Zonulin Family Protein (Serum)

What this laboratory test evaluates

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:• Celiac disease
• Non-celiac gluten sensitivity
• Type I diabetes
• Juvenile nonalcoholic fatty liver disease
• Multiple sclerosis
• Rheumatoid arthritis
• Asthma
• Inflammatory bowel disease
• Adult glucose intolerance

Additional test information

Elevated serum levels of a zonulin family protein (ZFP) are correlated with abnormal results of the Lactulose Mannitol test; the long-accepted standard for intestinal permeability ("leaky gut"). 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. The test may be used as a clinically equivalent alternative for those who don't want to use the "sugar" load test.

Collection and processing

• Sample type: Serum
• Fasting: No
• Estimated laboratory processing: Results should arrive 1 to 3 days after the lab receives samples.

How Sunridge uses laboratory information

Sunridge considers the medical question, symptoms, history, medications, prior results, and whether the finding could change care before recommending testing. A laboratory result is not interpreted in isolation and does not establish a diagnosis by itself.

Before requesting this test

Availability, collection requirements, eligibility, and processing estimates can change. Sunridge reviews each request and, when appropriate, creates the order through Fullscript. Follow the current instructions supplied with the approved order.

Related Sunridge care

Learn how Sunridge approaches Digestive Conditions and ask whether this test is appropriate for your clinical question.