Skip to main content
Gut logoLink to Gut
. 1974 Jan;15(1):1–8. doi: 10.1136/gut.15.1.1

Amino acid and peptide absorption in patients with coeliac disease and dermatitis herpetiformis

D B A Silk, Parveen J Kumar, D Perrett, M L Clark, A M Dawson
PMCID: PMC1412941  PMID: 4820629

Abstract

A double-lumen perfusion technique has been used to study amino acid and peptide absorption in eight normal control subjects, 13 patients with untreated adult coeliac disease, and 16 patients with dermatitis herpetiformis who had varying morphological abnormalities of the small bowel. All subjects were perfused with isotonic solutions containing 10 mM glycyl-L-alanine and 10 mM glycine + 10 mM L-alanine.

Patients with adult coeliac disease had impaired absorption of glycine (p < 0·01) and L-alanine (p < 0·05) from the amino acid solution compared with the control subjects. Amino acid uptake from the dipeptide solution was not significantly impaired, although four individual patients had impaired uptake of both amino acids. In contrast to these findings, very few patients with dermatitis herpetiformis had impaired amino acid absorption from either solution.

Sodium absorption was impaired from both solutions when the groups of patients with adult coeliac disease and dermatitis herpetiformis with subtotal villous atrophy and partial villous atrophy were studied, and there were patients in each group who secreted sodium and water.

The results suggest that malabsorption of dietary protein is unlikely to occur in dermatitis herpetiformis but may occur and contribute to protein deficiency seen in some severe cases of adult coeliac disease. The impairment of sodium and water absorption provides evidence that there may be functional impairment of the jejunal mucosa in dermatitis herpetiformis as well as in adult coeliac disease.

Full text

PDF
2

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adibi S. A. Intestinal transport of dipeptides in man: relative importance of hydrolysis and intact absorption. J Clin Invest. 1971 Nov;50(11):2266–2275. doi: 10.1172/JCI106724. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Asatoor A. M., Cheng B., Edwards K. D., Lant A. F., Matthews D. M., Milne M. D., Navab F., Richards A. J. Intestinal absorption of two dipeptides in Hartnup disease. Gut. 1970 May;11(5):380–387. doi: 10.1136/gut.11.5.380. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Berg N. O., Dahlqvist A., Lindberg T., Nordén A. Intestinal dipeptidases and disaccharidases in celiac disease in adults. Gastroenterology. 1970 Oct;59(4):575–582. [PubMed] [Google Scholar]
  4. Brow J. R., Parker F., Weinstein W. M., Rubin C. E. The small intestinal mucosa in dermatitis herpetiformis. I. Severity and distribution of the small intestinal lesion and associated malabsorption. Gastroenterology. 1971 Mar;60(3):355–361. [PubMed] [Google Scholar]
  5. CRANE C. W., NEUBERGER A. Absorption and elimination of 15-N after administration of isotopically labelled yeast protein and yeast protein hydrolysate to adult patients with coeliac disease. 1. Rate of absorption of 15-N yeast protein and yeast protein hydrolysate. Br Med J. 1960 Sep 17;2(5202):815–823. doi: 10.1136/bmj.2.5202.815. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. CRANE C. W., NEUBERGER A. Absorption and elimination of 15N after administration of isotopically labelled yeast protein and yeast protein hydrolysate to adult patients with coeliac disease. 2. Elimination of isotope in the urine and faeces. Br Med J. 1960 Sep 24;2(5203):888–894. doi: 10.1136/bmj.2.5203.888. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. CROSBY W. H., KUGLER H. W. Intraluminal biopsy of the small intestine; the intestinal biopsy capsule. Am J Dig Dis. 1957 May;2(5):236–241. doi: 10.1007/BF02231100. [DOI] [PubMed] [Google Scholar]
  8. Craft I. L., Geddes D., Hyde C. W., Wise I. J., Matthews D. M. Absorption and malabsorption of glycine and glycine peptides in man. Gut. 1968 Aug;9(4):425–437. doi: 10.1136/gut.9.4.425. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Douglas A. P., Booth C. C. Post-prandial plasma-free amino acids in adult coeliac disease after oral gluten and albumin. Clin Sci. 1969 Dec;37(3):643–653. [PubMed] [Google Scholar]
  10. Douglas A. P., Peters T. J. Peptide hydrolase activity of human intestinal mucosa in adult coeliac disease. Gut. 1970 Jan;11(1):15–17. doi: 10.1136/gut.11.1.15. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Fordtran J. S., Rector F. C., Locklear T. W., Ewton M. F. Water and solute movement in the small intestine of patients with sprue. J Clin Invest. 1967 Mar;46(3):287–298. doi: 10.1172/JCI105531. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. HOLDSWORTH C. D., DAWSON A. M. THE ABSORPTION OF MONOSACCHARIDES IN MAN. Clin Sci. 1964 Dec;27:371–379. [PubMed] [Google Scholar]
  13. Hellier M. D., Holdsworth C. D., McColl I., Perrett D. Dipeptide absorption in man. Gut. 1972 Dec;13(12):965–969. doi: 10.1136/gut.13.12.965. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Hellier M. D., Thirumalai C., Holdsworth C. D. The effect of amino acids and dipeptides on sodium and water absorption in man. Gut. 1973 Jan;14(1):41–45. doi: 10.1136/gut.14.1.41. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Lindberg T., Nordén A., Josefsson L. Intestinal dipeptidases. Dipeptidase activities in small intestinal biopsy specimens from a clinical material. Scand J Gastroenterol. 1968;3(2):177–182. doi: 10.3109/00365526809180119. [DOI] [PubMed] [Google Scholar]
  16. Matthews D. M., Craft I. L., Geddes D. M., Wise I. J., Hyde C. W. Absorption of glycine and glycine peptides from the small intestine of the rat. Clin Sci. 1968 Dec;35(3):415–424. [PubMed] [Google Scholar]
  17. Purdie J. W., Gravelle R. A., Hanafi D. E. Sulfur-containing amino acids. II. Chromatography of disulfides and trisulfides with an automatic analyzer. J Chromatogr. 1968 Dec 3;38(3):346–350. doi: 10.1016/0021-9673(68)85056-3. [DOI] [PubMed] [Google Scholar]
  18. RICHMOND J., GIRDWOOD R. H. Observations on aminoacid absorption. Clin Sci. 1962 Jun;22:301–314. [PubMed] [Google Scholar]
  19. Rubino A., Field M., Shwachman H. Intestinal transport of amino acid residues of dipeptides. I. Influx of the glycine residue of glycyl-L-proline across mucosal border. J Biol Chem. 1971 Jun 10;246(11):3542–3548. [PubMed] [Google Scholar]
  20. Russell R. I., Allan J. G., Gerskowitch V. P., Robertson J. W. A study by perfusion techniques of the absorption abnormalities in the jejunum in adult coeliac disease. Clin Sci. 1972 Jun;42(6):735–741. doi: 10.1042/cs0420735. [DOI] [PubMed] [Google Scholar]
  21. SCHEDL H. P., CLIFTON J. A. SOLUTE AND WATER ABSORPTION BY THE HUMAN SMALL INTESTINE. Nature. 1963 Sep 28;199:1264–1267. doi: 10.1038/1991264a0. [DOI] [PubMed] [Google Scholar]
  22. Sadikali F. Dipeptidase deficiency and malabsorption of glycylglycine in disease states. Gut. 1971 Apr;12(4):276–283. doi: 10.1136/gut.12.4.276. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Schedl H. P., Pierce C. E., Rider A., Clifton J. A. Absorption of L-methionine from the human small intestine. J Clin Invest. 1968 Feb;47(2):417–425. doi: 10.1172/JCI105738. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Schedl H. P. Use of polyethylene glycol and phenol red as unabsorbed indicators for intestinal absorption studies in man. Gut. 1966 Apr;7(2):159–163. doi: 10.1136/gut.7.2.159. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Schmid W. C., Phillips S. F., Summerskill W. H. Jejunal secretion of electrolytes and water in nontropical sprue. J Lab Clin Med. 1969 May;73(5):772–783. [PubMed] [Google Scholar]
  26. Silk D. B., Perrett D., Clark M. L. Intestinal transport of two dipeptides containing the same two neutral amino acids in man. Clin Sci Mol Med. 1973 Sep;45(3):291–299. doi: 10.1042/cs0450291. [DOI] [PubMed] [Google Scholar]
  27. Sladen G. E., Dawson A. M. Further studies on the perfusion method for measuring intestinal absorption in man: the effects of a proximal occlusive balloon and a mixing segment. Gut. 1970 Nov;11(11):947–954. doi: 10.1136/gut.11.11.947. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Sladen G. E., Dawson A. M. Interrelationships between the absorptions of glucose, sodium and water by the normal human jejunum. Clin Sci. 1969 Feb;36(1):119–132. [PubMed] [Google Scholar]
  29. Stewart J. S., Pollock D. J., Hoffbrand A. V., Mollin D. L., Booth C. C. A study of proximal and distal intestinal structure and absorptive function in idiopathic steatorrhoea. Q J Med. 1967 Jul;36(143):425–444. [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES