{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T08:20:30Z","timestamp":1774340430898,"version":"3.50.1"},"reference-count":47,"publisher":"Walter de Gruyter GmbH","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BM"],"published-print":{"date-parts":[[2018,4,25]]},"abstract":"<jats:p>Previously we showed that urine trefoil factor 3 (TFF3) levels were higher in females with irritable bowel syndrome (IBS) compared to non-IBS females. To assess if TFF3 is associated with symptoms and\/or reflect alterations in gastrointestinal permeability and gut microbiota in an IBS population, we correlated stool and urine TFF3 levels with IBS symptoms, intestinal permeability, stool microbial diversity and relative abundance of predominant bacterial families and genera. We also tested the relationship of stool TFF3 to urine TFF3, and compared results based on hormone contraception use. Samples were obtained from 93 females meeting Rome III IBS criteria and completing 4-week symptom diaries. TFF3 levels were measured by ELISA. Permeability was assessed with the urine lactulose\/mannitol (L\/M) ratio. Stool microbiota was assessed using 16S rRNA. Stool TFF3, but not urine TFF3, was associated positively with diarrhoea and loose stool consistency. Higher stool TFF3 was also associated with lower L\/M ratio and microbial diversity. Of the 20 most abundant bacterial families <jats:italic>Mogibacteriaceae<\/jats:italic> and <jats:italic>Christensenellaceae<\/jats:italic> were inversely related to stool TFF3, with only <jats:italic>Christensenellaceae<\/jats:italic> remaining significant after multiple comparison adjustment. There were no significant relationships between stool or urine TFF3 levels and other symptoms, nor between stool and urine levels. In premenopausal females, urine TFF3 levels were higher in those reporting hormone contraception. Collectively these results suggest that higher stool TFF3 levels are associated with IBS symptoms (loose\/diarrhoeal stools), lower gut permeability, and altered stool bacteria composition (decreased diversity and decreased <jats:italic>Christensenellaceae<\/jats:italic>), which further suggests that TFF3 may be an important marker of host-bacteria interaction.<\/jats:p>","DOI":"10.3920\/bm2017.0059","type":"journal-article","created":{"date-parts":[[2018,4,10]],"date-time":"2018-04-10T09:45:24Z","timestamp":1523353524000},"page":"345-356","source":"Crossref","is-referenced-by-count":19,"title":["Stool and urine trefoil factor 3 levels: associations with symptoms, intestinal permeability, and microbial diversity in irritable bowel syndrome"],"prefix":"10.1163","volume":"9","author":[{"given":"M.M.","family":"Heitkemper","sequence":"first","affiliation":[{"name":"Department of Biobehavioral Nursing and Health Informatics, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195-7266, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.C.","family":"Cain","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Office of Nursing Research, University of Washington, 1959 NE Pacific Street, Seattle, WA, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.J.","family":"Shulman","sequence":"additional","affiliation":[{"name":"Children\u2019s Nutrition Research Center, Baylor College of Medicine, Texas Children\u2019s Hospital, 6621 Fannin Street, Houston, TX 77030, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.L.","family":"Burr","sequence":"additional","affiliation":[{"name":"Department of Biobehavioral Nursing and Health Informatics, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195-7266, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Ko","sequence":"additional","affiliation":[{"name":"University of Washington 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