Gut permeability to lactulose and mannitol differs in treated Crohn's disease and celiac disease patients and healthy subjects

Lima

et al. 2013

Arq. Gastroenterol.

-Context -Glutamine is the main source of energy of the enterocyte and diarrhea and weight loss are frequent in HIV infected patients. Objective -To determine the effect of alanyl-glutamine supplementation on intestinal permeability and absorption in these patients. Methods -Randomized double-blinded, placebo-controlled study using isonitrogenous doses of alanyl-glutamine (24 g/day) and placebo (glycine, 25 g/day) during 10 days. Before and after this nutritional supplementation lactulose and mannitol urinary excretion were determined by high performance liquid chromatography. Results -Forty six patients with HIV/AIDS, 36 of whom were male, with 37.28 ± 3 (mean ± standard error) years were enrolled. Twenty two and 24 subjects were treated with alanyl-glutamine and with glycine respectively. In nine patients among all in the study protocol that reported diarrhea in the 14 days preceding the beginning of the study, mannitol urinary excretion was significantly lower than patients who did not report this symptom [median (

Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Acknowledgmentsunclassified

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Improvement of Intestinal Permeability With Alanyl-Glutamine in Hiv Patients:

Lima

et al. 2013

Arq. Gastroenterol.

“…The shortest mean doubling time was found for combination of indigenous isolate AdF10 and lactulose in this study (Table 2). Previous studies reported the positive effect of lactulose in combination with probiotic bacteria in treating intestinal disturbances (Gibson, Probert, Loo, Rastall, & Roberfroid, 2004;Guerra-Ordaz et al, 2014;Panesar & Kumari, 2011;Salminen & Salminen, 1997;Vilela, Torres, Ferrari, Lima, & Cunha, 2008).…”

Section: Discussionmentioning

confidence: 99%

Effect of prebiotics on growth behavior of Lactobacillus plantarum and their impact on adherence of strict anaerobic pathogens to intestinal cell lines

Sharma

Kanwar

2017

Journal of Food Safety

This study aimed to examine the influence of prebiotics on growth and activity of Lactobacillus plantarum and their effect on adherence of anaerobic pathogens to Caco-2 and HT-29 intestinal cell lines. The specific growth rate of indigenous L. plantarum in lactulose (0.51/hr) was found to be maximum followed by fructooligosaccharide (0.34/hr) and inulin (0.18/hr) which was statistically at par with reference strain. Shortest mean doubling time of indigenous strain was observed with lactulose (1 hr 35 min) followed by fructooligosaccharide (2 hr 3 min), and inulin (3 hr 85 min). Lactic and short-chain fatty acids namely, acetic, propionic, and butyric were the principle metabolites observed after fermentation of prebiotics as detected by ultra-performance liquid chromatography analysis. No significant change in growth and pH of anaerobic pathogens was observed in medium supplemented with different prebiotics. Presence of lactulose showed maximum inhibition in adherence of anaerobic pathogens namely, Peptostreptococcus anaerobius (39 and 37%), Clostridium perfringens (36 and 34%), and Bacteroides fragilis (18 and16%), to Caco-2 and HT-29 intestinal cell lines. Practical applicationsThe ability of certain bacteria to ferment prebiotics selectively is an important probiotic characteristic. According to the results of this study, lactulose was found to be the promising ingredient in combination with indigenous strain that not only supported the growth of lactobacillus strain, but also inhibited the adherence of anaerobic pathogens to intestinal cell lines. The metabolites produced on fermentation of prebiotic such as lactate, acetate, propionate, and butyrate have many reported health benefits in boosting the gut immunity of the host. Negligible growth of anaerobic pathogens in lactulose indicating its safe use without any ill effect to the host. Thus, the lactulose might have a potential for practical use in food industry for the development of future functional and dietary foods to impart health benefits at both colonic and systemic levels.

Journal of Crohn's and Colitis

“…Other factors, which support the use of the lactulose/mannitol test are the existing long clinical experience with these two non-toxic, not metabolized carbohydrates and that possible interfering factors like renal insufficiency or short bowel syndrome are corrected by the measurement of two independent substances. Up to now, there are only limited data on this test in CD 1,40,41 and results after anti-TNF-α are completely missing. Our study clearly showed that lactulose/mannitol ratios could serve as a good clinical marker for an effect of anti-TNF-α treatment on mucosal permeability.…”

Section: Discussionmentioning

confidence: 99%

Anti-TNF-α antibodies improve intestinal barrier function in Crohn's disease

Noth

Stüber

Häsler

et al. 2012

Background and aims: Intestinal barrier function in Crohn's disease patients and their first degree healthy relatives is impaired. The increased intestinal permeability may result in an enhanced mucosal immune response and thereby aggravate intestinal inflammation. Humanised anti-TNF-α antibodies have been shown to be effective in the treatment of active Crohn's disease and in the treatment of entero-cutaneous fistula. The aim of the present study was to investigate the influence of anti-TNF-α antibody (infliximab) treatment on the intestinal barrier function of patients with active Crohn's disease. Methods: The differential intestinal uptake of lactulose and mannitol was measured to quantify intestinal permeability in patients with long standing active Crohn's disease (n = 17) directly before and seven days after treatment with infliximab (5 mg/kg bodyweight). In parallel, intestinal permeability was studied in a healthy control group (n = 20). Serum samples were analysed with pulsed amperometric detection after separation on an anion exchange column. Results: Intestinal permeability was significantly increased in all patients with Crohn's disease (L/M ratio 0.24 ± 0.17) prior to infliximab treatment compared to the control group (L/M ratio 0.01 ± 0.02; p-value b 1 × 10 − 7 ). Treatment of patients with infliximab resulted in a marked decrease of intestinal permeability as measured by L/M ratio from 0.24 ± 0.17 before to 0.02 ± 0.02 (p-value b 1 × 10 − 7 ) seven days after infliximab application.Conclusions: Treatment with anti-TNF-α antibodies improved impaired intestinal barrier function in patients with Crohn's disease. This effect may correlate to the well documented antiinflammatory effect of TNF-α blockade in this intestinal disease.