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Intestinal fatty acid binding protein (I-FABP) as a sensitive and specific biomarker for necrotizing enterocolitis
Jessica Wright1, Sophia Hameedi1, Rahul Gadde1
1The Center for Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children's Hospital, 575 Children's Drive, Columbus, OH 43205, USA.
Insights
Plasma Intestinal Fatty Acid Binding Protein (I-FABP) can distinguish necrotizing enterocolitis (NEC) in infants. Elevated I-FABP levels accurately identify NEC compared to other neonatal conditions.
Area of Science:
- Neonatal Medicine
- Biomarker Discovery
- Gastroenterology
Background:
- Necrotizing enterocolitis (NEC) is a serious condition in premature infants.
- Early diagnosis of NEC is crucial for effective treatment.
- Intestinal fatty acid binding protein (I-FABP) is a potential biomarker for gastrointestinal injury.
Purpose of the Study:
- To evaluate plasma I-FABP as a specific biomarker for NEC in neonates.
- To differentiate NEC from other common neonatal diseases with similar clinical presentations.
- To assess the diagnostic accuracy of I-FABP in identifying NEC.
Main Methods:
- Retrospective case-control study of neonates born at <34 weeks' gestation.
- Plasma I-FABP levels quantified by ELISA in patients with NEC, other pathologies, and healthy controls.
- Statistical analysis using ANOVA and ROC curve analysis to determine predictive value.
Main Results:
- Plasma I-FABP levels were significantly higher in NEC patients compared to controls (p < 0.0001).
- An I-FABP cutoff of 5.5 ng/ml showed 75% sensitivity and 100% specificity for NEC.
- ROC analysis yielded an AUC of 0.95, indicating high diagnostic accuracy.
Conclusions:
- Plasma I-FABP is a promising biomarker for distinguishing NEC in neonates.
- I-FABP can differentiate NEC from sepsis, feeding intolerance, and spontaneous intestinal perforation.
- This biomarker may aid in the early and accurate diagnosis of NEC.
Purpose:
Intestinal fatty acid binding protein (I-FABP) levels have been shown to be elevated in infants with necrotizing enterocolitis (NEC). We hypothesized that plasma I-FABP is a specific biomarker for NEC that can differentiate NEC from other common diseases with similar presentations in neonates.
Methods:
With IRB approval, neonates born at <34 weeks' gestation had residual plasma samples scavenged from routine blood draws. Medical records were reviewed retrospectively to identify patients diagnosed with NEC and other pathologies (sepsis, feeding intolerance, and spontaneous intestinal perforation (SIP)). Samples collected within 7 days preceding and 7 days after diagnosis were utilized for plasma I-FABP quantification by ELISA. Healthy age-matched patients were selected as controls. Data were analyzed by ANOVA with mixed effects analysis in this case-control study.
Results:
Over a ten-month period 69 patients were enrolled, of which 7 were diagnosed with NEC, 9 were diagnosed with other common pathologies, and 8 were chosen as healthy controls. Plasma I-FABP was significantly higher in the NEC cohort prior to, at diagnosis, and after diagnosis compared to those with other pathologies and healthy controls (p < 0.0001). ROC curve analysis identified an I-FABP cutoff of 5.5 ng/ml as predictive of NEC compared to other pathologies with sensitivity of 75 % and specificity of 100 % (AUC 0.95).
Conclusion:
Plasma I-FABP has the potential to distinguish between patients with NEC and healthy patients or those with other common pathologies with similar presentations (sepsis, feeding intolerance).
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