Intestinal fatty acid-binding protein levels in Necrotizing Enterocolitis correlate with extent of necrotic bowel: results from a multicenter study ★★★

BackgroundIntestinal fatty acid-binding protein (I-FABP) is considered as a specific marker for enterocyte damage in necrotizing enterocolitis (NEC).ObjectiveThe purpose of this study was to evaluate the association of plasma and urinary I-FABP levels with the extent of macroscopic intestinal necrosis in surgical NEC.MethodsWe combined data from prospective trials from two large academic pediatric surgical centers. Nine and 10 infants with surgical NEC were included, respectively. Plasma and urinary of I-FABP at disease onset were correlated with the length of intestinal resection during laparotomy.ResultsMedian length of bowel resection was 10 cm (range 2.5–50) and 17 cm (range 0–51), respectively. Median I-FABP levels were 53 ng/mL (range 6.3–370) and 4.2 ng/mL (range 1.1–15.4) in plasma in cohort 1 respectively cohort 2 and 611 ng/mL (range 3–23,336) in urine. The length of bowel resection significantly correlated with I-FABP levels in plasma (Rho 0.68; p = 0.04 and Rho 0.66;p = 0.04) and in urine (Rho 0.92; p = 0.001).ConclusionThis ‘proof of concept’ study demonstrates that plasma and urine I-FABP levels at disease onset was strongly associated with the length of intestinal resection in surgical NEC. This offers further evidence that I-FABP levels are a promising biomarker for assessing intestinal necrosis in infants with advanced NEC.