Fecal zonulin is elevated in Crohn’s disease and in cigarette smokers

Abstract

ObjectivesHuman zonulin is a protein that increases permeability in the epithelial layer of the small intestine by reversibly modulating the intercellular tight junctions. There is not sufficient information available about zonulin's participation in inflammatory bowel diseases (IBD). The aim of this study was therefore to investigate fecal and serum zonulin in IBD patients and its relation to the disease localization, behavior and smoking status.Design and methodsForty IBD patients and forty healthy persons were examined for fecal and serum zonulin concentrations by competitive ELISA (DRG International Inc). Values were correlated to IBD type, localization and behavior, and smoking.ResultsSerum and fecal zonulin were significantly higher in patients with Crohn’s disease compared to ulcerative colitis (p = 0.038 for fecal zonulin, and p = 0.041 for serum zonulin concentrations). No association of serum or fecal zonulin was found with respect to IBD localization and behavior. The only difference was found with respect to smoking. Both the IBD cohort and healthy smokers showed significantly higher fecal zonulin levels (median 203 ng/mL) compared to non-smokers (median 35.8 ng/mL), p < 0.001.ConclusionsFecal and serum zonulin levels are elevated in patients with active Crohn’s disease but not with ulcerative colitis. High fecal zonulin levels in smokers irrespective of IBD point to the significant and undesirable up-regulation of gut permeability in cigarette smokers.

Analysis of Faecal Zonulin and Calprotectin Concentrations in Healthy Children During the First Two Years of Life. An Observational Prospective Cohort Study

“…Current literature gives different values for stool zonulin concentrations. Malíčková et al [39], based on the recommendations of the ELISA manufacturer-OrgenTec, Germany, indicated normal zonulin concentrations of 61 ng/mL ± 46 ng/mL. On the other hand, the cut-off upper normal limit for adults given by Lamprecht et al was a zonulin concentration value of 30 ng/mL [40].…”

Emerging concepts in non-invasive monitoring of Crohn’s disease

“…A widely studied inflammation-related biomarker called zonulin was found to be elevated in both faeces and serum during the active CD phase, but not in UC. 91 Another barrier-integrity-specific molecule is Rho-A, which was found to be downregulated in IBD 92 and Rho-associated kinase upregulated in inflamed mucosa of CD patients. 93 It was proved that these alterations are key mediators of chronic inflammation, cytoskeleton rearrangement and skewed cell shedding.…”

Risk factors associated with intestinal permeability in an adult population: A systematic review

“…Twenty‐four studies reported on 29 statistically significant biomarkers and association with altered IP . Two studies reported that fasting glucose had a weak positive correlation with IP (Table ).…”

“…Twenty-four studies reported on 29 statistically significant biomarkers and association with altered IP. 10,23,25,32,35,[40][41][42][43][44][50][51][52][53][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72] Two studies reported that fasting glucose had a weak positive correlation with IP 44,53 (Table 5). Moreover, an additional study reported that a plasma glucose level >5.7 nmol/L is associated with a greater odds of having altered IP (OR = 2.09; 95% CI: 2.09, 4.18; P = 0.036) in the general population 23 (Table 3).…”