Longitudinal changes in serum intestinal fatty acid-binding protein and claudin-2 levels in children during the first 24 months of life: a prospective observational cohort study

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Background . Maturation of the intestinal epithelial barrier in early life is accompanied by variability in biomarkers of enterocyte injury and permeability. However, longitudinal serum profiles of I-FABP and claudin-2 in seemingly healthy children, including those born preterm, remain insufficiently studied. Aim . To assess the dynamics of serum I-FABP and claudin-2 concentrations in children born at 34–41 weeks’ gestation during the first 24 months of life, with consideration of gestational age. Methods . This prospective observational cohort study included three time points: up to 7 days; 1–1.5 months/postmenstrual age (PMA) 40–41 weeks; and 18–24 months. At time points 1–2, 98 newborns were enrolled; by time point 3, follow-up was completed in 88 children: preterm (34–36 weeks, n = 30) and term (37–41 weeks, n = 58). Loss to follow-up was 10.2 % (n = 10). I-FABP and claudin-2 were measured by ELISA. Results. I-FABP remained stable during the first 1–1.5 months and increased by the second year of life: in preterm children 1.12 [1.07; 1.30] – 1.30 [0.97; 1.87] – 6.09 [3.18; 6.65] ng/mL (p < 0.001), and in term children 1.10 [0.80; 1.95] – 1.21 [0.92; 1.73] – 3.89 [2.33; 6.10] ng/mL (p < 0.001); no between-group differences were observed at the respective time points (p = 0.738; 0.610; 0.131). In preterm children, claudin-2 did not change significantly: 6.76 [3.00; 9.14] – 7.59 [5.20; 10.96] – 7.77 [6.33; 9.20] ng/mL (p = 0.497). In term children, claudin-2 increased: 1.85 [1.02; 5.22] – 5.10 [3.47; 8.31] – 7.95 [6.32; 11.28] ng/mL (p < 0.001). At time points 1–2, claudin-2 values were higher in preterm than in term children (p = 0.006; p = 0.009), whereas at time point 3 they were comparable (p = 0.326). Conclusions. Within the 34–41-week gestational range, gestational age does not determine I-FABP levels, whereas claudin-2 is gestational age-dependent. Interpretation of these biomarkers requires consideration of both chronological age and gestational age.

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