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

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