Evidence for a Cystic Fibrosis Enteropathy

M.P.M. Adriaanse, L.J.T.M. van der Sande, A.M. van den Neucker, P.P.C.A. Menheere, E. Dompeling, W.A. Buurman, A.C.E. Vreugdenhil

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Abstract

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.
Original languageEnglish
Article numbere0138062
Number of pages15
JournalPLOS ONE
Volume10
Issue number10
DOIs
Publication statusPublished - 20 Oct 2015

Keywords

  • INTESTINE BACTERIAL OVERGROWTH
  • MOUSE SMALL-INTESTINE
  • ACID-BINDING PROTEIN
  • SERUM I-FABP
  • CELIAC-DISEASE
  • LUNG-DISEASE
  • PANCREATIC INSUFFICIENCY
  • PULMONARY EXACERBATIONS
  • FECAL CALPROTECTIN
  • INFLAMMATION

Cite this

Adriaanse, M. P. M., van der Sande, L. J. T. M., van den Neucker, A. M., Menheere, P. P. C. A., Dompeling, E., Buurman, W. A., & Vreugdenhil, A. C. E. (2015). Evidence for a Cystic Fibrosis Enteropathy. PLOS ONE, 10(10), [e0138062]. https://doi.org/10.1371/journal.pone.0138062
Adriaanse, M.P.M. ; van der Sande, L.J.T.M. ; van den Neucker, A.M. ; Menheere, P.P.C.A. ; Dompeling, E. ; Buurman, W.A. ; Vreugdenhil, A.C.E. / Evidence for a Cystic Fibrosis Enteropathy. In: PLOS ONE. 2015 ; Vol. 10, No. 10.
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abstract = "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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Adriaanse, MPM, van der Sande, LJTM, van den Neucker, AM, Menheere, PPCA, Dompeling, E, Buurman, WA & Vreugdenhil, ACE 2015, 'Evidence for a Cystic Fibrosis Enteropathy', PLOS ONE, vol. 10, no. 10, e0138062. https://doi.org/10.1371/journal.pone.0138062

Evidence for a Cystic Fibrosis Enteropathy. / Adriaanse, M.P.M.; van der Sande, L.J.T.M.; van den Neucker, A.M.; Menheere, P.P.C.A.; Dompeling, E.; Buurman, W.A.; Vreugdenhil, A.C.E.

In: PLOS ONE, Vol. 10, No. 10, e0138062, 20.10.2015.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Evidence for a Cystic Fibrosis Enteropathy

AU - Adriaanse, M.P.M.

AU - van der Sande, L.J.T.M.

AU - van den Neucker, A.M.

AU - Menheere, P.P.C.A.

AU - Dompeling, E.

AU - Buurman, W.A.

AU - Vreugdenhil, A.C.E.

PY - 2015/10/20

Y1 - 2015/10/20

N2 - 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.

AB - 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.

KW - INTESTINE BACTERIAL OVERGROWTH

KW - MOUSE SMALL-INTESTINE

KW - ACID-BINDING PROTEIN

KW - SERUM I-FABP

KW - CELIAC-DISEASE

KW - LUNG-DISEASE

KW - PANCREATIC INSUFFICIENCY

KW - PULMONARY EXACERBATIONS

KW - FECAL CALPROTECTIN

KW - INFLAMMATION

U2 - 10.1371/journal.pone.0138062

DO - 10.1371/journal.pone.0138062

M3 - Article

VL - 10

JO - PLOS ONE

JF - PLOS ONE

SN - 1932-6203

IS - 10

M1 - e0138062

ER -

Adriaanse MPM, van der Sande LJTM, van den Neucker AM, Menheere PPCA, Dompeling E, Buurman WA et al. Evidence for a Cystic Fibrosis Enteropathy. PLOS ONE. 2015 Oct 20;10(10). e0138062. https://doi.org/10.1371/journal.pone.0138062