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2015 ; 10
(10
): e0138062
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Evidence for a Cystic Fibrosis Enteropathy
#MMPMID26484665
Adriaanse MP
; van der Sande LJ
; van den Neucker AM
; Menheere PP
; Dompeling E
; Buurman WA
; Vreugdenhil AC
PLoS One
2015[]; 10
(10
): e0138062
PMID26484665
show ga
BACKGROUND: Previous studies have suggested the existence of enteropathy in
cystic fibrosis (CF), which may contribute to intestinal function impairment, a
poor nutritional status and decline in lung function. This study evaluated
enterocyte damage and intestinal inflammation in CF and studied its associations
with nutritional status, CF-related morbidities such as impaired lung function
and diabetes, and medication use. METHODS: Sixty-eight CF patients and 107
controls were studied. Levels of serum intestinal-fatty acid binding protein
(I-FABP), a specific marker for enterocyte damage, were retrospectively
determined. The faecal intestinal inflammation marker calprotectin was
prospectively studied. Nutritional status, lung function (FEV1), exocrine
pancreatic insufficiency (EPI), CF-related diabetes (CFRD) and use of proton pump
inhibitors (PPI) were obtained from the medical charts. RESULTS: Serum I-FABP
levels were elevated in CF patients as compared with controls (p<0.001), and
correlated negatively with FEV1 predicted value in children (r-.734, p<0.05).
Faecal calprotectin level was elevated in 93% of CF patients, and correlated
negatively with FEV1 predicted value in adults (r-.484, p<0.05). No correlation
was found between calprotectin levels in faeces and sputum. Faecal calprotectin
level was significantly associated with the presence of CFRD, EPI, and PPI use.
CONCLUSION: This study demonstrated enterocyte damage and intestinal inflammation
in CF patients, and provides evidence for an inverse correlation between
enteropathy and lung function. The presented associations of enteropathy with
important CF-related morbidities further emphasize the clinical relevance.
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