Biomarkers of Leaky Gut

What is Leaky Gut?

Leaky gut, also known as increased intestinal permeability, is a condition where the lining of the small intestine becomes damaged, causing undigested food particles, toxic waste products, and bacteria to "leak" through the intestines and flood the bloodstream. The body's immune response to these invaders can often lead to a variety of health issues.

Biomarkers of Leaky Gut

Here's a breakdown of the markers mentioned:

  1. Zonulin: This is a protein that modulates the permeability of tight junctions between cells of the wall of the digestive tract. Increased levels of zonulin have been associated with increased intestinal permeability (Leaky Gut Syndrome). Zonulin levels can be elevated in a variety of conditions, including celiac disease and type 1 diabetes.

  2. Serum Lipopolysaccharides (LPS): These are components of the outer membrane of Gram-negative bacteria. Elevated levels of LPS in the blood (endotoxemia) can be indicative of increased intestinal permeability, as these molecules can translocate from the gut lumen to the bloodstream when the gut barrier is compromised. Chronic exposure to LPS can lead to chronic inflammation and has been linked to a variety of conditions, including metabolic endotoxemia, which is implicated in the pathogenesis of chronic fatigue syndrome (CFS) and fibromyalgia.

  3. Soluble CD14 (sCD14): CD14 is a co-receptor for the detection of bacterial LPS. The soluble form of CD14 can increase in the presence of LPS and is considered a marker for bacterial translocation and systemic immune activation. High levels of sCD14 have been observed in conditions associated with chronic inflammation, including those where leaky gut is suspected to play a role.

Leaky Gut: ME/CFS and FM

In the context of chronic fatigue syndrome (CFS) and fibromyalgia, research has suggested that patients often suffer from a range of gastrointestinal disturbances, and there is a growing body of evidence that links the pathophysiology of these conditions to altered gut microbiota and increased intestinal permeability. However, it's important to note that while these biomarkers can be associated with leaky gut, their presence alone does not confirm the diagnosis. Additionally, increased intestinal permeability can be a symptom rather than a cause of the underlying condition.

It is also crucial to recognize that the understanding of leaky gut syndrome and its implications for health is still evolving. More research is needed to fully understand the role of these biomarkers in disease processes and to establish standardized diagnostic criteria for leaky gut syndrome. Furthermore, while there is evidence of an association between gut health and conditions such as CFS and fibromyalgia, causation and the directionality of these relationships are complex and not fully elucidated.

These specific biomarkers are usually measured with more specialized tests that are not standard in routine medical examinations:

  1. Zonulin: Testing for zonulin as a marker for intestinal permeability can be done through serum or plasma tests. It is usually assessed through enzyme-linked immunosorbent assay (ELISA) kits designed specifically for zonulin.

  2. Serum LPS: Measurement of LPS in the blood is a more specialized assay and is not part of standard panels. It is also often measured by ELISA or similar immunoassay techniques.

  3. Soluble CD14 (sCD14): Similar to LPS, sCD14 is not typically measured in standard blood tests and is also quantified using ELISA or related immunoassays.

How to find these tests

These tests are usually ordered by specialists who are investigating specific conditions, such as gastroenterologists, immunologists, or doctors specializing in functional medicine, particularly if there is a suspicion of conditions like chronic fatigue syndrome, fibromyalgia, or other diseases associated with increased intestinal permeability.

They are not as widely available as routine tests and might not be covered by standard insurance plans without specific indications. Also, interpretation of the results usually requires specialized knowledge of the conditions associated with changes in these markers.

In Spanish-speaking countries, these specialized tests might be referred to by the same name as in English or with a direct translation, and they could be ordered as part of a "perfil de permeabilidad intestinal" or a similar specific panel, if available.

Read more here: https://www.topdoctors.es/diccionario-medico/test-de-permeabilidad-intestinal

Is Serum Lipopolysaccharides (LPS) the same as a "Prueba de Lipasa"?

No, Serum Lipopolysaccharides (LPS) and "Prueba de Lipasa" are not the same.

LPS, or lipopolysaccharides, are large molecules that are components of the outer membrane of Gram-negative bacteria. When LPS enters the bloodstream, it can act as an endotoxin and is associated with triggering inflammatory responses. The presence of LPS in the blood can be indicative of bacterial translocation from the gut, which is often related to increased intestinal permeability, also known as "leaky gut."

On the other hand, a "Prueba de Lipasa" refers to a lipase test, which measures the level of the enzyme lipase in your blood. Lipase is produced by the pancreas and helps the body to break down fats. Abnormal levels of lipase can indicate a problem related to the pancreas, such as pancreatitis.

So while both tests involve blood measurements and are related to digestive processes, they are measuring entirely different things: LPS is about bacterial components indicating potential infection or inflammation due to a compromised gut barrier, and lipase is an enzyme associated with the digestive system's function, particularly the pancreas.