Serum I‐FABP as marker for enterocyte damage in coeliac disease and its relation to villous atrophy and circulating autoantibodies

Summary Background Enterocyte damage is the hallmark of coeliac disease (CD) resulting in malabsorption. Little is known about the recovery of enterocyte damage and its clinical consequences. Serum intestinal fatty acid binding protein (I‐FABP) is a sensitive marker to study enterocyte damage. Aims To evaluate the severity of enterocyte damage in adult‐onset CD and its course upon a gluten‐free diet (GFD). Furthermore, the correlation among enterocyte damage, CD autoantibodies and histological abnormalities during the course of disease is studied. Methods Serum I‐FABP levels were determined in 96 biopsy‐proven adult CD patients and in 69 patients repeatedly upon a GFD. A total of 141 individuals with normal antitissue transglutaminase antibody (IgA‐tTG) levels served as controls. I‐FABP levels were related to the degree of villous atrophy (Marsh grade) and IgA‐tTG. Results I‐FABP levels were elevated in untreated CD (median 691 pg/mL) compared with controls (median 178 pg/mL, P