Zonulin is not Useful for the Diagnosis of Intestinal Permeability in Cirrhotic

Year 2023, Volume: 76 Issue: 4, 328 - 332, 05.04.2024

Muhammet Yener Akpınar

Abstract

Objectives: Increased intestinal permeability is an important cause of serious complications in cirrhotic. In addition, intestinal permeability can promote impaired liver functions. Zonulin, well-known intestinal permeability marker, has never studied sufficiently before in cirrhotic as a potential marker of increased intestinal permeability.

Materials and Methods: This is a cross-sectional study. Forty-one cirrhotic patients (11 patients in compensated phase and 30 patients in decompensated phase) were enrolled into the study. Meanwhile forty-one healthy controls were also enrolled. Zonulin was assessed by enzymelinked immunosorbent assay technique.

Results: Zonulin levels was not significantly different between patients with cirrhotic and healthy individuals; however lower levels was observed in cirrhotic (p=0.068). In patients with cirrhotic, zonulin level was significantly different between child-pugh A and child-pugh B (p=0.05). Also zonulin was significantly lower in child-pugh C compared to child-pugh-A and child-pugh-B (p=0.011 and p=0.026, respectively). In all patients with cirrhotic, MELD score was positively correlated with zonulin levels (p=0.001, R=0.358).

Conclusion: This study reveals that serum zonulin levels were decreased, especially in decompensated phase in cirrhotic compared to healthy individuals. It is possible to speculate that zonulin is not a causal factor for intestinal permeability in cirrhotic, instead of this, its synthesis effects negatively in cirrhotic situation.

Key Words: Cirrhotic, Intestinal Permeability, Zonulin

Keywords

Siroz , İntestinal Geçirgenlik , Zonulin

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Zonulin Sirozlu Hastalarda İntestinal Geçirgenlik Tanısında Kullanışlı Değildir

Abstract

Amaç: Sirozlu hastalarda artmış intestinal geçirgenlik ciddi komplikasyonların önemli bir nedenidir. Ek olarak artmış intestinal geçirgenlik karaciğer fonksiyonlarında kötüleşmeye de yol açar. Zonulin, intestinal geçirgenlik için iyi tanımlanmış bir belirteç olsa da, sirozlu hastalarda artmış intestinal geçirgenlik varlığının tanısında yeterince çalışılmamıştır.

Gereç ve Yöntem: Bu çalışma kesitsel bir çalışmadır. Kırk bir siroz tanılı hasta (11 tanesi kompanse, 30 tanesi ise dekompanse fazda olan) çalışmaya dahil edilmiştir. Eş zamanlı 41 sağlıklı kontrol grubu da çalışmaya alınmıştır. Zonulin enzyme-linked immunosorbent assay ile çalışılmıştır.

Bulgular: Zonulin seviyeleri sirozlu hastalar ve sağlıklı bireyler arasında önemli ölçüde farklı değildi; ancak sirozda daha düşük seviyeler gözlendi (p=0,068). Sirozlu hastalarda zonulin düzeyi, child-pugh A ve child-pugh B arasında anlamlı olarak farklıydı (p=0,05). Ayrıca zonulin, child-pugh C’de child-pugh-A ve child-pugh-B’ye göre anlamlı olarak daha düşüktü (sırasıyla p=0,011 ve p=0,026). Tüm sirozlu hastalarda MELD skoru zonulin seviyeleri ile pozitif korelasyon gösterdi (p=0,001, R=0,358).

Sonuç: Bu çalışma, sağlıklı bireylere göre sirozda özellikle dekompanse fazda serum zonulin düzeylerinin azaldığını ortaya koymaktadır. Sirozda zonülinin İP için nedensel bir faktör olmadığı, bunun yerine sentezinin sirotik durumda olumsuz etkilendiği söylenebilir.

Anahtar Kelimeler: Siroz, İntestinal Geçirgenlik, Zonulin

Keywords

Siroz , İntestinal Geçirgenlik , Zonulin

Ethical Statement

Ethics Committee Approval: The study protocol was approved by the Ethics Committee of Keçiören Training and Research Hospital (approval no: 2012-KAEK-15/1825, date: 13.02.2019). Informed Consent: All individuals gave written informed consent. Peer-review: Externally peer-reviewed

Supporting Institution

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Project Number

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Thanks

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