Abu Faddan Nagla H, Sherif Tahra M K, Mohammed Omnia A, Nasif Khalid A, El Gezawy Ebtesam M
Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt.
Department of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt.
Intest Res. 2017 Jan;15(1):118-123. doi: 10.5217/ir.2017.15.1.118. Epub 2017 Jan 31.
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.
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.
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.
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.
背景/目的：人体安全通过对黏膜表面完整性的有效监测以及抵御潜在有害化合物来维持。肠道的这一功能即肠屏障功能，可能会受到胆汁淤积以及肠腔内胆汁缺乏的影响。我们旨在通过评估肠脂肪酸结合蛋白（I-FABP）和回肠胆汁酸结合蛋白（I-BABP）作为肠上皮细胞损伤的标志物，以及血浆D-乳酸水平作为肠壁通透性的标志物，来确定胆汁淤积婴儿的肠屏障完整性是否受损。
这项病例对照研究纳入了53例胆汁淤积婴儿和29例对照。检测了所有受试者血清中I-FABP、I-BABP和D-乳酸的水平。
新生儿肝炎组和胆道闭锁组患者的I-FABP和I-BABP水平均显著高于对照组。病例组和对照组血清D-乳酸水平无差异。两组患者（I组和II组）在所研究的任何参数方面均无差异。在胆汁淤积婴儿中，未发现I-FABP、I-BABP或D-乳酸血清水平与总胆红素或直接胆红素水平之间存在显著相关性。
胆汁淤积婴儿的肠道几乎所有部位的肠上皮屏障完整性均被破坏。建议进一步研究以确定这一发现对这些婴儿管理的影响。肠道物理屏障损伤与其功能衰竭之间的关系仍有待进一步研究。
