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

Background: Intestinal fatty acid-binding protein (I-FABP) is considered as a specific marker for enterocyte damage in necrotizing enterocolitis (NEC). Objective: The 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. Methods: We 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. Results: Median 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). Conclusion: This '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. (C) 2015 Elsevier Inc. All rights reserved.