• Hamiyet Donmez-Altuntas, Serap Sahin Ergul, Pinar Altin-Celik, Kadir Bulut, Hamiyet Eci Roglu, Ramazan Uzen, Gulsah Gunes Sahin, Nurhayat Tugra Ozer, Sahin Temel, Turkmen Bahadir Arikan, Aliye Esmaoglu, Recep Civan Yuksel, Murat Sungur, and Kursat Gundogan.
• Department of Medical Biology, Medical Faculty, Erciyes University, 38030, Kayseri, Turkey. donmezh@erciyes.edu.tr.
• Eur J Trauma Emerg Surg. 2023 Oct 1; 49 (5): 220322132203-2213.

PurposeIn an effort to better manage critically ill patients hospitalised in the intensive care unit (ICU) after experiencing multiple traumas, the present study aimed to assess whether plasma levels of intestinal epithelial cell barrier proteins, including occludin, claudin-1, junctional adhesion molecule (JAM-1), tricellulin and zonulin, could be used as novel biomarkers. Additional potential markers such as intestinal fatty acid-binding protein (I-FABP), D-lactate, lipopolysaccharide (LPS) and citrulline were also evaluated. We also aimed to determine the possible relationships between the clinical, laboratory, and nutritional status of patients and the measured marker levels.MethodsPlasma samples from 29 patients (first, second, fifth and tenth days in the ICU and on days 7, 30 and 60 after hospital discharge) and 23 controls were subjected to commercial enzyme-linked immunosorbent assay (ELISA) testing.ResultsOn first day (admission) and on the second day, plasma I-FABP, D-lactate, citrulline, occludin, claudin-1, tricellulin and zonulin levels were high in trauma patients and positively correlated with lactate, C-reactive protein (CRP), number of days of ICU hospitalisation, Acute Physiology and Chronic Health Evaluation II (APACHE II) score and daily Sequential Organ Failure Assessment (SOFA) scores (P < 0.05-P < 0.01).ConclusionThe results of the present study showed that occludin, claudin-1, tricellulin and zonulin proteins, as well as I-FABP, D-lactate and citrulline, may be used as promising biomarkers for the evaluation of disease severity in critically ill trauma patients, despite the complexity of the analysis of various barrier markers. However, our results should be supported by future studies.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

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