目的:为了更好地管理在重症监护病房(ICU)住院的重症患者,本研究旨在评估肠上皮细胞屏障蛋白的血浆水平,包括occludin,claudin-1,连接粘附分子(JAM-1),三细胞蛋白和zonulin,可以用作新的生物标志物。其他潜在标志物,如肠脂肪酸结合蛋白(I-FABP),D-乳酸,还评估了脂多糖(LPS)和瓜氨酸。我们还旨在确定临床之间可能的关系,实验室,以及患者的营养状况和测量的标志物水平。
方法:来自29名患者的血浆样本(首先,第二,在ICU的第5天和第10天以及出院后的第7、30和60天)和23个对照进行了商业酶联免疫吸附测定(ELISA)测试。
结果:第一天(入院)和第二天,血浆I-FABP,D-乳酸,瓜氨酸,occludin,创伤患者claudin-1、三细胞蛋白和zonulin水平较高,与乳酸呈正相关,C反应蛋白(CRP),ICU住院天数,急性生理学和慢性健康评估II(APACHEII)评分和每日序贯器官衰竭评估(SOFA)评分(P<0.05-P<0.01)。
结论:本研究的结果表明,claudin-1,三细胞蛋白和zonulin蛋白,以及I-FABP,D-乳酸和瓜氨酸,可用作有希望的生物标志物,用于评估危重创伤患者的疾病严重程度,尽管各种屏障标记的分析很复杂。然而,我们的研究结果应该得到未来研究的支持.
OBJECTIVE: In an effort to better manage critically ill patients hospitalised in the intensive care unit (ICU) after experiencing multiple traumas, the present study aimed to assess whether plasma levels of intestinal epithelial cell barrier proteins, including occludin, claudin-1, junctional adhesion molecule (JAM-1), tricellulin and zonulin, could be used as novel biomarkers. Additional potential markers such as intestinal fatty acid-binding protein (I-FABP), D-lactate, lipopolysaccharide (LPS) and citrulline were also evaluated. We also aimed to determine the possible relationships between the clinical, laboratory, and nutritional status of patients and the measured marker levels.
METHODS: Plasma samples from 29 patients (first, second, fifth and tenth days in the ICU and on days 7, 30 and 60 after hospital discharge) and 23 controls were subjected to commercial enzyme-linked immunosorbent assay (ELISA) testing.
RESULTS: On first day (admission) and on the second day, plasma I-FABP, D-lactate, citrulline, occludin, claudin-1, tricellulin and zonulin levels were high in trauma patients and positively correlated with lactate, C-reactive protein (CRP), number of days of ICU hospitalisation, Acute Physiology and Chronic Health Evaluation II (APACHE II) score and daily Sequential Organ Failure Assessment (SOFA) scores (P < 0.05-P < 0.01).
CONCLUSIONS: The results of the present study showed that occludin, claudin-1, tricellulin and zonulin proteins, as well as I-FABP, D-lactate and citrulline, may be used as promising biomarkers for the evaluation of disease severity in critically ill trauma patients, despite the complexity of the analysis of various barrier markers. However, our results should be supported by future studies.