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*MARKERS OF MUCOSAL AND TRANSMURAL INTESTINAL DAMAGE
Author(s) -
Evennett N. J.,
Cerigioni E.,
Hall N. J.,
Pierro A.,
Eaton S.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04917_16.x
Subject(s) - medicine , laparotomy , sma* , necrotizing enterocolitis , urine , gastroenterology , urinary system , ischemia , pathology , surgery , mathematics , combinatorics
Purpose: To investigate intestinal fatty acid binding protein (iFABP) and smooth muscle actin (SMA) as markers of mucosal and transmural intestinal damage, respectively, in both rat intestinal ischaemia reperfusion injury, and in human necrotising enterocolitis (NEC). Methodology: Plasma was collected from anaesthetized rats that underwent intestinal ischaemia reperfusion (IIR) injury and from control rats undergoing sham laparotomy. In a separate study, plasma and urine was collected from infants with NEC, and from control infants with non‐abdominal diagnoses. iFABP was measured in urine and plasma using a commercially available ELISA. SMA was detected in plasma using a western blot technique. Results are median [IQR] and compared by Mann‐Whitney test unless otherwise stated. Results: Animal model: Plasma iFABP was significantly higher in the IRI group compared with control group (IRI 32.4 [29.2] ng/ml vs. control 3.8 [3.3] ng/ml; p < 0.01). SMA became detectable in IRI plasma during reperfusion (p < 0.01 compared with pre‐ischaemia, Wilcoxon Signed Ranks test), but never in the control group. Human NEC Study: Urinary iFABP was significantly higher in the NEC group (2.1 [3.9] pg/nmol) compared to controls (1.1 [0.7] pg/nmol, p, < 0.05). Furthermore plasma and urinary iFABP correlated with extent of intestinal damage at laparotomy, and decreased with NEC resolution. SMA was detectable in the plasma of infants with multifocal or panintestinal NEC, but in neither focal nor non‐operative disease. Conclusion: FABP and SMA are markers of mucosal and transmural intestinal damage, respectively, and may offer clinically relevant information in the diagnosis and management of severe intestinal disease.