Analysis of fecal zonulin performance as a marker of intestinal permeability in patients in clinical remission of inflammatory bowel disease

• Grant number: 24/08297-7
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: December 01, 2024
• End date: November 30, 2025
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Raquel Susana Matos de Miranda Torrinhas
• Grantee: Eduardo Figueiredo Vicaroni de Souza
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Inflammatory bowel diseases (IBD) involve several factors in their pathophysiology. Among them is the influence of an unbalanced interaction between the intestine and the intestinal microbiota, which can impair the intestinal barrier and increase its permeability. Disturbances in the different specialized components of the intestinal mucosal barrier are described in patients with IBD, as well as their potential to predict the course of IBD. Recently, fecal zonulin (ZF) has been applied to indicate early changes in intestinal permeability. Evaluation of ZF can provide important information about the status of the intestinal barrier in patients with IBD, especially during the disease remission phase, when symptoms may be absent but physiological changes may persist. Objective: To evaluate the performance of ZF as a marker of intestinal permeability in patients with clinically remissive IBD. Methods: This prospective, observational, and longitudinal study will evaluate 40 patients with IBD in remission and 45 healthy volunteers. Fecal concentrations of ZF (ELISA), biochemical (vitamin D and C-reactive protein) and clinical (disease relapse in 1 year) data will be studied. ROC curve analyses will be generated to evaluate the performance and predictive capability of ZF in diagnosing intestinal permeability. The relationship between ZF and biochemical and clinical biomarkers will be investigated, as well as the potential of intestinal permeability in predicting disease relapses. Expected Results: It is expected that ZF will be able to distinguish patients with IBD in remission from healthy individuals and that its concentrations will correlate with biomarkers and disease relapse.