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Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1990 Jul;43(7):537–540. doi: 10.1136/jcp.43.7.537

Activity of duodenal disaccharidases in relation to normal and abnormal mucosal morphology.

J M Langman 1, R Rowland 1
PMCID: PMC502575  PMID: 2116456

Abstract

Endoscopic duodenal biopsy specimens from 100 predominantly adult Caucasian patients under investigation for gastrointestinal symptoms were used to establish reference ranges for lactase, sucrase, and maltase in the duodenum. Duodenal and jejunal disaccharidase values were compared and the association between disaccharidase activity and morphology in the duodenum was examined. Mean lactase activities were about 40% lower in the duodenum compared with the jejunum; maltase was reduced to a lesser extent; and sucrase activities were much the same in the two sites. Lactase deficiency was found in 24 patients of whom 14 (58%) had duodenal disease. The presence of moderate to severe duodenal lesions was associated with a significant decrease in all disaccharidase activities, while only lactase was reduced in mild lesions. Twelve patients had normal lactase activity, despite the presence of duodenal disease. It is concluded that specific reference ranges for duodenal mucosal disaccharidase activity are required as this is less than that of jejunum. Reduced duodenal disaccharidase activity is usually but not invariably associated with morphological abnormality.

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Selected References

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

  1. Asp N. G., Gudmand-Höyer E., Andersen B., Berg N. O., Dahlqvist A. Distribution of disaccharidases, alkaline phosphatase, and some intracellular enzymes along the human small intestine. Scand J Gastroenterol. 1975;10(6):647–651. [PubMed] [Google Scholar]
  2. Berg N. O., Dahlqvist A., Lindberg T., Nordén A. Correlation between morphological alterations and enzyme activities in the mucosa of the small intestine. Scand J Gastroenterol. 1973;8(8):703–712. [PubMed] [Google Scholar]
  3. Bergoz R., Griessen M., Infante F., de Peyer R., Vallotton M. C. Significance of duodenal disaccharidases. A comparative study of duodenal and jejunal values. Digestion. 1981;22(2):108–112. doi: 10.1159/000198604. [DOI] [PubMed] [Google Scholar]
  4. Calvin R. T., Klish W. J., Nichols B. L. Disaccharidase activities, jejunal morphology, and carbohydrate tolerance in children with chronic diarrhea. J Pediatr Gastroenterol Nutr. 1985 Dec;4(6):949–953. doi: 10.1097/00005176-198512000-00016. [DOI] [PubMed] [Google Scholar]
  5. Dahlquist A., Semenza G. Disaccharidases of small-intestinal mucosa. J Pediatr Gastroenterol Nutr. 1985 Dec;4(6):857–865. doi: 10.1097/00005176-198512000-00002. [DOI] [PubMed] [Google Scholar]
  6. Dahlqvist A. Assay of intestinal disaccharidases. Anal Biochem. 1968 Jan;22(1):99–107. doi: 10.1016/0003-2697(68)90263-7. [DOI] [PubMed] [Google Scholar]
  7. Gillberg R., Kastrup W., Mobacken H., Stockbrügger R., Ahrén C. Endoscopic duodenal biopsy compared with biopsy with the Watson capsule from the upper jejunum in patients with dermatitis herpetiformis. Scand J Gastroenterol. 1982 Mar;17(2):305–308. doi: 10.3109/00365528209182058. [DOI] [PubMed] [Google Scholar]
  8. Harrison M., Walker-Smith J. A. Reinvestigation of lactose intolerant children: lack of correlation between continuing lactose intolerance and small intestinal morphology, disaccharidase activity, and lactose tolerance tests. Gut. 1977 Jan;18(1):48–52. doi: 10.1136/gut.18.1.48. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Jennings W., Rowland R., Hecker R., Gibson G. E., Fitch R. J., Reid D. P. The significance of lowered jejunal disaccharidase levels. Aust N Z J Med. 1976 Dec;6(6):556–560. doi: 10.1111/j.1445-5994.1976.tb03994.x. [DOI] [PubMed] [Google Scholar]
  10. Jönsson K. A., Bodemar G., Tagesson C., Walan A. Variation of disaccharidase activities in duodenal biopsy specimens. Scand J Gastroenterol. 1986 Jan;21(1):51–54. doi: 10.3109/00365528609034621. [DOI] [PubMed] [Google Scholar]
  11. Keane R., O'Grady J. G., Sheil J., Stevens F. M., Egan-Mitchell B., McNicholl B., McCarthy C. F., Fottrell P. F. Intestinal lactase, sucrase and alkaline phosphatase in relation to age, sex and site of intestinal biopsy in 477 Irish subjects. J Clin Pathol. 1983 Jan;36(1):74–77. doi: 10.1136/jcp.36.1.74. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Lee J. H., Griffiths W. J., Zantout I., Welsh J. D. Adequacy of endoscopic biopsy specimens for disaccharidase assays. Am J Dig Dis. 1978 Dec;23(12):1129–1131. doi: 10.1007/BF01072890. [DOI] [PubMed] [Google Scholar]
  13. McMichael H. B., Webb J., Dawson A. M. Jejunal disaccharidases and some observations on the cause of lactase deficiency. Br Med J. 1966 Oct 29;2(5521):1037–1041. doi: 10.1136/bmj.2.5521.1037. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Newcomer A. D., McGill D. B. Distribution of disaccharidase activity in the small bowel of normal and lactase-deficient subjects. Gastroenterology. 1966 Oct;51(4):481–488. [PubMed] [Google Scholar]
  15. Welsh J. D. Isolated lactase deficiency in humans: report on 100 patients. Medicine (Baltimore) 1970 Jul;49(4):257–277. doi: 10.1097/00005792-197007000-00001. [DOI] [PubMed] [Google Scholar]
  16. Welsh J. D., Poley J. R., Bhatia M., Stevenson D. E. Intestinal disaccharidase activities in relation to age, race, and mucosal damage. Gastroenterology. 1978 Nov;75(5):847–855. [PubMed] [Google Scholar]

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