Trefoil factor 3 (TFF3) is a small peptide secreted mainly by goblet cells in the gut, where it plays a key role in gastrointestinal defence and repair. Plasma TFF3 has been reported as a biomarker of intestinal injury and as such it has been evaluated as a marker of disease activity in colitis. Impaired gut barrier function has been postulated as the "motor" of critical illness. We here sought to determine the temporal dynamics of plasma TFF3 in adult patients admitted to intensive care unit with abdominal sepsis or after major abdominal surgery for a non-infectious condition (post-op GI patients). TFF3 was measured in plasma obtained from 143 patients with abdominal sepsis and 98 post-op GI patients on admission to the intensive care (day 0) and at days 2 and 4 thereafter. Abdominal sepsis patients showed sustained elevated plasma TFF3 levels from day 0 to 4 relative to healthy control values, while in post-op GI patients admission TFF3 levels were not increased, only rising at day 2 and 4. In both patient groups, the presence of shock was associated with higher TFF3 levels. Moreover, patients with 3 or more organs failing had higher plasma TFF3 concentrations. While plasma TFF3 was higher in sepsis patients who did not survive until day 30, TFF3 levels were not independently associated with 30-day mortality in a Cox regression analysis. These results could support the theory that intestinal injury contributes to the pathogenesis of critical illness. Future studies are needed to elucidate whether the proposed gut dysfunction precedes or supersedes organ dysfunction in time.

中文翻译：

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腹腔脓毒症或非感染性腹腔疾病危重患者血浆三叶因子 3 水平升高

三叶因子 3 (TFF3) 是一种主要由肠道杯状细胞分泌的小肽，在胃肠道防御和修复中起关键作用。血浆 TFF3 已被报道为肠道损伤的生物标志物，因此它已被评估为结肠炎疾病活动的标志物。肠道屏障功能受损被认为是危重疾病的“动力”。我们在这里试图确定因腹部脓毒症或因非感染性疾病（术后胃肠道患者）接受腹部大手术后入住重症监护病房的成年患者血浆 TFF3 的时间动态。TFF3 在从 143 名腹部脓毒症患者和 98 名术后 GI 患者进入重症监护室（第 0 天）及其后第 2 天和第 4 天获得的血浆中测量。与健康对照值相比，腹部脓毒症患者从第 0 天到第 4 天的血浆 TFF3 水平持续升高，而入院后胃肠道患者的 TFF3 水平没有增加，仅在第 2 天和第 4 天升高。在两个患者组中，休克与较高的 TFF3 水平有关。此外，有 3 个或更多器官衰竭的患者具有更高的血浆 TFF3 浓度。虽然在第 30 天后才存活的败血症患者的血浆 TFF3 较高，但在 Cox 回归分析中，TFF3 水平与 30 天死亡率不独立相关。这些结果可以支持肠道损伤导致危重病发病机制的理论。未来的研究需要阐明所提出的肠道功能障碍是否先于或取代了器官功能障碍。