Urinary Intestinal Fatty Acid Binding Protein Predicts Necrotizing Enterocolitis

Abstract

Necrotizing enterocolitis (NEC), characterized by sudden onset and rapid progression, remains the most significant gastrointestinal disorder among premature infants. In seeking a predictive biomarker, we found intestinal fatty acid binding protein, an indicator of enterocyte damage, was substantially increased within three and seven days before the diagnosis of NEC.

Diagnostic Value of Intestinal Fatty-Acid-Binding Protein in Necrotizing Enterocolitis: A Systematic Review and Meta-Analysis

“…There was one repetitive study [11]. Fourteen measured up to the criteria and were included [2,[5][6][7][8][12][13][14][15][16][17][18][19][20]. One hundred and thirty-five were excluded because they were animal studies, review articles, or irrelevant to the current study (Fig.…”

“…Table 1 shows the characteristics of included studies with the optimal cut-off point values identified in the individual studies. They were conducted in Germany [6], USA [8,12,14,18,20], UK [13,19], Netherlands [5,7,16], Turkey [17], China [15] and Austria [2]. Eleven were finished in the past 5 y [2,5,7,[12][13][14][15][16][17][18][19].…”

“…Three studies evaluated the diagnostic accuracy of iFABPu in diagnosis of NEC [7,14,18]. Pooled sensitivity, specificity, PLR, NLR were 0.64 (95% CI 0.53 to 0.74), 0.73 (95% CI 0.64 to 0.80), 2.60 (95% CI 1.93 to 3.49) and 0.49 (95% CI 0.33 to 0.71).…”

“…In order to detect NEC early in preterms with high risk, several biomarkers were investigated in the past decades, including markers of epithelial damage, smooth muscle injures, inflammation and pathogen invasion. Fatty-acid-binding proteins (FABP) comprise a group of cytoplasmic small molecular mass proteins (14)(15) with high organ sensitivity [2]. Intestinal fatty-acid-binding protein (i-FABP) constitutes up to 2% of the cytoplasmic protein content of the mature enterocyte [3].…”

Stooling Pattern and Early Nutritional Exposures Associated With Necrotizing Enterocolitis in Premature Infants

“…Feeding is typically a precursor to NEC, which is then characterized by insidious disease onset and rapid disease progression. Scientific advances related to early intestinal colonization, the human microbiome, and identification of sensitive and specific biomarkers of NEC will result in the development of novel interventions for more effective detection and treatment of this disease 6–10 . However, while we wait for the findings generated by these studies to be replicated and then translated to effective patient care interventions, there is a need to better understand clinical signs and symptoms in proximity to disease onset.…”