Table 2.
Biomarkers which may be informative in the study of Environmental Enteropathya
| Biomarker | Description | Refs |
|---|---|---|
| Zonulin | Human homolog of zonnula occudens toxin from V. cholerae that modulates tight junctions. In celiac sprue, gliadin induces zonulin release by binding to the CXCR3 receptor causing cytoskeletal rearrangement and ZO-1 reorganization, leading to increased intestinal permeability. | 65,66, 70 |
| Fecal Calprotectin | A complex of S100A8/S100A9, this protein accounts for 60% of neutrophilic cytosol. It has been used to predict relapse in IBD patients. | 54,55, 71,72 |
| Fecal S100A12 | Marker of neutrophil activation, elevated in IBD and bacterial enteritis, but not viral enteritis. | 72,73, 74 |
| Endocab a | Antibody to bacterial cell wall LPS core oligosaccharide. Endocab has is the only biomarker that has been studied in EE | 52,70 |
| Granulocyte macrophage Colony Stimulating Factor Autoantibody | Reported to be associated with increased intestinal permeability as measured by lactulose:mannitol test in patients with Crohn Disease. | 75 |
| Neopterin | Protein produced by monocytes and macrophages after stimulation with IFN-gamma. Marker of TH1 cell activation. | 76 |
| Myeloperoxidase | A lysosomal protein in neutrophilic granulocytes. Found to be elevated in mouse model of IBD. | 77 |
| Citrulline | Amino acid produced by enterocytes. Proposed as measure of gross enterocyte mass. | 57,58 |
| Reg 1A, Reg 1B | Gene family involved in tissue regeneration. Protein found in colonic crypt epithelial cells with anti-apoptotic and pro-proliferative properties. Up-regulated during amebiasis, and may play a protective role against parasite-induced apoptosis. Also being studied for diagnosis and monitoring of Celiac disease. | 78,79 |
| Lactoferrin | Iron-binding glycoprotein found in secondary granules of leukocytes. Used as a surrogate for fecal leukocytes, and a measure of intestinal inflammation. | 80,81, 82 |
a
Endocab is the only biomarker that has been evaluated in EE, the rest have been studied in other inflammatory bowel conditions and may be potentially useful in understanding EE.