Evaluation of intestinal permeability using serum biomarkers in Learning
Early About Peanut allergy trial
Abstract
Background: Intestinal barrier dysfunction may lead to a break
in tolerance and development of food allergy (FA). There is
contradictory evidence on whether intestinal permeability (IP) is
altered in IgE-mediated FA. Thus, we sought to determine whether IP
differed between children with eczema who did (FA group) or did not
(atopic controls, ACs) develop FA and whether peanut sensitization,
allergy and early introduction impacted IP using serum biomarkers
zonulin, soluble CD14, and Intestinal Fatty Acid Binding Protein among
randomly selected participants enrolled in the Learning Early About
Peanut allergy trial. Methods: FA group was defined as having
at least one FA at either baseline (4-11 months) or 60 months of age
(V60). ACs had eczema at baseline and no FA at either visit. Serum IP
markers (sIPMs) were measured by ELISA at baseline and V60 and their
relationship with clinical characteristics of participants were analyzed
using parametric tests and linear regression models. Results:
We evaluated 237 FA subjects and 76 ACs. sIPM levels were similar in FA
subjects and ACs at baseline and V60. Age when the child first developed
any FA (<1 year vs >1 year), eczema severity, peanut
sensitization, peanut allergy, and early peanut introduction were not
statistically significantly associated with sIPM levels. Total IgE and
eosinophil levels, peanut-specific IgE, IgG4 and IgG4/IgE ratio were not
correlated with sIPM levels. Conclusion: No differences in
sIPMs were detected to support altered IP in infants with FA compared to
ACs or following early peanut introduction among peanut sensitized
children.