Clinical and diagnostic significance of the intestinal fraction of fatty acid binding protein in children with protein-induced enteropathy

Abstract

Protein-induced enteropathyis a common manifestation of gastrointestinal food allergy in young children. Non-invasive diagnostic methods are especially relevant for the timely diagnosis and prevention of exacerbations.Objective. To evaluate serum, fecal and urinal levels of the intestinal fraction of fatty acids-binding proteins in children with protein-induced enteropathy and their clinical and diagnostic significance.Material and methods. The authors examined 29 children with protein-induced enteropathy aged from 1,5 to 12 months and 20 healthy children (control group). For differential diagnosis with congenital diseases of the gastrointestinal tract, all patients underwent esophagogastroduodenoscopy with morphological examination of biopsies. The Cow’s Milk-related Symptom Score (CoMMiS) was used to assess clinical symptoms. In all children, the intestinal fraction of the protein binding fatty acids (I-FABP) was determined in blood serum, urine, coprofiltrate byenzyme-linked immunosorbent assay.Results. The scientists found an increase in the protein level in the blood 125,20±23,79 pg/ml, in coprofiltrate 0,36±0,05 ng/ml, in urine 0,164±0,031 pg/ml compared with those in the control group (19,21±4,94pg/ml, 0,18±0,02 ng/ml and 0,039±4,62 pg/ ml, respectively; p<0,05). The authors found direct strong relationship between the degreeof morphological changes, clinical severity of gastrointestinal manifestations and the concentration of fatty acid binding protein in serum and urine, moderate relationship with the indicators in coprofiltrate (p<0,05).Conclusion. An increase in serum, fecal and urinal levels of I-FABP in children with protein-induced enteropathy confirms the clinical and diagnostic significance of this biomarker in all biological fluids. Its high sensitivity and specificity of determination in urine is promising for pediatric practice.