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. Author manuscript; available in PMC: 2018 Aug 1.
Published in final edited form as: Pediatr Clin North Am. 2017 Aug;64(4):815–836. doi: 10.1016/j.pcl.2017.03.003

Table 1.

Potential biomarkers of environmental enteropathy.6,29,33

Function Biomarker Description Sample type
Intestinal absorptive function Lactulose Disaccharide, indicator of gut barrier disruption Administered orally and measured in urine
Mannitol Monosaccharide, indicator of gut absorptive surface Administered orally and measured in urine
Lactulose:Mannitol ratio (%L and %M) Indicator of barrier disruption per surface area Administered orally and measured in urine
Rhamnose Monosaccharide, indicator of absorptive surface Administered orally and measured in urine
D-xylose Monosaccharide, indicator of absorptive surface Administered orally and measured in urine
GMCSF antibody Granulocyte macrophage colony stimulating factor autoantibody Plasma
Intestinal barrier function alpha-1-antitrypsin Plasma protease inhibitor, indicator of relatively severe gut barrier disruption Stool
Claudin-2 Tight junction peptide reflecting increased permeability Intestinal tissue staining
Claudin-15 A marker of “healthy” gut absorptive and barrier function Urine
Translocation LPS Lipopolysaccharide Plasma
IgA and IgG anti-LPS Antibody produced against lipopolysaccharide Plasma
IgA and IgG anti-FliC Antibody produced against bacterial FliC (flagellin) Plasma
Zonulin Tight junction peptide regulator of gut permeability (haptoglobin) Plasma
TJP1 Tight junction protein gene encoding for ZO-1 Intestinal biopsy, tissue DNA
Intestinal inflammation MPO Myeloperoxidase, a neutrophil granule component Stool
Calprotectin Neutrophil marker Plasma; stool
Neopterin Monocyte/macrophage marker of immune activation (GTP metabolite) Stool
Lactoferrin Neutrophil granule component Stool
Lipocalin Protein in neutrophils and epithelial cells Stool
Reg 1A Regenerating islet-derived protein-α
Reg1β Marker of epithelial repair Stool
I-FABP Intestinal fatty acid binding protein Plasma
Fecal S100A12 Calcium (and zinc, copper)-binding protein regulator of inflammatory signaling Stool
Systemic inflammation AGP Acid glycoprotein, a hepatic “acute phase reaction” product Plasma
IL-1β Interleukin-1β, inflammatory cytokine produced by monocytes and macrophages Plasma
IL-4 Th2 cytokine Plasma
IL-5 Th2 and mast cell cytokine Plasma
IL-6 Pro or anti-inflammatory T cell or macrophage cytokine or myokine Plasma
IL-7 Lymphokine stimulator of stem cell differentiation into B, T or NK lymphoid cells Plasma
IL-10 Anti-inflammatory STAT3 inducer cytokine Plasma
TNFα Proinflammatory cytokine Plasma
MIP1β Macrophage inflammatory protein 1β (CCL4) Plasma
Ferritin Iron binding protein reflecting iron stores Serum
Hepcidin Inflammation driven inhibitor of iron exporter ferroportin, thus blocker of iron uptake or release into the circulation; hence anemia of chronic inflammation Plasma
C-reactive Protein (CRP) An acute phase reactant (APR) Plasma
hsCRP High sensitivity C-reactive protein (APR) Plasma
sCD14 Soluble CD14; shed by activated monocytes, binds LPS Plasma
EndoCAb Antibody produced against bacterial lipopolysaccharide Plasma
Serum amyloid A Acute phase reactant driver of inflammation Plasma
LBP LPS binding protein Plasma
Metabolites/ Growth markers Tryptophan Essential amino acid for protein synthesis and growth as well as the neurotransmitter, serotonin Plasma
Kynurenine Tryptophan metabolite via IDO, potentially driven by inflammation Plasma
K:T ratio Kynurenine:tryptophan ratio Plasma
Citrulline Key amino acid for intestinal repair Plasma
IGFBP-3 Insulin-like growth factor binding protein-3 Plasma
IGF-1 Insulin-like growth factor 1 Plasma
Activin Growth regulation factor Plasma