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. 2022 Aug 7;11(15):4599.
doi: 10.3390/jcm11154599.

I-FABP as a Potential Marker for Intestinal Barrier Loss in Porcine Polytrauma

Jan Tilmann Vollrath  1 , Felix Klingebiel  1   2   3 , Felix Bläsius  4 , Johannes Greven  4 , Eftychios Bolierakis  4 , Aleksander J Nowak  3 , Marija Simic  3 , Frank Hildebrand  4 , Ingo Marzi  1 , Borna Relja  3
Affiliations

I-FABP as a Potential Marker for Intestinal Barrier Loss in Porcine Polytrauma

Jan Tilmann Vollrath et al. J Clin Med. .

Abstract

Polytrauma and concomitant hemorrhagic shock can lead to intestinal damage and subsequent multiple organ dysfunction syndrome. The intestinal fatty acid-binding protein (I-FABP) is expressed in the intestine and appears quickly in the circulation after intestinal epithelial cell damage. This porcine animal study investigates the I-FABP dynamics in plasma and urine after polytrauma. Furthermore, it evaluates to what extent I-FABP can also act as a marker of intestinal damage in a porcine polytrauma model. Eight pigs (Sus scrofa) were subjected to polytrauma which consisted of lung contusion, tibial fracture, liver laceration, and hemorrhagic shock followed by blood and fluid resuscitation and fracture fixation with an external fixator. Eight sham animals were identically instrumented but not injured. Afterwards, intensive care treatment including mechanical ventilation for 72 h followed. I-FABP levels in blood and urine were determined by ELISA. In addition, immunohistological staining for I-FABP, active caspase-3 and myeloperoxidase were performed after 72 h. Plasma and urine I-FABP levels were significantly increased shortly after trauma. I-FABP expression in intestinal tissue showed significantly lower expression in polytraumatized animals vs. sham. Caspase-3 and myeloperoxidase expression in the immunohistological examination were significantly higher in the jejunum and ileum of polytraumatized animals compared to sham animals. This study confirms a loss of intestinal barrier after polytrauma which is indicated by increased I-FABP levels in plasma and urine as well as decreased I-FABP levels in immunohistological staining of the intestine.

Keywords: I-FABP; biomarker; hemorrhagic shock; intestinal damage; major trauma.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
The experimental design is shown. Animals were subjected to polytrauma which consisted of lung contusion, tibial fracture, liver laceration and hemorrhagic shock. Polytrauma was followed by blood and fluid resuscitation as well as fracture fixation with an external fixator. Blood sampling was performed at the beginning shortly after implementation of the central venous catheter (ctrl), shortly after trauma (trauma) and in the further course after the Advanced Trauma Life Support (ATLS) phase (post-trauma).
Figure 2
Figure 2
Intestinal fatty acid binding protein (I-FABP) levels in plasma and urine. Plasma (A) and urine (B) I-FABP levels shortly after implementation of the central venous catheter (ctrl), shortly after trauma (trauma, within 90 min during trauma and hemorrhagic shock) and in the further course after the Advanced Trauma Life Support (ATLS) phase (post-trauma, within 6 h after reperfusion and surgery) are shown. *: p < 0.05.
Figure 3
Figure 3
Expression intensity of intestinal fatty acid binding protein (I-FABP) in jejunum (A) and ileum (B) in polytraumatized (PT) and sham animals after 72 h is shown. (C) Exemplary images of immunohistological staining for I-FABP of ileum and jejunum from polytraumatized and sham animals. *: p < 0.05.
Figure 4
Figure 4
Number of caspase-3 positive cells per high power field (HPF) in jejunum (A) and ileum (B) of polytraumatized (PT) and sham animals after 72 h is shown. (C) Exemplary images of immunohistological staining for caspase-3 of ileum and jejunum from polytraumatized and sham animals. *: p < 0.05.
Figure 5
Figure 5
Number of myeloperoxidase positive cells (MPO+) per high power field (HPF) in jejunum (A) and ileum (B) of polytraumatized (PT) and sham animals after 72 h is shown. (C) Exemplary images of immuno-histological staining for MPO of ileum and jejunum from polytraumatized and sham animals. *: p < 0.05.
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