Biomarkers of Bacterial Translocation and Intestinal Wall Damage in Patients With Multiple Organ Dysfunction Syndrome

IF 2.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL International Journal of Clinical Practice Pub Date : 2024-10-28 DOI:10.1155/2024/3015526

Yermek Turgunov, Alina Ogizbayeva, Sofiko Asamidanova, Olga Avdiyenko, Dana Amanova, Nurlan Aukenov, Miras Mugazov

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Abstract

Introduction: The aim of this study was to evaluate the potential biomarkers of bacterial translocation: lipopolysaccharide-binding protein (LBP) and soluble CD14 subtype (sCD14-ST), and intestinal wall damage: intestinal fatty acid binding protein (I-FABP), zonulin, and regenerating islet-derived protein-3α (REG3α), in the patients with multiple organ dysfunction syndrome (MODS).

Methods: The study involved 78 patients over the age of 18 with MODS set according to the Sequential Organ Failure Assessment (SOFA) scale. Venous blood was sampled during diagnostics of MODS, on the 3rd and on the 7th day of its development. The sCD14-ST, LBP, I-FABP, REG3α, and zonulin in blood serum were determined by enzyme-linked immunosorbent assay (ELISA).

Results: Out of 78 patients with MODS, 43 patients survived (55.1%) and 35 patients died (44.9%). Levels of sCD14-ST on Day 1, I-FABP on Day 3, and REG3α on Days 3 and 7 and SOFA scores on Days 1, 3, and 7, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores on Days 1, 3, and 7, and Modified Nutrition Risk in Critically Ill (mNUTRIC) scores on Days 1, 3, and 7 were statistically significantly higher in deceased patients (p < 0.05).

Conclusion: In patients with MODS, an increase in sCD14-ST, I-FABP, and REG3α in blood serum can indicate the violation of intestinal barrier function and increased bacterial translocation, which ultimately may aggravate the severity of MODS and increase the risk of death. It is required to further study the factors leading to intestinal wall permeability disorders in order to screen for timely intensive care measures that can help reduce the stay of patients in the intensive care unit (ICU) as well as mortality.

Trial Registration: ClinicalTrials.gov identifier: NCT06221293

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多器官功能障碍综合征患者细菌迁移和肠壁损伤的生物标志物

简介本研究旨在评估多器官功能障碍综合征（MODS）患者体内细菌转运的潜在生物标志物：脂多糖结合蛋白（LBP）和可溶性 CD14 亚型（sCD14-ST），以及肠壁损伤的潜在生物标志物：肠脂肪酸结合蛋白（I-FABP）、zonulin 和再生胰岛衍生蛋白-3α（REG3α）。研究方法这项研究涉及 78 名 18 岁以上的 MODS 患者，他们都是根据序列器官衰竭评估（SOFA）量表设定的。在 MODS 诊断期间、发病第 3 天和第 7 天抽取静脉血。血清中的 sCD14-ST、LBP、I-FABP、REG3α 和 zonulin 通过酶联免疫吸附试验（ELISA）进行检测。结果78 名 MODS 患者中，43 人存活（55.1%），35 人死亡（44.9%）。死亡患者第 1 天的 sCD14-ST、第 3 天的 I-FABP、第 3 天和第 7 天的 REG3α 水平，以及第 1 天、第 3 天和第 7 天的 SOFA 评分、第 1 天、第 3 天和第 7 天的急性生理学和慢性健康评估 II（APACHE II）评分和第 1 天、第 3 天和第 7 天的重症患者营养风险（mNUTRIC）评分均显著高于存活患者（P <0.05）。结论在 MODS 患者中，血清中 sCD14-ST、I-FABP 和 REG3α 的升高表明肠道屏障功能受到破坏，细菌易位增加，最终可能加重 MODS 的严重程度并增加死亡风险。有必要进一步研究导致肠壁通透性障碍的因素，以便及时筛查出有助于减少重症监护室（ICU）患者住院时间和死亡率的重症监护措施。试验注册：临床试验注册：ClinicalTrials.gov identifier：NCT06221293

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来源期刊

International Journal of Clinical Practice 医学-医学：内科

CiteScore

5.30

自引率

0.00%

发文量

274

审稿时长

3-8 weeks

期刊介绍： IJCP is a general medical journal. IJCP gives special priority to work that has international appeal. IJCP publishes: Editorials. IJCP Editorials are commissioned. [Peer reviewed at the editor''s discretion] Perspectives. Most IJCP Perspectives are commissioned. Example. [Peer reviewed at the editor''s discretion] Study design and interpretation. Example. [Always peer reviewed] Original data from clinical investigations. In particular: Primary research papers from RCTs, observational studies, epidemiological studies; pre-specified sub-analyses; pooled analyses. [Always peer reviewed] Meta-analyses. [Always peer reviewed] Systematic reviews. From October 2009, special priority will be given to systematic reviews. [Always peer reviewed] Non-systematic/narrative reviews. From October 2009, reviews that are not systematic will be considered only if they include a discrete Methods section that must explicitly describe the authors'' approach. Special priority will, however, be given to systematic reviews. [Always peer reviewed] ''How to…'' papers. Example. [Always peer reviewed] Consensus statements. [Always peer reviewed] Short reports. [Always peer reviewed] Letters. [Peer reviewed at the editor''s discretion] International scope IJCP publishes work from investigators globally. Around 30% of IJCP articles list an author from the UK. Around 30% of IJCP articles list an author from the USA or Canada. Around 45% of IJCP articles list an author from a European country that is not the UK. Around 15% of articles published in IJCP list an author from a country in the Asia-Pacific region.