Associations of clinical indexes and prognosis with gut-vascular barrier damage in patients with intestinal obstruction

doi:10.4240/wjgs.v17.i12.111041

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

World J Gastrointest Surg. Dec 27, 2025; 17(12): 111041
Published online Dec 27, 2025. doi: 10.4240/wjgs.v17.i12.111041

Associations of clinical indexes and prognosis with gut-vascular barrier damage in patients with intestinal obstruction

Hu-Fei Zhang, Yi Guo, Xiao-Jun Chen, Yi-Nan Zhang, Hui Peng, Zi-Meng Liu, Xu-Yu Zhang

Hu-Fei Zhang, Yi-Nan Zhang, Hui Peng, Xu-Yu Zhang, Department of Anesthesiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China

Yi Guo, Xiao-Jun Chen, Department of Anesthesiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China

Zi-Meng Liu, Department of Critical Care Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China

Co-first authors: Hu-Fei Zhang and Yi Guo.

Co-corresponding authors: Zi-Meng Liu and Xu-Yu Zhang.

Author contributions: Zhang HF and Guo Y contribute equally to this study as co-first authors; Liu ZM and Zhang XY contribute equally to this study as co-corresponding authors; Zhang HF and Guo Y helped design and perform the studies and write the manuscript; Chen XJ helped perform the studies; Zhang YN helped perform the studies; Peng H helped analyze the data; Liu ZM helped generate the concept of the studies and write the manuscript; Zhang XY helped generate the concept of the studies and write the manuscript.

Supported by National Natural Science Foundation of China, No. 82072204 and No. 81701874; and Natural Science Foundation of Guangdong Province, China, No. 2021A1515010990 and No. 2025A1515012493.

Institutional review board statement: This study was approved by the Ethic Committee of The First Affiliated Hospital of Sun Yat-sen University, No.[2021]810.

Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.

Conflict-of-interest statement: There is no conflict of interest.

STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.

Data sharing statement: No additional data are available.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Xu-Yu Zhang, MD, PhD, Department of Anesthesiology, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan 2^th Road, Guangzhou 510080, Guangdong Province, China. zhangxuy@mail.sysu.edu.cn

Received: July 29, 2025
Revised: September 2, 2025
Accepted: October 17, 2025
Published online: December 27, 2025
Processing time: 148 Days and 17.8 Hours

Abstract

BACKGROUND

The gut-vascular barrier (GVB) is critical for maintaining intestinal homeostasis, but its involvement in intestinal obstruction (IO) remains unclear.

AIM

To investigate GVB disruption in patients with IO and its association with perioperative infection, organ injury, and clinical prognosis.

METHODS

Intestinal tissues from surgical patients with IO (IO group) and without obstruction (control group) were analyzed for PV1, a biomarker of GVB disruption. In the IO group, PV1 expression correlated with clinical data. Patients were further stratified into PV1-high and PV1-low subgroups, and clinical parameters were compared.

RESULTS

PV1 expression was significantly elevated in the IO group. In the IO group, PV1 levels were positively correlated with perioperative infection markers, liver and kidney injury indices, and adverse prognostic indicators, including prolonged hospitalization, antibiotic use, fever duration, and postoperative complications. Several of these outcomes were significantly worse in the PV1-high subgroup than in the PV1-low subgroup, although severe postoperative complications and mortality did not differ.

CONCLUSION

Our findings demonstrate that IO induces GVB damage, and the extent of impairment is closely associated with infection, organ injury, and adverse clinical outcomes in surgical patients, suggesting a pathogenic role for GVB disruption in IO.

Keywords: Intestinal obstruction; Gut-vascular barrier; PV1; Infection; Organ injury; Clinical prognosis

Core Tip: This study reveals that intestinal obstruction (IO) leads to gut-vascular barrier (GVB) damage, with PV1 expression positively correlating with infection, liver/kidney injury, and adverse outcomes. GVB impairment may contribute to IO pathogenesis, highlighting PV1 as a potential prognostic biomarker.