Intest Res.  2017 Jan;15(1):118-123. 10.5217/ir.2017.15.1.118.

Intestinal barrier integrity and function in infants with cholestasis

• Abu Faddan NH
• Sherif TM
• Mohammed O
• Nasif KA
• El Gezawy

• KMID: 2368494
• DOI: http://doi.org/10.5217/ir.2017.15.1.118

Abstract

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.
METHODS
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.
RESULTS
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.
CONCLUSIONS
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.

Keyword

Infant; Cholestasis; Intestinal barrier

MeSH Terms

Bile
Biliary Atresia
Bilirubin
Carrier Proteins
Case-Control Studies
Cholestasis*
Epithelial Cells
Fatty Acid-Binding Proteins
Hepatitis
Human Body
Humans
Infant*
Intestines
Permeability
Plasma
Bilirubin
Carrier Proteins
Fatty Acid-Binding Proteins

Figure

• 

  Fig. 1 Comparison of the serum level of intestinal fatty acid binding proteins (I-FABP) between infants with cholestasis and controls. aSignificant difference compared with the control group. P-value <0.00 for the NH group vsersus controls; P-value <0.00 for the BA group versus controls; P-value=0.58 for the NH group versus the BA group. NH, neonatal hepatitis; BA, biliary atresia.

• 

  Fig. 2 Comparison of the serum level of ileal bile acid binding protein (I-BABP) between infants with cholestasis and controls. aSignificant difference compared with the control group. P-value <0.00 for the NH group versus controls; P-value <0.00 for the BA group versus controls; P-value=0.18 for the NH group versus the BA group. NH, neonatal hepatitis; BA, biliary atresia.

• 

  Fig. 3 Comparison of the serum level of D-lactate between infants with cholestasis and controls. P-value=0.65 for the NH group versus controls; P-value=0.36 for the BA group versus controls; P-value=0.66 for the NH group versus the BA group. NH, neonatal hepatitis; BA, biliary atresia.

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