, SP, Brazil.
Clinics +

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April 24, 2025

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April 24, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

COVID-19 intestinal damage stems from SARS-CoV-2 affecting tight junctions, particularly in older adults. Biomarkers like LPS-Binding Protein and ileal Fatty Acid-Binding Protein indicate barrier dysfunction and aid in patient discrimination.

Area Of Science

  • Gastroenterology
  • Infectious Diseases
  • Immunology

Background

  • SARS-CoV-2 infection can trigger systemic inflammatory response syndrome and extrapulmonary complications.
  • Intestinal damage in COVID-19 patients is investigated for direct viral action on epithelial cells, focusing on tight junctions.

Purpose Of The Study

  • To determine if COVID-19 causes intestinal damage via direct viral effects on intestinal epithelial cells, specifically targeting tight junctions.
  • To analyze plasma markers (LPS-Binding Protein and ileal Fatty Acid-Binding Protein) and cytokine levels in relation to bacterial co-infection and age in severe SARS-CoV-2 patients.

Main Methods

  • Retrospective observational study involving 87 patients with severe SARS-CoV-2 infection.
  • Measurement of plasma LPS-Binding Protein (LBP) and ileal Fatty Acid-Binding Protein (iFABP) levels.
  • Evaluation of tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β) in relation to co-infections and age groups.

Main Results

  • Higher TNF-α and IL-1β levels were observed in patients with bacterial co-infection; TNF-α was also elevated in older patients.
  • Plasma LBP levels were higher in bacterially co-infected patients but not significantly different between age groups.
  • Plasma iFABP levels were higher in the older population, suggesting increased intestinal epithelial damage in this group.

Conclusions

  • SARS-CoV-2-induced intestinal barrier dysfunction primarily involves damage to the intestinal tight junction complex, with less impact on enterocytes.
  • Elevated LBP, iFABP, and cytokine levels can differentiate between bacterially infected patients and identify elderly patients with increased intestinal epithelial damage.

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