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. 1996 Jun;38(6):864–869. doi: 10.1136/gut.38.6.864

Assessing the site of increased intestinal permeability in coeliac and inflammatory bowel disease.

K Teahon 1, S Somasundaram 1, T Smith 1, I Menzies 1, I Bjarnason 1
PMCID: PMC1383194  PMID: 8984025

Abstract

BACKGROUND: The precise site of intestinal permeability changes in patients with coeliac and inflammatory bowel disease is unknown. AIMS: To design a non-invasive technique for the localisation of altered gastrointestinal permeability to 51chromium labelled EDTA (51CrEDTA). The method depends on comparing and defining concentration/time profiles in serum of a series of simultaneously ingested indicators with a well defined absorption site (3-0-methyl-D-glucose (jejunal indicator), 57cobalt labelled vitamin B12 (ileal indicator), and sulphasalazine (caecal-colonic indicator)) in relation to simultaneously ingested 51CrEDTA. SUBJECTS: Five normal controls, six patients with untreated coeliac disease, five with Crohn's ileitis, and five with pan-ulcerative colitis underwent study, which entailed the simultaneous ingestion of the above four test substances followed, during the next 24 hours, by timed serial collection of urine and serum for marker analysis. RESULTS: Urinary excretion of 51CrEDTA was significantly increased in all patient groups. Analysis of serum appearances and profiles of the markers suggested that the increased intestinal permeation of 51CrEDTA took place in the diseased jejunum in patients with coeliac disease, predominantly in the ileum in Crohn's disease and in the colon in the patients with pan-ulcerative colitis. CONCLUSION: A new non-invasive technique has been assessed that permits the localisation of the site of permeability changes with the gastrointestinal tract.

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Selected References

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  1. Best W. R., Becktel J. M., Singleton J. W., Kern F., Jr Development of a Crohn's disease activity index. National Cooperative Crohn's Disease Study. Gastroenterology. 1976 Mar;70(3):439–444. [PubMed] [Google Scholar]
  2. Bjarnason I., MacPherson A., Hollander D. Intestinal permeability: an overview. Gastroenterology. 1995 May;108(5):1566–1581. doi: 10.1016/0016-5085(95)90708-4. [DOI] [PubMed] [Google Scholar]
  3. Bjarnason I., Peters T. J. In vitro determination of small intestinal permeability: demonstration of a persistent defect in patients with coeliac disease. Gut. 1984 Feb;25(2):145–150. doi: 10.1136/gut.25.2.145. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Chantler C., Garnett E. S., Parsons V., Veall N. Glomerular filtration rate measurement in man by the single injection methods using 51Cr-EDTA. Clin Sci. 1969 Aug;37(1):169–180. [PubMed] [Google Scholar]
  5. Chungi V. S., Rekhi G. S., Shargel L. A simple and rapid liquid chromatographic method for the determination of major metabolites of sulfasalazine in biological fluids. J Pharm Sci. 1989 Mar;78(3):235–238. doi: 10.1002/jps.2600780313. [DOI] [PubMed] [Google Scholar]
  6. DOSCHERHOLMEN A., HAGEN P. S. Delay of absorption of radiolabeled cyanocobalamin in the intestinal wall in the presence of intrinsic factor. J Lab Clin Med. 1959 Sep;54:434–439. [PubMed] [Google Scholar]
  7. Dawson D. J., Lobley R. W., Burrows P. C., Notman J. A., Mahon M., Holmes R. Changes in jejunal permeability and passive permeation of sugars in intestinal biopsies in coeliac disease and Crohn's disease. Clin Sci (Lond) 1988 Apr;74(4):427–431. doi: 10.1042/cs0740427. [DOI] [PubMed] [Google Scholar]
  8. FORDTRAN J. S., CLODI P. H., SOERGEL K. H., INGELFINGER F. J. Sugar absorption tests, with special reference to 3-0-methyl-d-glucose and d-xylose. Ann Intern Med. 1962 Dec;57:883–891. doi: 10.7326/0003-4819-57-6-883. [DOI] [PubMed] [Google Scholar]
  9. Jenkins A. P., Nukajam W. S., Menzies I. S., Creamer B. Simultaneous administration of lactulose and 51Cr-ethylenediaminetetraacetic acid. A test to distinguish colonic from small-intestinal permeability change. Scand J Gastroenterol. 1992 Sep;27(9):769–773. doi: 10.3109/00365529209011181. [DOI] [PubMed] [Google Scholar]
  10. Jenkins W. J., Empson R., Jewell D. P., Taylor K. B. Subcellular localisation of vitamin B12 during absorption in the guinea-pig ileum. Gut. 1981 Aug;22(8):617–622. doi: 10.1136/gut.22.8.617. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Kapadia C. R., Serfilippi D., Voloshin K., Donaldson R. M., Jr Intrinsic factor-mediated absorption of cobalamin by guinea pig ileal cells. J Clin Invest. 1983 Mar;71(3):440–448. doi: 10.1172/JCI110788. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Kellow J. E., Borody T. J., Phillips S. F., Haddad A. C., Brown M. L. Sulfapyridine appearance in plasma after salicylazosulfapyridine. Another simple measure of intestinal transit. Gastroenterology. 1986 Aug;91(2):396–400. doi: 10.1016/0016-5085(86)90574-3. [DOI] [PubMed] [Google Scholar]
  13. Madara J. L., Trier J. S. Structural abnormalities of jejunal epithelial cell membranes in celiac sprue. Lab Invest. 1980 Sep;43(3):254–261. [PubMed] [Google Scholar]
  14. Maxton D. G., Bjarnason I., Reynolds A. P., Catt S. D., Peters T. J., Menzies I. S. Lactulose, 51Cr-labelled ethylenediaminetetra-acetate, L-rhamnose and polyethyleneglycol 400 [corrected] as probe markers for assessment in vivo of human intestinal permeability. Clin Sci (Lond) 1986 Jul;71(1):71–80. doi: 10.1042/cs0710071. [DOI] [PubMed] [Google Scholar]
  15. Menzies I. S., Mount J. N., Wheeler M. J. Quantitative estimation of clinically important monosaccharides in plasma by rapid thin layer chromatography. Ann Clin Biochem. 1978 Mar;15(2):65–76. doi: 10.1177/000456327801500116. [DOI] [PubMed] [Google Scholar]
  16. O'Morain C. A., Abelow A. C., Chervu L. R., Fleischner G. M., Das K. M. Chromium 51-ethylenediaminetetraacetate test: a useful test in the assessment of inflammatory bowel disease. J Lab Clin Med. 1986 Nov;108(5):430–435. [PubMed] [Google Scholar]
  17. Peters T. J., Hoffbrand A. V. Absorption of vitamin B 12 by the guinea-pig. I. Subcellular localization of vitamin B 12 in the ileal enterocyte during absorption. Br J Haematol. 1970 Sep;19(3):369–382. doi: 10.1111/j.1365-2141.1970.tb01634.x. [DOI] [PubMed] [Google Scholar]
  18. Rask-Madsen J., Schwartz M. Absorption of 51Cr-EDTA in ulcerative colitis following rectal instillation. Scand J Gastroenterol. 1970;5(5):361–368. [PubMed] [Google Scholar]
  19. TRUELOVE S. C., WITTS L. J. Cortisone in ulcerative colitis; final report on a therapeutic trial. Br Med J. 1955 Oct 29;2(4947):1041–1048. doi: 10.1136/bmj.2.4947.1041. [DOI] [PMC free article] [PubMed] [Google Scholar]

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