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

Leech, Bradley; Sibbritt, David; Steel, Amie; McIntyre, Erica

doi:10.1016/j.aimed.2019.03.260

Cited by 14 publications

(30 citation statements)

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“…Several explanatory variables were associated with s-zonulin at the first of the three visits. Abdominal obesity (waist-hip ratio), a marker of fatty liver disease (gamma-GT), reduced glucose tolerance (HbA1C) and increased low-grade inflammation were associated with high levels of s-zonulin, in accordance with earlier studies [ 3 , 5 , 6 , 8 , 26 ]. S-zonulin was not associated with BMI, but the levels of s-zonulin in the cohort as a whole were much higher than previously observed levels of s-zonulin in individuals without obesity [ 6 , 8 ].…”

Section: Discussionsupporting

confidence: 89%

“…A few longitudinal studies of zonulin before and after conservative weight-loss interventions have been performed, but no studies of the changes after bariatric surgery [5,13,14]. If the changes in s-zonulin partly explain the metabolic changes after bariatric surgery, zonulin inhibitors could have an effect on some of the metabolic disorders related to obesity.…”

Section: Introductionmentioning

confidence: 99%

“…Zonulin can be measured in the blood and the faeces. High serum zonulin (s-zonulin) has been interpreted as increased intestinal permeability [ 1 , 2 , 5 ]. Measured with the available enzyme-linked immunosorbent assay (ELISA) methods, s-zonulin has been associated with obesity and high energy intake in cross-sectional studies [ 3 , 6 – 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Changes in serum zonulin in individuals with morbid obesity after weight-loss interventions: a prospective cohort study

Aasbrenn

Lydersen²,

Farup

2020

BMC Endocr Disord

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Background: Zonulin is a biomarker of impaired intestinal permeability, which has been associated with various disorders. The primary aim was to study serum zonulin (s-zonulin) in individuals with morbid obesity before and after a conservative weight loss intervention followed by bariatric surgery. The secondary aims were to explore predictors of s-zonulin, and the associations between the changes of the predictors and changes in s-zonulin, and to compare the associations in the two treatment periods. Methods: Individuals with morbid obesity were included. Data before any weight loss interventions, after a 6 months' conservative weight loss intervention, and 6 months after bariatric surgery were used. S-zonulin was measured with an ELISA method from Immundiagnostik AB, Bensheim, Germany. Data were analysed with mixed models. Results: The mean body mass index was 42.1 kg/m 2 (SD 3.8) at inclusion and was reduced to 38.7 kg/m 2 (SD 3.8) and 29.8 kg/m 2 (SD 3.8) after the conservative treatment and bariatric surgery respectively. S-zonulin was 63 ng/mL (SD 32) at inclusion and was reduced with 19 ng/ml (95% CI 12 to 26, p < 0.001) after conservative treatment and 11 ng/ml (95% CI 0 to 21, p = 0.04) after bariatric surgery. At inclusion, s-zonulin was significantly associated with factors including p-glucose (B = 2.21, 95% CI 1.09 to 3.33, p < 0.001), c-reactive protein (B = 1.02, 95% CI 0.45 to 1.58, p < 0.001) and the intake of proteins (B = 0.23, 95% CI 0.08 to 0.38, p = 0.003) and non-nutritive sweeteners (B = 0.68, 95% CI 0.19 to 1.17, p = 0.007). The reduction in s-zonulin after the conservative weight loss intervention was significantly associated with improvement in diarrhoea (B = 6.6, 95% CI 1.3 to 11.8, p = 0.02), HbA1c (B = 9.7, 95% CI 1.1 to 18.3, p = 0.03), p-glucose (B = 3.5, 95% CI 1.2 to 5.9, p = 0.004) and gamma-GT (B = 0.28, 95% CI 0.09 to 0.47, p = 0.004), but not associated with the change in body mass index (B = 0.9, 95% CI − 1.5 to 3.3, p = 0.46). Conclusions: S-zonulin was markedly reduced after the conservative weight loss intervention, and further reduced after bariatric surgery. The reduction in s-zonulin was associated with improvement of diarrhoea, markers of glucose intolerance and liver disease, but not associated with the change in body mass index.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Changes in serum zonulin in individuals with morbid obesity after weight-loss interventions: a prospective cohort study

Aasbrenn

Lydersen²,

Farup

2020

BMC Endocr Disord

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“…We then assessed the concentrations of fecal zonulin and fecal calprotectin, which are biomarkers of gut barrier and gut inflammatory disorders, respectively. 19,20 The fecal level of these two markers was not affected by CG treatment.…”

Section: Discussionmentioning

confidence: 85%

Metabolite profiling reveals the interaction of chitin-glucan with the gut microbiota

et al. 2020

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Dietary fibers are considered beneficial nutrients for health. Current data suggest that their interaction with the gut microbiota largely contributes to their physiological effects. In this context, chitin-glucan (CG) improves metabolic disorders associated with obesity in mice, but its effect on gut microbiota has never been evaluated in humans. This study explores the effect of a 3-week intervention with CG supplementation in healthy individuals on gut microbiota composition and bacterial metabolites. CG was given to healthy volunteers (n = 15) for three weeks as a supplement (4.5 g/day). Food diary, visual analog and Bristol stool form scales and a "quality of life" survey were analyzed. Among gut microbiotaderived metabolites, bile acids (BA), long-and short-chain fatty acids (LCFA, SCFA) profiling were assessed in stool samples. The gut microbiota (primary outcome) was analyzed by Illumina sequencing. A 3-week supplementation with CG is well tolerated in healthy humans. CG induces specific changes in the gut microbiota composition, with Eubacterium, Dorea and Roseburia genera showing the strongest regulation. In addition, CG increased bacterial metabolites in feces including butyric, iso-valeric, caproic and vaccenic acids. No major changes were observed for the fecal BA profile following CG intervention. In summary, our work reveals new potential bacterial genera and gut microbiota-derived metabolites characterizing the interaction between an insoluble dietary fiber-CG-and the gut microbiota.

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“…Furthermore, recent studies reported clear differences between adult and pediatric IBD patients’ gut fungal communities [ 8 ] and more heterogeneous fungal communities in CD patients compared to healthy subjects [ [23] , [24] , [25] , [26] ], suggesting a role of altered mycobiota in inflammatory diseases and “leaky gut” syndrome. Sokol and collaborators [ 23 ] observed a clear fungal dysbiosis in CD patients with an enrichment in Candida spp.…”

Section: Introductionmentioning

confidence: 99%

Comparative immunophenotyping of Saccharomyces cerevisiae and Candida spp. strains from Crohn’s disease patients and their interactions with the gut microbiome

Paola

Rizzetto

Stefanini

et al. 2020

Journal of Translational Autoimmunity

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Investigation of the fungal communities in animal models of Inflammatory Bowel Diseases (IBD) showed a controversial role of Saccharomyces cerevisiae and Candida spp . In health and disease. These conflicting observations could be ascribed to immunogenic differences among co-specific strains. To assess the relevance of intra-strains differences on yeast immunogenicity and impact on the microbiota, we screened S. cerevisiae and Candida spp. Strains isolated from fecal samples of IBD patients. We compared the cytokine profiles, obtained upon stimulation of Peripheral Blood Mononuclear Cells (PBMCs) and Dendritic Cells with different yeast strains, and evaluated the relationship between strain’s cell wall sugar amount and immune response. Moreover, the gut microbiota composition was explored in relation to fungal isolation from fecal samples by metabarcoding analysis. The comparison of cytokine profiles showed strain dependent rather than species-dependent differences in immune responses. Differences in immunogenicity correlated with the cell wall composition of S. cerevisiae intestinal strains. Stimulation of human healthy PBMCs with different strains showed a pro-inflammatory IL-6 response counterbalanced by IL-10 production. Interestingly, Crohn’s (CD) patients responded differently to “self” and “non-self” strains, eliciting pure Th1 or Th17 cytokine patterns. The differences observed in vitro were recapitulated in vivo , where different strains contributed in dramatically different ways to local epithelial activity and to the inflammation of wild type and Interleukin-deficient mice. Furthermore, we observed that the gut microbiota profiles significantly differentiated according to the presence of Saccharomyces or Candida spp. or the absence of fungal isolates in fecal samples. Our results show the importance to deepen metagenomics and immunophenotyping analyses to the strain level, to elucidate the role of fungal and bacterial communities in health and disease.

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

Cited by 14 publications

References 0 publications

Changes in serum zonulin in individuals with morbid obesity after weight-loss interventions: a prospective cohort study

Changes in serum zonulin in individuals with morbid obesity after weight-loss interventions: a prospective cohort study

Metabolite profiling reveals the interaction of chitin-glucan with the gut microbiota

Comparative immunophenotyping of Saccharomyces cerevisiae and Candida spp. strains from Crohn’s disease patients and their interactions with the gut microbiome

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