The intestinal fatty acid-binding protein as a marker for intestinal damage in gastroschisis.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2019
2019
Historique:
received:
31
07
2018
accepted:
02
01
2019
entrez:
15
1
2019
pubmed:
15
1
2019
medline:
2
11
2019
Statut:
epublish
Résumé
We analyzed the capacity of urinary Intestinal fatty acid-binding protein (I-FABP) to quantify the degree of mucosal injury in neonates with gastroschisis (GS) and to predict the speed of their clinical recovery after surgery. In this prospective study, we collected urine during the first 48h after surgery from neonates operated between 2012 and 2015 for GS. Neonates with surgery that did not include gut mucosa served as controls for simple GS and neonates with surgery for intestinal atresia served as control for complex GS patients. The I-FABP levels were analyzed by ELISA. Urinary I-FABP after the surgery is significantly higher in GS newborns than in control group; I-FABP in complex GS is higher than in simple GS. I-FABP can predict subsequent operation for ileus in patients with complex GS. Both ways of abdominal wall closure (i.e. primary closure and stepwise reconstruction) led to similar levels of I-FABP. None of the static I-FABP values was useful for the outcome prediction. The steep decrease in I-FABP after the surgery is associated with faster recovery, but it cannot predict early start of minimal enteral feeding, full enteral feeding or length of hospitalization. Urinary I-FABP reflects the mucosal damage in gastroschisis but it has only a limited predictive value for patients' outcome.
Sections du résumé
BACKGROUND/PURPOSE
We analyzed the capacity of urinary Intestinal fatty acid-binding protein (I-FABP) to quantify the degree of mucosal injury in neonates with gastroschisis (GS) and to predict the speed of their clinical recovery after surgery.
METHODS
In this prospective study, we collected urine during the first 48h after surgery from neonates operated between 2012 and 2015 for GS. Neonates with surgery that did not include gut mucosa served as controls for simple GS and neonates with surgery for intestinal atresia served as control for complex GS patients. The I-FABP levels were analyzed by ELISA.
RESULTS
Urinary I-FABP after the surgery is significantly higher in GS newborns than in control group; I-FABP in complex GS is higher than in simple GS. I-FABP can predict subsequent operation for ileus in patients with complex GS. Both ways of abdominal wall closure (i.e. primary closure and stepwise reconstruction) led to similar levels of I-FABP. None of the static I-FABP values was useful for the outcome prediction. The steep decrease in I-FABP after the surgery is associated with faster recovery, but it cannot predict early start of minimal enteral feeding, full enteral feeding or length of hospitalization.
CONCLUSION
Urinary I-FABP reflects the mucosal damage in gastroschisis but it has only a limited predictive value for patients' outcome.
Identifiants
pubmed: 30640955
doi: 10.1371/journal.pone.0210797
pii: PONE-D-18-22654
pmc: PMC6331122
doi:
Substances chimiques
Biomarkers
0
FABP2 protein, human
0
Fatty Acid-Binding Proteins
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0210797Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Am J Obstet Gynecol. 2010 Apr;202(4):396.e1-6
pubmed: 20044065
Curr Opin Pediatr. 2016 Jun;28(3):363-9
pubmed: 26974976
J Pediatr Surg. 2014 Nov;49(11):1577-84
pubmed: 25475797
J Pediatr Surg. 1989 Oct;24(10):992-7
pubmed: 2530329
J Pediatr Surg. 2013 Apr;48(4):845-57
pubmed: 23583145
J Pediatr Surg. 2005 May;40(5):789-92
pubmed: 15937815
Gut. 2007 Oct;56(10):1473-5
pubmed: 17872576
Aliment Pharmacol Ther. 2013 Feb;37(4):482-90
pubmed: 23289539
Ann Surg. 2011 Feb;253(2):303-8
pubmed: 21245670
Am J Obstet Gynecol. 2004 May;190(5):1326-30
pubmed: 15167837
Arch Gynecol Obstet. 2016 May;293(5):1001-6
pubmed: 26525691
Surg Infect (Larchmt). 2015 Jun;16(3):247-53
pubmed: 25831240
J Immunol Res. 2016;2016:5727312
pubmed: 27110575
Semin Fetal Neonatal Med. 2011 Jun;16(3):164-72
pubmed: 21474399
J Clin Invest. 1974 Aug;54(2):326-38
pubmed: 4211161
J Pediatr Gastroenterol Nutr. 2005 Nov;41 Suppl 2:S1-87
pubmed: 16254497
Surgery. 1997 Mar;121(3):335-42
pubmed: 9068676
J Pediatr Surg. 2001 Jan;36(1):51-5
pubmed: 11150437
Clin Lab. 2015;61(1-2):87-91
pubmed: 25807642
Pediatr Surg Int. 2015 Apr;31(4):381-7
pubmed: 25697276
BJOG. 2012 Jan;119(1):102-9
pubmed: 22017923
World J Surg. 1996 Jan;20(1):11-6
pubmed: 8588401
MMWR Morb Mortal Wkly Rep. 2016 Jan 22;65(2):23-6
pubmed: 26796490
World J Gastroenterol. 2016 Mar 7;22(9):2760-70
pubmed: 26973414
J Pediatr Surg. 1999 Oct;34(10):1453-7
pubmed: 10549746
W V Med J. 2013 Mar-Apr;109(2):22-7
pubmed: 23600101
J Pediatr Surg. 1993 Mar;28(3):367-70; discussion 370-1
pubmed: 8468648