title: Intestinal barrier integrity and function in infants with cholestasis.
abstract: OBJECTIVE
  The safety of the human body is maintained by effective monitoring of the mucosal surface integrity and protection against potentially harmful compounds. This function of the gut called intestinal barrier function can be affected by cholestasis and the absence of bile in the intestinal lumen. We aimed to determine whether the gut barrier integrity is impaired in infants with cholestasis by evaluation of the intestinal fatty acid binding proteins (I-FABP) and ileal bile acid binding protein (I-BABP) as markers of intestinal epithelial cell damage and plasma D-lactate level as a marker of gut wall permeability.
  
  
  METHODS
  This case-control study included 53 infants with cholestasis and 29 controls. Serum levels of I-FABP, I-BABP, and D-lactate were measured in all subjects.
  
  
  RESULTS
  Both groups of patients with neonatal hepatitis and biliary atresia showed significantly higher levels of I-FABP and I-BABP than the controls. There were no differences in the serum D-lactate level between the cases and controls. There was no difference between the two groups of patients (I and II) regarding any of the parameters studied. No significant correlations between serum levels of I-FABP, I-BABP, or D-lactate and total or direct bilirubin levels were found in the cholestatic infants.
  
  
  CONCLUSIONS
  The intestinal epithelial barrier integrity is breached nearly in all parts of the intestine in infants with cholestasis. Further research is recommended to determine the impact of this finding on the management of these infants. The relationship between physical intestinal barrier damage and its functional failure remains subject for further research.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt.
authors.forename: Nagla H
authors.initials: NH
authors.lastname: Abu Faddan
authors.affiliation: Department of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt.
authors.forename: Tahra M K
authors.initials: TM
authors.lastname: Sherif
authors.affiliation: Department of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt.
authors.forename: Omnia A
authors.initials: OA
authors.lastname: Mohammed
authors.affiliation: Department of Biochemistry, Faculty of Medicine, Minya University, Minya, Egypt.
authors.forename: Khalid A
authors.initials: KA
authors.lastname: Nasif
authors.affiliation: Department of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt.
authors.forename: Ebtesam M
authors.initials: EM
authors.lastname: El Gezawy
keywords: Cholestasis; Infant; Intestinal barrier