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Zonulin measurement conundrum: add confusion to confusion does not lead to clarity
  1. Alessio Fasano
  1. Mucosal Immunology and Biology Research Center, Massachusetts General Hospital, Boston, MA, USA
  1. Correspondence to Professor Alessio Fasano, Chief of Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital, Boston, MA 02114, USA; afasano{at}

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I read with great interest the commentary by Massier et al 1 to the paper published in GUT by Talley et al 2 on their report suggesting that zonulin is not a good gut permeability biomarker for irritable bowel disease, functional dyspepsia and non-coeliac gluten sensitivity. While I appreciate the authors’ effort in making the point of the poor reliability of the commercially available ELISA in measuring zonulin, I think that some issues need to be clarified to avoid misleading the readership and, therefore, add more confusion to a field that would strongly benefit from greater clarity on this topic. Having been responsible for the discovery of zonulin and for the development of the first ‘in house’ ELISA for measuring zonulin, I think I am well positioned to provide the following clarifying points

Zonulin is not exclusively pre-haptoglobin 2, rather is a family of structurally and functionally related proteins

Since our discovery in …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.