title: Prediction of reversibility of intestinal mucosal damage after ischemia-reperfusion injury by plasma intestinal fatty acid-binding protein levels in pigs.
abstract: OBJECTIVE
  The aims of this study were to elucidate the association between plasma intestinal fatty acid-binding protein (I-FABP) level and actual pathological damage of intestinal mucosa and its reversibility.
  
  
  METHODS
  An intestinal ischemia-reperfusion model was created by temporary occlusion of the descending aorta in 9 pigs which were divided into 3 groups according to the duration of visceral ischemic insult: 15-minute ischemia (n=3), 30-minute ischemia (n=3) and 60-minute ischemia (n=3). Blood samples and short segments of the jejunum for pathological examinations, including immunohistochemical staining of I-FABP, Ki-67 and E-cadherin, were taken at the beginning of the operation (T1) and 15 minutes (T2), 30 minutes (T3), 45 minutes (T4) and 60 minutes (T5) after reperfusion.
  
  
  RESULTS
  Plasma I-FABP after 15 minutes of ischemia reached a peak of 1859 ± 1089 pg/ml at T3, while the level after 30 minutes of ischemia achieved a peak level of 5053 ± 1 717 pg/ml at T5. The level after 60 minutes of ischemia demonstrated a rapid increment up to 10734 ± 93 pg/ml at T3. There was a significant difference in the trend of plasma I-FABP levels between 30 minutes and 60 minutes of ischemia (p=0.01). The strongest immunohistochemical staining of the intestinal epithelium for I-FABP was observed at T4 after 30 minutes of ischemia, with the shedding of injured epithelium followed by re-epithelialisation, with sequential up-regulation of Ki67 and E-cadherin. However, the intestinal epithelium after 60 minutes of ischemia demonstrated the lack of I-FABP expression with irreversible damage.
  
  
  CONCLUSIONS
  Plasma I-FABP levels may be a crucial marker to recognize the reversibility of damage of the intestinal epithelium after an ischemic insult and the level of 5000 pg/ml is considered to be the critical borderline for irreversibility, which might prevent diagnostic delay in the clinical setting.
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kano
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan yutamo@aol.com.
authors.forename: K
authors.initials: K
authors.lastname: Okada
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Morimoto
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: W
authors.initials: W
authors.lastname: Bao
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Fukase
authors.affiliation: Department of Pathology, Kinki University Faculty of Medicine, Osaka, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Ito
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Okita
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000097:blood*; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D007124:Immunoenzyme Techniques; D007410:Intestinal Diseases / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D007413:Intestinal Mucosa / Q000098:blood supply / Q000293:injuries / Q000473:pathology*; D008297:Male; D011237:Predictive Value of Tests; D015427:Reperfusion Injury / Q000150:complications*; D013552:Swine
chemical_list: D015415:Biomarkers; D050556:Fatty Acid-Binding Proteins
keywords: E-cadherin; cardiovascular surgery; intestinal fatty acid-binding protein; intestinal ischemia; reperfusion injury