BACKGROUND: Enterocyte damage is the hallmark of coeliac disease (CD) resulting in malabsorption. Little is known about the recovery of enterocyte damage and its clinical consequences. Serum intestinal fatty acid binding protein (I-FABP) is a sensitive marker to study enterocyte damage. AIMS: To evaluate the severity of enterocyte damage in adult-onset CD and its course upon a gluten-free diet (GFD). Furthermore, the correlation among enterocyte damage, CD autoantibodies and histological abnormalities during the course of disease is studied. METHODS: Serum I-FABP levels were determined in 96 biopsy-proven adult CD patients and in 69 patients repeatedly upon a GFD. A total of 141 individuals with normal antitissue transglutaminase antibody (IgA-tTG) levels served as controls. I-FABP levels were related to the degree of villous atrophy (Marsh grade) and IgA-tTG. RESULTS: I-FABP levels were elevated in untreated CD (median 691 pg/mL) compared with controls (median 178 pg/mL, P < 0.001) and correlated with Marsh grade (r = 0.265, P < 0.05) and IgA-tTG (r = 0.403, P < 0.01). Upon a GFD serum levels decreased significantly, however, not within the range observed in controls, despite the common observed normalisation of IgA-tTG levels and Marsh grade. CD patients with elevated I-FABP levels nonresponding to GFD showed persistent histological abnormalities. CONCLUSIONS: Enterocyte damage assessed by serum I-FABP correlates with the severity of villous atrophy in coeliac disease at the time of diagnosis. Although enterocyte damage improves upon treatment, substantial enterocyte damage persists despite absence of villous atrophy and low IgA-tTG levels in the majority of cases. Elevated I-FABP levels nonresponding to gluten-free diet are indicative of histological abnormalities and warrant further evaluation.
"The present study aslo has demonstrated that DHFZT obviously increased intestinal blood blow and serum concentration of IFABP realesed from broken gastrointestinal epithelial cells, which can be easily detected when the intestinal mucosa is ischemia and hypoxia. Serum concentration of IFABP is a marker of damage of the intestinal mucosa [18,19]. The authors found that when HS, IFABP quickly entered into the blood, and then leaded to high serum IFABP, indicating HS causes damage of the intestine . "
[Show abstract][Hide abstract] ABSTRACT: Dai Huang Fu Zi Tang(DHFZT),an oriental herbal formula, has long been used clinically in treatment of intestinal obstruction,acute pancreatitis,cholecystalgia and chronic diarrhea for thousands of years. Recent studies have demonstrated that DHFZT can reduce intestinal pathological injury and the concentration of enterogenous endotoxin in an animal model. But the underlying mechanism has not been fully elucidated.
SD male rats in adult were used to model HS and treated with DHFZT. The serum concentration of endotoxin were analyzed by dynamic turbidimetric method. In addition, the blood flow of small intestine were measured using laser speckle technique. Phosphorylated vasodilator-stimulated phosphoprotein (p-VASP) and zonula occludens(ZO)-1 protein, intestinal fatty acid binding protein (IFABP) were measured by Western Blotting, RT-PCR, ELISA respectively.
Present study showed that DHFZT markedly elevated the blood flow of small intestine, protected the intestinal barrier function by up-regulating the expression of ZO-1 protein and down-regulating expression of p-VASP,and notely decreased serum concentration of IFABP and endotoxin in HS.
These results reveal that DHFZT improves intestinal blood flow,protects the intestinal barrier function, and ameliorates intestinal endotoxaemia in rats with HS.
BMC Complementary and Alternative Medicine 03/2014; 14(1):80. DOI:10.1186/1472-6882-14-80 · 2.02 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: OBJECTIVES:: : To examine the impact of Serum-derived Bovine Immunoglobulin, an oral medical food known to neutralized bacterial antigen and reduce intestinal inflammation, on restoration of mucosal immunity and gastrointestinal (GI) function in subjects with HIV enteropathy. DESIGN:: : Open-label trial with intensive 8-week phase of SBI 2.5 grams twice daily with a 4-week wash-out period and an optional 9-month extension study. METHODS:: : HIV enteropathy was defined as chronic GI symptoms including frequent loose or watery stools despite no identifiable, reversible etiology. Upper endoscopy for tissue immunofluorescent antibody assay and disaccharide gut permeability/absorption studies were performed pre- and post-8 weeks of SBI to test mucosal immunity and GI function. Blood was collected for markers of microbial translocation, inflammation, and collagen kinetics. A validated GI questionnaire assessed changes in symptoms. RESULTS:: : All eight subjects experienced profound improvement in symptoms with reduced bowel movements/day (P = 0.008) and improvements in stool consistency (P = 0.008). Gut permeability was normal before and after the intervention but D-xylose absorption increased in 7/8 subjects. Mucosal CD4 lymphocyte densities increased by a median of 139.5 cells/mm from 213 to 322 cells/mm (P = 0.016). Intestinal-Fatty Acid Binding Protein (I-FABP), a marker of enterocyte damage, initially rose in 7/8 subjects after 8 weeks (P = 0.039), and then fell below baseline in 4/5 who continued receiving SBI (P = 0.12). Baseline serum I-FABP levels were negatively correlated with subsequent rise in mucosal CD4 lymphocyte densities (r = -0.74, P = 0.046). CONCLUSIONS:: : SBI significantly increases intestinal mucosal CD4 lymphocyte counts, function, and showed evidence of intestinal repair in the setting of HIV enteropathy.
AIDS (London, England) 05/2013; 27(14). DOI:10.1097/QAD.0b013e328362e54c · 5.55 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background:
Microbial translocation has been implicated in the pathogenesis of liver fibrosis and cirrhosis. We sought to determine whether markers of microbial translocation are associated with liver disease progression during coinfection with human immunodeficiency virus (HIV) and hepatitis C virus (HCV).
We measured serial plasma lipopolysaccharide (LPS), endotoxin core antibody, intestinal fatty acid-binding protein (I-FABP), soluble CD14 (sCD14), interleukin 6 (IL-6), interleukin 10, and tumor necrosis factor α (TNF-α) levels over a 5-year period in 44 HIV/HCV-coinfected women, 21 of whom experienced liver disease progression and 23 were nonprogressors.
While LPS levels did not differ significantly over time between progressors and nonprogressors (P = .60), progressors had significantly higher plasma levels of sCD14, a marker of monocyte activation by LPS, at the first time point measured (P = .03) and throughout the study period (P = .001); progressors also had higher IL-6 and I-FABP levels over the 5-year study period (P = .02 and .03, respectively). The associations between progression and sCD14, I-FABP, and IL-6 levels were unchanged in models controlling for HIV RNA and CD4(+) T-cell count.
Although LPS levels did not differ between liver disease progressors and nonprogressors, the association of sCD14, I-FABP, and IL-6 levels with liver disease progression suggests that impairment of gut epithelial integrity and consequent microbial translocation may play a role in the complex interaction of HIV and HCV pathogenesis.
The Journal of Infectious Diseases 05/2013; 208(4). DOI:10.1093/infdis/jit225 · 6.00 Impact Factor
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