Is there an association between the serum zonulin concentration and the occurrence of PPROM?

Yıl 2025, Cilt: 8 Sayı: 1, 47 - 51, 12.01.2025

Şule Atalay Mert , Gizem Aktemur , Tuğba Kınay , Hüseyin Levent Keskin

https://doi.org/10.32322/jhsm.1550594

Öz

Aims: The aim is to evaluate the association between intestinal permeability, as assessed by zonulin levels, and preterm premature rupture of membranes (PPROM).
Methods: A prospective case-control study was conducted involving 44 pregnant women: 22 with PPROM and 22 matched controls. High-risk pregnancies (gestational diabetes, preeclampsia, multiple pregnancies), chronic diseases, and smoking were exclusion criteria. Demographic and clinical data were collected from medical records. Venous and umbilical cord blood samples were obtained post-delivery, centrifuged at 3000 rpm for 10 min, and stored at -80°C.
Results: No significant differences were found between the PPROM and control groups regarding age, body-mass index, gravidity, previous abortions, history of preterm rupture of membrane (PROM), or PPROM. Maternal and cord blood zonulin levels were comparable between groups (p>0.05). In the PPROM group, maternal and fetal cord zonulin levels correlated positively with newborn birthweight (r=0.607, p=0.003; r=0.617, p=0.002, respectively). A strong positive correlation was observed between maternal serum and fetal cord blood zonulin levels (r=0.837, p<0.001).
Conclusion: A positive correlation existed between newborn birthweight and both maternal and fetal cord zonulin levels in the PPROM group. Additionally, a strong positive correlation was observed between maternal serum and fetal cord blood zonulin levels in all participants.

Anahtar Kelimeler

zonulin, intestinal permeability, PPROM (premature preterm rupture of membrane), maternal serum, umbilical cord blood

Etik Beyan

This study was performed in accordance with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of University B (Date 10.01.2024./No.023).

Serum zonulin konsantrasyonu ile PPROM oluşumu arasında bir ilişki var mıdır?

Öz

Amaçlar: Zonulin düzeyleri ile değerlendirilen bağırsak geçirgenliği ile preterm prematür membran rüptürü (PPROM) arasındaki ilişkiyi değerlendirmektir.
Yöntemler: 44 gebe kadını içeren prospektif bir vaka kontrol çalışması yürütülmüştür: 22'si PPROM'lu ve 22 eşleştirilmiş kontrol. Yüksek riskli gebelikler (gestasyonel diyabet, preeklampsi, çoklu gebelikler), kronik hastalıklar ve sigara kullanımı dışlama kriterleriydi. Demografik ve klinik veriler tıbbi kayıtlardan toplandı. Venöz ve göbek kordonu kanı örnekleri doğumdan sonra alındı, 10 dakika boyunca 3000 rpm'de santrifüj edildi ve -80°C'de saklandı.
Sonuçlar: PPROM ve kontrol grupları arasında yaş, vücut kitle indeksi, gebelik, önceki düşükler, preterm membran rüptürü (PROM) veya PPROM öyküsü açısından anlamlı bir fark bulunmadı. Anne ve göbek kordonu kanı zonulin düzeyleri gruplar arasında benzerdi (p>0,05). PPROM grubunda, maternal ve fetal kordon zonulin seviyeleri yenidoğan doğum ağırlığı ile pozitif korelasyon gösterdi (sırasıyla r=0,607, p=0,003; r=0,617, p=0,002). Maternal serum ve fetal kordon kanı zonulin seviyeleri arasında güçlü bir pozitif korelasyon gözlendi (r=0,837, p<0,001).
Sonuç: PPROM grubunda yenidoğan doğum ağırlığı ile hem maternal hem de fetal kordon zonulin seviyeleri arasında pozitif bir korelasyon vardı. Ek olarak, tüm katılımcılarda maternal serum ve fetal kordon kanı zonulin seviyeleri arasında güçlü bir pozitif korelasyon gözlendi.

Anahtar Kelimeler

Zonulin, bağırsak geçirgenliği, PPROM, prematüre preterm membran rüptürü, maternal serum, göbek kordonu kanı

Kaynakça

• Wang W, Uzzau S, Goldblum SE, Fasano A. Human zonulin, a potential modulator of intestinal tight junctions. J Cell Sci. 2000; 113(24):4435-4440.
• Fasano A. Zonulin and its regulation of intestinal barrier function: the biological door to inflammation, autoimmunity, and cancer. Physiol Rev. 2011;91(1):151-175.
• Sturgeon C, Fasano A. Zonulin, a regulator of epithelial and endothelial barrier functions, and its involvement in chronic inflammatory diseases. Tissue Barriers. 2016;4(4):e1251384.
• Çelik S, Yurtcu N, Çalışkan CS, Çelik S. Zonulin as a potential biomarker for diminished ovarian reserve: a prospective study. Turk J Obstet Gynecol. 2023;20(2):120-125.
• Daneshvar M, Yadegari A, Ribaldone DG, Hasanzadeh M, Djafarian K. Zonulin levels in complicated pregnancy: a systematic review and meta-analysis. J Obstet Gynaecol. 2022; 42(7):2621-2628.
• Lin JH, Hsu YH, Wang PH. Risks for preterm premature labor: many of them are preventable. J Chin Med Assoc. 2020;83(5):421-422.
• Chu YT, Hsu A, Wu CC, Tsai H Der, Tsung-Che Hsieh C, Hsiao YH. Acute chorioamnionitis complicated with symmetrical peripheral gangrene. Taiwan J Obstet Gynecol. 2020;59(6):972-974.
• Park JE, Park Y, Yuk JS. Incidence of and risk factors for thromboembolism during pregnancy and postpartum: a 10-year nationwide population-based study. Taiwan J Obstet Gynecol. 2021;60(1):103-110.
• Skupski D. Preterm premature rupture of membranes (PPROM). J Perinat Med. 2019;47(5):491-492.
• Hosseini SA, Ghalesardi OK, Kamaei Z, et al. Associations of maternal serum zonulin and elements concentrations with neonatal birth weight: a case-control study. J Clin Diagnos Res. 2017;11(12):1-4.
• Tarko A, Suchojad A, Michalec M, Majcherczyk M, Brzozowska A, Maruniak-Chudek I. Zonulin: a potential marker of intestine injury in newborns. Dis Markers. 2017;2017:2413437.
• Tekgündüz SE. Zonulin: can it be used as a marker for preterm labor?. Eur Rev Med Pharmacol Sci. 2024;28(6):2403-2408.
• Łoniewska B, Węgrzyn D, Adamek K, et al. The influence of maternal-foetal parameters on concentrations of zonulin and calprotectin in the blood and stool of healthy newborns during the first seven days of life. An observational prospective cohort study. J Clin Med. 2019;8(4):473.
• Sochaczewska D, Ziętek M, Dołęgowska B, Kordek A, Szczuko M. Implications of indirect biomarkers of intestinal permeability in the stools of newborns and infants with perinatal risk factors for intestinal colonization disorders and infant feeding patterns. Nutrients. 2022;14(11):2224.
• Cheng C, Wei H, Xu C, Xie X, Jiang S, Peng J. Maternal soluble fiber diet during pregnancy changes the intestinal microbiota, improves growth performance, and reduces intestinal permeability in piglets. Appl Environ Microbiol. 2018;84(17): e01047-18.
• Mokkala K, Tertti K, Rönnemaa T, Vahlberg T, Laitinen K. Evaluation of serum zonulin for use as an early predictor for gestational diabetes. Nutr Diabetes. 2017;7(3):e253.
• Güvey H, Çelik S, Çalışkan CS, et al. How do serum zo nulin levels change in gestational diabetes mellitus, pregnancy cholestasis, and the coexistence of both diseases?. Int J Environ Res Public Health. 2021;18(23):12555.
• Cetin Z, Kosem A, Can B, et al. Serum zonulin level is not elevated in patients with polycystic ovary syndrome without metabolic syndrome. Arch Gynecol Obstet. 2019;300(6):1785-1790.
• Lacombe LAC, Matiollo C, da ROSA JS, Felisberto M, Dalmarco EM, Schiavon L de L. Factors associated with circulating zonulin inflammatory bowel disease. Arq Gastroenterol. 2022;59(2):238-243.
• Tonyalı NV, Arslan B, Sucu ST, et al. Does second trimester maternal serum zonulin level predict gestational diabetes mellitus? J Clin Med. 2024;13(2):394.