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Review
. 2021 Nov;190(4):1465-1472.
doi: 10.1007/s11845-020-02490-2. Epub 2021 Jan 25.

Review of claudin proteins as potential biomarkers for necrotizing enterocolitis

Victoria Griffiths  1 , Niazy Al Assaf  2 , Rizwan Khan  2
Affiliations
Review

Review of claudin proteins as potential biomarkers for necrotizing enterocolitis

Victoria Griffiths et al. Ir J Med Sci. 2021 Nov.

Abstract

Background: Claudin proteins are a component of tight junctions found in cell-cell adhesion complexes. A central feature of necrotizing enterocolitis (NEC) is intestinal permeability, with changes to claudin proteins potentially contributing to intestinal instability, inflammation, and the progression of NEC. A current area of interest is the development of a novel, noninvasive biomarker for the detection of NEC in neonates at risk of developing this disease, in order to reduce morbidity and mortality through earlier intervention.

Aims: This review aims to explore the relevance of claudin proteins in the pathophysiology of NEC and their potential usefulness as a biomarker.

Methods: This review was conducted using the search terms "claudin" + "necrotizing enterocolitis", with 27 papers selected for review.

Results: Claudin proteins appear to have a role in the stability of the gut epithelium through the regulation of intestinal permeability, maturity, and inflammation. Formula feeding has been shown to promote inflammation and result in changes to claudin proteins, while breastfeeding and certain nutritional supplements lead to reduced inflammation and improved intestinal stability as demonstrated through changes to claudin protein expression. Preliminary studies in human neonates suggest that urinary claudin measurements may be used to predict the development of NEC.

Conclusions: Alterations to claudin proteins may reflect changes seen to intestinal permeability and inflammation in the context of NEC. Further research is necessary to understand the relevance of claudin proteins in the pathophysiology of NEC and their use as a biomarker.

Keywords: Biomarker; Claudin; Intestinal permeability; Necrotizing enterocolitis; Tight junction.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

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