I-FABP as biomarker for the early diagnosis of acute mesenteric ischemia and resultant lung injury

PLoS One. 2014 Dec 26;9(12):e115242. doi: 10.1371/journal.pone.0115242. eCollection 2014.

Abstract

Acute mesenteric ischemia (AMI) is a life-threatening condition that can result in multiple organ injury and death. A timely diagnosis and treatment would have a significant impact on the morbidity and mortality in high-risk patient population. The purpose of this study was to investigate if intestinal fatty acid binding protein (I-FABP) and α-defensins can be used as biomarkers for early AMI and resultant lung injury. C57BL/6 mice were subjected to intestinal ischemia by occlusion of the superior mesenteric artery. A time course of intestinal ischemia from 0.5 to 3 h was performed and followed by reperfusion for 2 h. Additional mice were treated with N-acetyl-cysteine (NAC) at 300 mg/kg given intraperitoneally prior to reperfusion. AMI resulted in severe intestinal injury characterized by neutrophil infiltrate, myeloperoxidase (MPO) levels, cytokine/chemokine levels, and tissue histopathology. Pathologic signs of ischemia were evident at 1 h, and by 3 h of ischemia, the full thickness of the intestine mucosa had areas of coagulative necrosis. It was noted that the levels of α-defensins in intestinal tissue peaked at 1 h and I-FABP in plasma peaked at 3 h after AMI. Intestinal ischemia also resulted in lung injury in a time-dependent manner. Pretreatment with NAC decreased the levels of intestinal α-defensins and plasma I-FABP, as well as lung MPO and cytokines. In summary, the concentrations of intestinal α-defensins and plasma I-FABP predicted intestinal ischemia prior to pathological evidence of ischemia and I-FABP directly correlated with resultant lung injury. The antioxidant NAC reduced intestinal and lung injury induced by AMI, suggesting a role for oxidants in the mechanism for distant organ injury. I-FABP and α-defensins are promising biomarkers, and may guide the treatment with antioxidant in early intestinal and distal organ injury.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetylcysteine / administration & dosage
  • Animals
  • Biomarkers / metabolism
  • Disease Models, Animal
  • Early Diagnosis
  • Fatty Acid-Binding Proteins / metabolism*
  • Lung Injury / diagnosis
  • Lung Injury / metabolism*
  • Male
  • Mesenteric Ischemia / chemically induced
  • Mesenteric Ischemia / complications
  • Mesenteric Ischemia / diagnosis*
  • Mesenteric Ischemia / metabolism
  • Mice
  • Mice, Inbred C57BL
  • alpha-Defensins / metabolism*

Substances

  • Biomarkers
  • Fatty Acid-Binding Proteins
  • alpha-Defensins
  • Acetylcysteine