Zonulin Family Protein (Serum)

This test measures a zonulin family protein (ZFP), identified as properdin. High serum levels of ZFP (antigen) are correlated with abnormal results of the Lactulose Mannitol test; the long-accepted standard for intestinal permeability.

Elevated levels of ZFP have been associated with metabolic syndrome, obesity, and several autoimmune, inflammatory and neoplastic diseases. Such diseases include Celiac disease, type I diabetes, juvenile nonalcoholic fatty liver disease, and evidence is accumulating for multiple sclerosis, rheumatoid arthritis, asthma and inflammatory bowel disease.

Elevated serum levels of ZFP and increased permeability are commonly observed in patients at risk of developing Crohn’s disease and type 1 diabetes patients, prior to the onset of symptoms. ZFP levels may increase with corticosteroid use, but in one study prednisone decreased intestinal permeability in twenty Crohn’s disease patients. Triggers associated with elevated levels of ZFP and breakdown of tight junction protein complexes (TJP) include gliadin fragments and the adherence of bacteria to the epithelial cell surface.

Simple sugars, sodium, and food additives such as emulsifiers, microbial transglutaminase and nano-particles also appear to disrupt epithelial barrier function. Clinical intervention to normalize intestinal permeability should first attempt to eliminate the trigger(s).

Use of specific probiotics, and prebiotics such as inulin and fructo-oligosaccharides, have been shown to remediate gastrointestinal permeability. Other clinical interventions to restore the epithelial barrier may include dietary changes (increase soluble fiber), treatment of microbial dysbiosis, digestive supports and anti-inflammatory therapies.

Anti-inflammatory therapies may include supplements such as quercetin, vitamin C, curcumin, gamma-linolenic acid, omega-3 fatty acids (EPA, DHA), and aloe vera. Other nutrients such as zinc, beta-carotene, pantothenic acid, and L-glutamine may provide some support for rejuvenation of the TJP.

Consider a Comprehensive Stool Analysis to further investigate potential causes of increased intestinal permeability.

Useful for:

Please read all of the directions, and familiarize yourself with the collection
procedures.

Fasting is not required for these tests. It is generally recommended to refrain
from taking non-essential medications and dietary supplements (especially
biotin) for 72 hours prior to the specimen collection unless otherwise instructed
by your physician. 

Never discontinue prescription medications without first consulting your physician.

Celiac/Gluten testing should not be performed on patients currently on a
gluten-free diet, unless used to monitor long-term compliance, or as otherwise
directed by your physician.