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Serum I-FABP as marker for enterocyte damage in coeliac disease and its relation to villous atrophy and circulating autoantibodies.
Aliment Pharmacol Ther 2013; 37(4):482-90AP

Abstract

BACKGROUND

Enterocyte damage is the hallmark of coeliac disease (CD) resulting in malabsorption. Little is known about the recovery of enterocyte damage and its clinical consequences. Serum intestinal fatty acid binding protein (I-FABP) is a sensitive marker to study enterocyte damage.

AIMS

To evaluate the severity of enterocyte damage in adult-onset CD and its course upon a gluten-free diet (GFD). Furthermore, the correlation among enterocyte damage, CD autoantibodies and histological abnormalities during the course of disease is studied.

METHODS

Serum I-FABP levels were determined in 96 biopsy-proven adult CD patients and in 69 patients repeatedly upon a GFD. A total of 141 individuals with normal antitissue transglutaminase antibody (IgA-tTG) levels served as controls. I-FABP levels were related to the degree of villous atrophy (Marsh grade) and IgA-tTG.

RESULTS

I-FABP levels were elevated in untreated CD (median 691 pg/mL) compared with controls (median 178 pg/mL, P < 0.001) and correlated with Marsh grade (r = 0.265, P < 0.05) and IgA-tTG (r = 0.403, P < 0.01). Upon a GFD serum levels decreased significantly, however, not within the range observed in controls, despite the common observed normalisation of IgA-tTG levels and Marsh grade. CD patients with elevated I-FABP levels nonresponding to GFD showed persistent histological abnormalities.

CONCLUSIONS

Enterocyte damage assessed by serum I-FABP correlates with the severity of villous atrophy in coeliac disease at the time of diagnosis. Although enterocyte damage improves upon treatment, substantial enterocyte damage persists despite absence of villous atrophy and low IgA-tTG levels in the majority of cases. Elevated I-FABP levels nonresponding to gluten-free diet are indicative of histological abnormalities and warrant further evaluation.

Authors+Show Affiliations

Department of Paediatrics & Nutrition and Toxicology Research Institute Maastricht (NUTRIM), Maastricht University Medical Centre, Maastricht, the Netherlands. marlou.adriaanse@maastrichtuniversity.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23289539

Citation

Adriaanse, M P M., et al. "Serum I-FABP as Marker for Enterocyte Damage in Coeliac Disease and Its Relation to Villous Atrophy and Circulating Autoantibodies." Alimentary Pharmacology & Therapeutics, vol. 37, no. 4, 2013, pp. 482-90.
Adriaanse MP, Tack GJ, Passos VL, et al. Serum I-FABP as marker for enterocyte damage in coeliac disease and its relation to villous atrophy and circulating autoantibodies. Aliment Pharmacol Ther. 2013;37(4):482-90.
Adriaanse, M. P., Tack, G. J., Passos, V. L., Damoiseaux, J. G., Schreurs, M. W., van Wijck, K., ... Vreugdenhil, A. C. (2013). Serum I-FABP as marker for enterocyte damage in coeliac disease and its relation to villous atrophy and circulating autoantibodies. Alimentary Pharmacology & Therapeutics, 37(4), pp. 482-90. doi:10.1111/apt.12194.
Adriaanse MP, et al. Serum I-FABP as Marker for Enterocyte Damage in Coeliac Disease and Its Relation to Villous Atrophy and Circulating Autoantibodies. Aliment Pharmacol Ther. 2013;37(4):482-90. PubMed PMID: 23289539.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum I-FABP as marker for enterocyte damage in coeliac disease and its relation to villous atrophy and circulating autoantibodies. AU - Adriaanse,M P M, AU - Tack,G J, AU - Passos,V Lima, AU - Damoiseaux,J G M C, AU - Schreurs,M W J, AU - van Wijck,K, AU - Riedl,R G, AU - Masclee,A A M, AU - Buurman,W A, AU - Mulder,C J J, AU - Vreugdenhil,A C E, Y1 - 2013/01/07/ PY - 2012/07/09/received PY - 2012/07/19/revised PY - 2012/12/05/revised PY - 2012/12/07/accepted PY - 2013/1/8/entrez PY - 2013/1/8/pubmed PY - 2013/6/28/medline SP - 482 EP - 90 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 37 IS - 4 N2 - BACKGROUND: Enterocyte damage is the hallmark of coeliac disease (CD) resulting in malabsorption. Little is known about the recovery of enterocyte damage and its clinical consequences. Serum intestinal fatty acid binding protein (I-FABP) is a sensitive marker to study enterocyte damage. AIMS: To evaluate the severity of enterocyte damage in adult-onset CD and its course upon a gluten-free diet (GFD). Furthermore, the correlation among enterocyte damage, CD autoantibodies and histological abnormalities during the course of disease is studied. METHODS: Serum I-FABP levels were determined in 96 biopsy-proven adult CD patients and in 69 patients repeatedly upon a GFD. A total of 141 individuals with normal antitissue transglutaminase antibody (IgA-tTG) levels served as controls. I-FABP levels were related to the degree of villous atrophy (Marsh grade) and IgA-tTG. RESULTS: I-FABP levels were elevated in untreated CD (median 691 pg/mL) compared with controls (median 178 pg/mL, P < 0.001) and correlated with Marsh grade (r = 0.265, P < 0.05) and IgA-tTG (r = 0.403, P < 0.01). Upon a GFD serum levels decreased significantly, however, not within the range observed in controls, despite the common observed normalisation of IgA-tTG levels and Marsh grade. CD patients with elevated I-FABP levels nonresponding to GFD showed persistent histological abnormalities. CONCLUSIONS: Enterocyte damage assessed by serum I-FABP correlates with the severity of villous atrophy in coeliac disease at the time of diagnosis. Although enterocyte damage improves upon treatment, substantial enterocyte damage persists despite absence of villous atrophy and low IgA-tTG levels in the majority of cases. Elevated I-FABP levels nonresponding to gluten-free diet are indicative of histological abnormalities and warrant further evaluation. SN - 1365-2036 UR - https://www.unboundmedicine.com/medline/citation/23289539/Serum_I_FABP_as_marker_for_enterocyte_damage_in_coeliac_disease_and_its_relation_to_villous_atrophy_and_circulating_autoantibodies_ L2 - https://doi.org/10.1111/apt.12194 DB - PRIME DP - Unbound Medicine ER -