Intestinal-FABP and liver-FABP: Novel markers for severe abdominal injury.
OBJECTIVE
Fatty acid-binding proteins (FABPs) have relatively high tissue concentrations and low plasma concentrations and are released into the circulation following organ injury. We explored the utility of intestinal-(I)-FABP and liver-(L)-FABP for the diagnosis of abdominal injury in patients with multiple trauma.


METHODS
This prospective study included 102 trauma patients and 30 healthy volunteers. Plasma I-FABP and L-FABP levels were measured in the emergency department (ED) by enzyme-linked immunosorbent assay (ELISA). Forty-one patients suffered from serious or severe abdominal trauma (Abbreviated Injury Score [AIS] code "ai" for abdominal injury, AISai > or = 3) and nine were moderately abdominally injured (AISai < 3). Fifty-two had no abdominal injury.


RESULTS
Median I-FABP and L-FABP levels in the AISai > or = 3 group (516 pg/mL and 135 ng/mL, respectively) were significantly higher compared to the AISai < 3 group (154 pg/mL and 13 ng/mL, respectively) or those without abdominal injury (207 pg/mL and 21 ng/mL, respectively) or normal controls (108 pg/mL and 13 ng/mL, respectively). The cutoff to distinguish the ai > or = 3 is 359 pg/mL for I-FABP and 54 ng/mL for L-FABP, with 93% specificity and 75% sensitivity for I-FABP and 93% and 82% for L-FABP, respectively.


CONCLUSIONS
High I-FABP and L-FABP levels correlate with relevant severity of abdominal tissue damage in patients with multiple trauma. I-FABP and L-FABP could be useful as markers for the early detection of significant abdominal injury in acute multiple trauma and identify patients who require rapid intervention.
Relja
Borna
B
Department of Trauma Surgery, Johann Wolfgang Goethe University Frankfurt am Main, Germany. info@bornarelja.com
Szermutzky
Maika
M
Henrich
Dirk
D
Maier
Marcus
M
de Haan
Jacco-Juri
JJ
Lubbers
Tim
T
Buurman
Wim A
WA
Marzi
Ingo
I
D000007:Abdominal Injuries / Q000097:blood*; D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007413:Intestinal Mucosa / Q000378:metabolism*; D008099:Liver / Q000378:metabolism*; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity
D015415:Biomarkers; D050556:Fatty Acid-Binding Proteins