Can Zonulin level be a new diagnosis and follow-up criterion in active ulcerative colitis?

Main Article Content

Enver Akbaş
Gözde Ülfer

Abstract

Objective: In this study, we compared the serum zonulin levels in patients diagnosed for the first time with active ulcerative colitis with those in healthy cases and attempted to determine whether serum zonulin levels were different in the active ulcerative colitis.


Material and Methods: A total of 53 naive patients admitted to our hospital between 2019 and 2020 and diagnosed with active ulcerative colitis by colonoscopy were included as a group of cases and 37 patients with no acute or chronic diseases whose colonoscopy was normal as the control group.


Results: The study was conducted on 90 cases, 65.5% male and 34.5% female. The patients with ulcerative colitis were compared with the control group in terms of serum zonulin levels. Average serum zonulin levels of the patients with ulcerative colitis (16.73 ± 5.49 ng/ml) were not significantly different than those in the control group 17.48 ± 8.31 ng/ml). Serum zonulin levels of the patients were also compared according to location and severity of disease and did not differ statistically significantly between the groups in terms of the Montreal Classification. When serum zonulin levels were grouped according to the Truelove and Witts criteria, there was no statistically significant difference between the patient groups themselves and the control group.


Conclusion: Serum zonulin levels were not greater in the patients with naive active ulcerative colitis compared to the healthy controls. Several previous studies have shown that serum zonulin levels are elevated in patients with ulcerative colitis, but more studies are needed on this subject.

Downloads

Download data is not yet available.

Article Details

How to Cite
Akbaş, E., & Ülfer, G. (2021). Can Zonulin level be a new diagnosis and follow-up criterion in active ulcerative colitis?. Medical Science and Discovery, 8(2), 68–72. https://doi.org/10.36472/msd.v8i2.467
Section
Research Article
Received 2021-01-17
Accepted 2021-02-07
Published 2021-02-07

References

Fasano A. Physiological, pathological, and therapeutic implications of zonulin-mediated intestinal barrier modulation: Living life on the edge of the wall. Am J Path Pathol 2008; 173 (5): 1243–52. doi: 10.2353/ajpath.2008.080192.

Fasano A. Zonulin and its regulation of intestinal barrier function: The biological door to inflammation, autoimmunity, and cancer. Physiol Rev 2011; 91 (1): 151–75. doi: 10.1152/physrev.00003.2008.

Arrieta M-C, Bistritz L, Meddings JB. Alterations in intestinal permeability. Gut 2006; 55 (10): 1512–20. doi: 10.1136/gut.2005.085373.

Lamprecht M, Frauwallner A. Exercise, intestinal barrier dysfunction and probiotic supplementation. In: Lamprecht M, ed. Acute Topics in Sport Nutrition Medicine and Sport Science. 59. Basel: Karger Publishers; 2012. 47–56. doi: 10.1159/000342169.

Wang W, Uzzau S, Goldblum SE, Fasano A. Human zonulin, a potential modulator of intestinal tight junctions. J Cell Sci 2000; 113 (24): 4435–40.

Fasano A. Intestinal permeability and its regulation by zonulin: diagnostic and therapeutic implications. Clin Gastroenterol Hepatol 2012; 10 (10): 1096–100. doi: 10.1016/j.cgh.2012.08.012.

El Asmar R, Panigrahi P, Bamford P, Berti I, Not T, Coppa GV, et al. Host-dependent zonulin secretion causes the impairment of the small intestine barrier function after bacterial exposure. Gastroenterology 2002; 123 (5): 1607–15. doi: 10.1016/j.cgh.2012.08.012.

Tripathi A, Lammers KM, Goldblum S, Shea-Donohue T, Netzel-Arnett S, Buzza MS, et al. Identification of human zonulin, a physiological modulator of tight junctions, as prehaptoglobin-2. Proc Natl Acad Sci U S A 2009; 106 (39): 16799–804. doi: 10.1073/pnas.0906773106.

Fasano A, Shea-Donohue T. Mechanisms of disease: the role of intestinal barrier function in the pathogenesis of gastrointestinal autoimmune diseases. Nat Rev Gastroenterol Hepatol 2005; 2 (9): 416–22. doi: 10.1038/ncpgasthep0259.

Sapone A, De Magistris L, Pietzak M, Clemente MG, Tripathi A, Cucca F, et al. Zonulin upregulation is associated with increased gut permeability in subjects with type 1 diabetes and their relatives. Diabetes 2006; 55 (5): 1443–9. doi: 10.2337/db05-1593.

Fasano A. Zonulin, regulation of tight junctions, and autoimmune diseases. Ann N Y Acad Sci 2012; 1258 (1): 25–33. doi: 10.1111/j.1749-6632.2012.06538.x.

Caviglia GP, Dughera F, Ribaldone DG, Rosso C, Abate ML, Pellicano R, et al. Serum zonulin in patients with inflammatory bowel disease: A pilot study. Minerva Med 2019; 110 (2): 95–100. doi: 10.23736/s0026-4806.18.05787-7.

Vanuytsel T, Vermeire S, Cleynen I. The role of Haptoglobin and its related protein, Zonulin, in inflammatory bowel disease. Tissue Barriers 2013; 1 (5): e27321. doi: 10.4161/tisb.27321.

Arrieta M-C, Madsen K, Doyle J, Meddings J. Reducing small intestinal permeability attenuates colitis in the IL10 gene-deficient mouse. Gut 2009; 58 (1): 41–8. doi: 10.1136/gut.2008.150888.

Madsen K, Cornish A, Soper P, McKaigney C, Jijon H, Yachimec C, et al. Probiotic bacteria enhance murine and human intestinal epithelial barrier function. Gastroenterology 2001; 121 (3): 580–91. doi: 10.1053/gast.2001.27224.

Kühn R, Löhler J, Rennick D, Rajewsky K, Müller W. Interleukin-10-deficient mice develop chronic enterocolitis. Cell 1993; 75 (2): 263–74. doi: 10.1016/0092-8674(93)80068-P.

Madsen KL, Malfair D, Gray D, Doyle JS, Jewell LD, Fedorak RN. Interleukin-10 gene-deficient mice develop a primary intestinal permeability defect in response to enteric microflora. Inflamm Bowel Dis 1999; 5 (4): 262–70. doi: 10.1097/00054725-199911000-00004.

Sturgeon C, Fasano A. Zonulin, a regulator of epithelial and endothelial barrier functions, and its involvement in chronic inflammatory diseases. Tissue Barriers 2016; 4 (4): e1251384. doi: 10.1080/21688370.2016.1251384.

Akao T, Morita A, Onji M, Miyake T, Watanabe R, Uehara T, et al. Low serum levels of Zonulin in patients with HCV-infected chronic liver diseases. Euroasian J Hepatogastroenterol 2018; 8 (2): 112–5. doi: 10.5005/jp-journals-10018-1275.

Frin A-C, Filippi J, Boschetti G, Flourie B, Drai J, Ferrari P, et al. Accuracies of fecal calprotectin, lactoferrin, M2-pyruvate kinase, neopterin and zonulin to predict the response to infliximab in ulcerative colitis. Dig Liver Dis 2017; 49 (1): 11–6. doi: 10.1016/j.dld.2016.09.001.

Wegh CAM, De Roos NM, Hovenier R, Meijerink J, Besseling-Van Der Vaart I, Van Hemert S, et al. Intestinal permeability measured by urinary sucrose excretion correlates with serum Zonulin and faecal Calprotectin concentrations in UC patients in remission. J Nutr Metab 2019; 2019: Article ID 2472754, 10 pages. doi: 10.1155/2019/2472754.

Ajamian M, Steer D, Rosella G, Gibson PR. Serum zonulin as a marker of intestinal mucosal barrier function: May not be what it seems. PLoS ONE 2019; 14 (1): e0210728. doi: 10.1371/journal.pone.0210728.