The intestinal fatty acid-binding protein as a marker for intestinal damage in gastroschisis

• Published in: PloS one 2019-01, Vol.14 (1), p.e0210797-e0210797
• Main Authors: Kokesova, Alena, Coufal, Stepan, Frybova, Barbora, Kverka, Miloslav, Rygl, Michal
• Format: Article
• Language: English
• Subjects: Abdomen; Abdominal wall; Analysis; Binding proteins; Biology and Life Sciences; Biomarkers; Biomarkers - urine; Care and treatment; Case-Control Studies; Child health; Enteral feeding; Enteral nutrition; Enzyme-linked immunosorbent assay; Fatty acid-binding protein; Fatty Acid-Binding Proteins - urine; Fatty acids; Feeding; Female; Gastroschisis; Gastroschisis - pathology; Gastroschisis - surgery; Gastroschisis - urine; Hospitals; Humans; Infant, Newborn; Intestinal Atresia - surgery; Intestinal Atresia - urine; Intestinal Mucosa - injuries; Intestine; Ischemia; Male; Medicine; Medicine and Health Sciences; Mucosa; Neonates; Newborn babies; Nutrition; Outcome and process assessment (Medical care); Parenteral nutrition; Patients; Pediatrics; Predictions; Predictive Value of Tests; Prognosis; Prospective Studies; Proteins; Recovery; Risk factors; Surgery; Ultrasonic imaging; Urinalysis; Urine
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0210797

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.