E.P. Salyanova1, N.N. Zybina2, D.V. Rogozhin3, T.A. Skvortsova4, E.L. Nikonov5

1 A.I. Evdokimov Moscow State University of Medicine and Dentistry
of the Ministry of Health of Russia (Moscow, Russia)

2 A.M. Nikiforov All-Russian Center for Emergency and Radiation Medicine
Ministry of Emergency Situations of Russia (St. Petersburg, Russia)

3 N.N. Blokhin National Medical Research Center for Oncology
of the Ministry of Health of the Russian Federation (Moscow, Russia)

4,5 N.I. Pirogov Russian National Medical Research University of the Ministry of Health of Russia (Moscow, Russia)

Formulation of the problem. Controversial evidence from clinical studies suggests that when tight junctions are destroyed, intestinal permeability increases, invading pathogens can cause an immune imbalance in the intestinal mucosa and, as a result, a systemic inflammatory response. Zonulin, as a predictor of increased intestinal permeability, serves as the basis for more extensive studies on the study of its content in the blood serum of patients with intestinal diseases, in the pathogenesis of which inflammation is a key link.

The purpose of the work is a comparative clinical and laboratory analysis of the levels of zonulin in the blood serum of healthy donors and patients with Crohn's disease and other inflammatory bowel diseases.

Results. In the vast majority of healthy donors, serum zonulin concentrations ranged from 20 to 50 pg/ml. The lowest concentrations of zonulin were found in the group of practically healthy women of the control group under the age of 50 (31.1±2.9 pg/ml). When analyzing the content of zonulin in the blood serum of 14 patients with Crohn's disease, it was revealed that the levels of zonulin varied widely from 8.7 to 94.9 pg/ml and averaged 55.4±6.0 pg/ml. When comparing the average concentrations of zonulin in the blood serum of patients with CD and such indicators in the examined healthy donors of the control group, statistically significant differences were revealed (p=0.00029). When analyzing the content of zonulin in the blood serum of 70 patients with inflammatory diseases of the colon, it was found that the levels of the serum predictor varied widely from 3.3 to 82.4 pg/ml and averaged 48.2±2.0 pg/ml. We found a statistically significant increase in the concentration of zonulin in the blood serum of patients with inflammatory diseases of the colon compared with those in the control group (p=0.00047). According to the ROC analysis, the area under the curve was 0.734, which allows us to consider the potential for using elevated zonulin concentrations as a factor associated with other inflammatory diseases.

Practical significance. The concentration of zonulin in the blood serum of practically healthy donors is statistically significantly lower than the level of the marker in the general group of patients with inflammatory diseases of the colon (52.3±1.7 ng/ml; p<0.01). Determination of zonulin in the blood serum of patients with intestinal diseases can be used in the biochemical evaluation of inflammatory diseases such as Crohn's disease, ulcerative colitis, and mixed irritable bowel syndrome.

Salyanova E.P., Zybina N.N., Rogozhin D.V., Skvortsova T.A., Nikonov E.L. Comparative clinical and laboratory analysis of serum zonulin in healthy donors, patients with Crohn's disease and other inflammatory bowel diseases. Technologies of Living Systems. 2023. V. 20. № 3. Р. 48-54. DOI: https://doi.org/10.18127/j20700997-202303-06 (In Russian).

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