Department of Medical Biology, Medical Faculty, Erciyes University, 38030, Kayseri, Turkey.
Division of Intensive Care Medicine, Department of Internal Medicine, Medical Faculty, Erciyes University, 38030, Kayseri, Turkey.
Eur J Trauma Emerg Surg. 2023 Oct;49(5):2203-2213. doi: 10.1007/s00068-023-02298-6. Epub 2023 Jun 9.
In an effort to better manage critically ill patients hospitalised in the intensive care unit (ICU) after experiencing multiple traumas, the present study aimed to assess whether plasma levels of intestinal epithelial cell barrier proteins, including occludin, claudin-1, junctional adhesion molecule (JAM-1), tricellulin and zonulin, could be used as novel biomarkers. Additional potential markers such as intestinal fatty acid-binding protein (I-FABP), D-lactate, lipopolysaccharide (LPS) and citrulline were also evaluated. We also aimed to determine the possible relationships between the clinical, laboratory, and nutritional status of patients and the measured marker levels.
Plasma samples from 29 patients (first, second, fifth and tenth days in the ICU and on days 7, 30 and 60 after hospital discharge) and 23 controls were subjected to commercial enzyme-linked immunosorbent assay (ELISA) testing.
On first day (admission) and on the second day, plasma I-FABP, D-lactate, citrulline, occludin, claudin-1, tricellulin and zonulin levels were high in trauma patients and positively correlated with lactate, C-reactive protein (CRP), number of days of ICU hospitalisation, Acute Physiology and Chronic Health Evaluation II (APACHE II) score and daily Sequential Organ Failure Assessment (SOFA) scores (P < 0.05-P < 0.01).
The results of the present study showed that occludin, claudin-1, tricellulin and zonulin proteins, as well as I-FABP, D-lactate and citrulline, may be used as promising biomarkers for the evaluation of disease severity in critically ill trauma patients, despite the complexity of the analysis of various barrier markers. However, our results should be supported by future studies.
为了更好地管理在经历多次创伤后入住重症监护病房（ICU）的重症患者，本研究旨在评估肠上皮细胞屏障蛋白（包括紧密连接蛋白、Claudin-1、连接黏附分子-1、三细胞连接蛋白和紧密连接蛋白）的血浆水平是否可作为新型生物标志物。还评估了其他潜在的标志物，如肠脂肪酸结合蛋白（I-FABP）、D-乳酸、脂多糖（LPS）和瓜氨酸。我们还旨在确定患者的临床、实验室和营养状况与测量标志物水平之间的可能关系。
对 29 名患者（入住 ICU 的第 1、2、5 和 10 天以及出院后第 7、30 和 60 天）和 23 名对照者的血浆样本进行商业酶联免疫吸附试验（ELISA）检测。
在创伤患者中，I-FABP、D-乳酸、瓜氨酸、occludin、Claudin-1、tricellulin 和 zonulin 的血浆水平在入院第 1 天（入院时）和第 2 天升高，与乳酸、C 反应蛋白（CRP）、ICU 住院天数、急性生理学和慢性健康评估 II（APACHE II）评分和每日序贯器官衰竭评估（SOFA）评分呈正相关（P<0.05-P<0.01）。
本研究结果表明，紧密连接蛋白、Claudin-1、tricellulin 和 zonulin 蛋白以及 I-FABP、D-乳酸和瓜氨酸可能作为评估重症创伤患者疾病严重程度的有前途的生物标志物，尽管分析各种屏障标志物的复杂性。然而，我们的结果应该得到未来研究的支持。
