Trefoil factor 3 as a marker of intestinal cell damage during sepsis

• Authors: Jiří Žurek , Michal Kýr , Martin Vavřina , Michal Fedora
• Languages of publication: EN

Abstracts

EN

Objective: Gastrointestinal dysfunction or gut
failure frequently occurs in seriously ill patients and can
be responsible for multi-organ failure. Trefoil factor 3
(TFF3) was characterized for its role in reconstitution of an
epithelial barrier after mucosal injury in the jejunum. The
aims of our study was an analysis of TFF3 levels dynamics
in patients with sepsis and the correlation of TFF3 with
severity of sepsis and mortality. Methods: Prospective observational study, a ten days evaluation
period in children aged 0-19 years with systemic
inflammatory response syndrome or septic state. Blood
tests to determine levels of TFF3 were obtained as long
as the patient met the criteria for systemic inflammatory
response syndrome or sepsis. Results: Analysis of dynamics revealed steady levels of
TFF3 during the 10 day period evaluated. TFF3 levels
could not differentiate between various septic conditions
in patients until a marked organ dysfunction developed.
Higher Area Under Curve was noticed between control
group and patients with sepsis. We could not make any
strong conclusions based on mortality model. Conclusions: Levels of TFF3 are elevated in paediatric
patients with sepsis through organ dysfunction.

Keywords

EN

Trefoil factor; gut injury; sepsis; children; mortality

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2014
• Volume: 10
• Issue: 1

Dates

accepted

11 - 12 - 2014

online

24 - 4 - 2015

received

28 - 8 - 2013

Contributors

author

Jiří Žurek

• University Children‘s Hospital,
  Department of Anesthesia and Intensive Care, Černopolní 9, Brno,
  62500, Czech Republic

author

Michal Kýr

• Faculty of Medicine, Masaryk University, Černopolní 9,
  Brno, 62500, Czech Republic

author

Martin Vavřina

• University Children‘s Hospital,
  Department of Anesthesia and Intensive Care, Černopolní 9, Brno,
  62500, Czech Republic

author

Michal Fedora

• University Children‘s Hospital,
  Department of Anesthesia and Intensive Care, Černopolní 9, Brno,
  62500, Czech Republic

References

• [1] Derikx J.P., Poeze M., van Bijnen A.A., Buurman W.A., HeinemanE., Evidence for intestinal and liver epithelial cell injury in theearly phase of sepsis, Shock, 2007, 28, 544-548[WoS]
• [2] Azzopardi N., Fenech M., Piscopo T., Sepsis, the Liver and theGut, Sepsis–An Ongoing and Significant Challenge, InTech,2012
• [3] Puleo F., Arvanitakis M., Van Gossum A., Preiser J.C., Gut failurein the ICU, Semin Respir Crit Care Med., 2011, 32, 626-638[WoS]
• [4] Mammen J.M.V.M., Matthews J.B.M., Mucosal repair in thegastrointestinal tract, Critical Care Medicine Healing Responsesin Critical Illness, 2003,31,S532-S537
• [5] Thim L., A new family of growth factor-like peptides: ‘trefoil’disulphide loop structures as a common feature in breastcancer associated peptide (pS2), pancreatic spasmolyticpolypeptide (PSP) and frog skin peptides (spasmolysins), FEBSLett., 1989, 250, 85-90
• [6] Hauser F., Poulsom R., Chinery R., Rogers L.A., HanbyA.M., Wright N.A., et al., hP1.B, a human P-domain peptidehomologous with rat intestinal trefoil factor, is expressed alsoin the ulcer-associated cell lineage and the uterus, Proc. Natl.Acad. Sci. USA, 1993, 90, 6961-6965
• [7] Xian C.J., Howarth G.S., Mardell C.E., Cool J.C., Familari M.,Read L.C., et al., Temporal changes in TFF3 expression andjejunal morphology during methotrexate-induced damage andrepair, Am J Physiol, 1999,277, G785-G795
• [8] Babyatsky M.W., deBeaumont M., Thim L., Podolsky D.K., Oraltrefoil peptides protect against ethanol- and indomethacininducedgastric injury in rats, Gastroenterology, 1996,110,489-497
• [9] Schwarzberg H., Kalbacher H., Hoffmann W., Differentialbehavioral effects of TFF peptides: Injections of syntheticTFF3 into the ratamygdala, Pharmacol BiochemBehav,1999,62,173-178
• [10] Goldstein B., Giroir B., Randolph A., International pediatricsepsis consensus conference: Definitions for sepsis and organdysfunction in pediatrics, Pediatr Crit Care Med, 2005, 6, 2-8[Crossref]
• [11] Leteurtre S., Martinot A., Duhamel A., Gauvin F., GrandbastienB., Nam T.V., et al.. Development of a pediatric multiple organdysfunction score: use of two strategies, Med Decis Making,1999, 19, 399-410
• [12] Ng E.W., Poon T.C., Lam H.S., Cheung H.M., Ma T.P., Chan K.Y.,et al., Gut-Associated Biomarkers L-FABP, I-FABP, and TFF3 andLIT Score for Diagnosis of Surgical Necrotizing Enterocolitis inPreterm Infants, Ann Surg. , 2013, 258, 1111-1118
• [13] Vestergaard E.M., Poulsen S.S., Grønbaek H., LarsenR., Nielsen A.M., Ejskjaer K., et al., Development andevaluation of an ELISA for human trefoil factor 3, Clin Chem.,2002,48,1689-1695
• [14] Moran P., Beasley H., Gorrell A., Martin E., Gribling P., Fuchs H.,et al., Human recombinant soluble decay accelerating factorinhibits complement activation in vitro and in vivo, J. Immunol.,1992, 149, 1736-1743
• [15] Heeger P.S., Lalli P.N., Lin F., Valujskikh A., Liu J., Muqim N.,et al., Decay-accelerating factor modulates induction of T cellimmunity, J. Exp. Med., 2005, 201, 1523-1530
• [16] Fink M.P., Delude R.L., Epithelial barrier dysfunction: aunifying theme to explain the pathogenesis of multiple organdysfunction at the cellular level, Crit Care Clin 2005, 2, 177-196
• [17] Gatt M., Reddy B.S., MacFie J., Review article: bacterialtranslocation in the critically ill–evidence and methods ofprevention, Aliment Pharmacol Ther., 2007, 25, 741-757[WoS]
• [18] Stephens R.C., Fidler K., Wilson P., Barclay G.R., Mythen M.G.,Dixon G.L., et al., Endotoxin immunity and the development ofthe systemic inflammatory response syndrome in critically illchildren, Intensive Care Med, 2006, 32, 286-294

Identifiers

DOI

10.1515/med-2015-0020