Abnormal Small Intestinal Permeability in Patients with Idiopathic Malabsorption in Tropics (Tropical Sprue) Does Not Change Even After Successful Treatment

Kumar, Sunil; Ghoshal, Uday C; Jayalakshmi, K.; Roy, Raja; Misra, Asha; Khetrapal, C. L.

doi:10.1007/s10620-010-1232-3

Cited by 17 publications

(13 citation statements)

References 36 publications

(47 reference statements)

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“…In routine NMR based metabonomic studies, native as well as lyophilized human urine [43][44][45][46][47][48][49] samples are used. It has been shown earlier that lyophilization 41 reconstruction.…”

Section: Verification Of the Methods By Spike-in Experimentsmentioning

confidence: 99%

Fast and Accurate Quantitative Metabolic Profiling of Body Fluids by Nonlinear Sampling of ¹H–¹³C Two-Dimensional Nuclear Magnetic Resonance Spectroscopy

Kumar

Sinha

2012

Anal. Chem.

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Two-dimensional (2D) nuclear magnetic resonance (NMR) methods have shown to be an excellent analytical tool for the identification and characterization of statistically relevant changes in low-abundance metabolites in body fluid. The advantage of 2D NMR in terms of minimized ambiguities in peak assignment, aided in metabolite identifications and comprehensive metabolic profiling comes with the cost of increased NMR data collection time; making it inconvenient choice for routine metabolic profiling. We present here a method for the reduction in NMR data collection time of 2D (1)H-(13)C NMR spectroscopy for the purpose of quantitative metabolic profiling. Our method combines three techniques; which are nonlinear sampling (NLS), forward maximum (FM) entropy reconstruction, and J-compensated quantitative heteronuclear single quantum (HSQC) (1)H-(13)C NMR spectra. We report here that approximately 22-fold reduction in 2D NMR data collection time for the body fluid samples can be achieved by this method, without any compromise in quantitative information recovery of various low abundance metabolites. The method has been demonstrated in standard mixture solution, native, and lyophilized human urine samples. Our proposed method has potential to make quantitative metabolic profiling by 2D NMR as a routine method for various metabonomic studies.

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Section: Verification Of the Methods By Spike-in Experimentsmentioning

confidence: 99%

Fast and Accurate Quantitative Metabolic Profiling of Body Fluids by Nonlinear Sampling of ¹H–¹³C Two-Dimensional Nuclear Magnetic Resonance Spectroscopy

Kumar

Sinha

2012

Anal. Chem.

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“…Increased small intestinal permeability (SIP) has been implicated in the pathogenesis of various diseases such as autoimmune diseases, 1 coeliac disease, 2 Crohn's disease, 3 irritable bowel syndrome 4 and tropical sprue. 5 SIP is increased in patients with cirrhosis. [6][7][8][9] Increased SIP may predispose to malnutrition and bacterial translocation leading to endotoxaemia, septicaemia and spontaneous Tropical Gastroenterology 2013; 34(3):136-143 bacterial peritonitis.…”

Section: Introductionmentioning

confidence: 91%

Frequency and factors associated with increased small intestinal permeability in patients with portal hypertension

Goyal¹

2013

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Aim: Cirrhosis with portal hypertension (PHT) may be associated with increased small intestinal permeability (SIP), predisposing to malnutrition and bacterial translocation causing septicaemia, endotoxaemia and spontaneous bacterial peritonitis. However, data on SIP in extrahepatic portal venous obstruction (EHPVO), in which PHT occurs without hepatic dysfunction, are scanty. Such studies would help to know the effect of PHT on SIP independent of hepatic dysfunction; hence, we undertook this study. Methods: A total of 96 patients with PHT (cirrhosis 71, EHPVO 25) underwent evaluation of SIP using urinary lactulose/mannitol excretion ratio over 6 hours after oral administration of 15 mL (10 g) lactulose and 5 g mannitol using 1H-NMR spectroscopy by a method described by us previously. Results: Gender of patients with EHPVO and cirrhosis was comparable but patients with EHPVO were younger in age. The causes of cirrhosis were cryptogenic (n=22), alcohol (n=20), post-viral (n=21) and others (n=8). Twenty-seven (38%) patients with cirrhosis had ascites. Abnormal SIP was detected in 47 (49%) patients (40/71, 56% with cirrhosis vs. 7/25, 28% with EHPVO, p=0.01). Patients with cirrhosis had a higher urinary lactulose/mannitol excretion ratio than those with EHPVO (0.09, range 0-0.87 mmol vs. 0.05, 0-0.19 mmol; p=0.008). Patients with abnormal SIP had a higher Child score, and more often had cirrhosis than EHPVO, ascites and deranged liver function. On multivariate analysis, presence of cirrhosis, ascites, high serum bilirubin level and prothrombin time were associated with abnormal SIP. Conclusions: Cirrhosis was associated with abnormal SIP, which was related to liver dysfunction. However, SIP was normal in patients with EHPVO.

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Section: Introductionmentioning

confidence: 91%

“…Abnormal SIP was also reported in several other diseases, which primarily affect small intestinal mucosa such as coeliac disease, 20 Crohn's disease, 21 small intestinal bacterial overgrowth (SIBO), 22,23 and tropical sprue. 5 In these conditions, abnormal SIP might be due to direct damage to intestinal epithelial cells and the tight junctions between these cells. 24,25 In patients with cirrhosis of liver, however, damage to the tight junctions in the small intestinal epithelium might be related to retention of substances that are toxic to small intestinal mucosa, which are normally metabolized by the healthy liver.…”

Section: 17mentioning

confidence: 99%

“…Abnormal SIP may contribute to this as in other diseases such as tropical sprue; also, abnormal SIP has been shown to be associated with malnutrition. 5 Increased permeability of intestinal tight junctions, retention of endotoxin and increased apoptosis have been implicated in the pathogenesis of primary biliary cirrhosis 36 and alcoholic cirrhosis. 8 In an earlier study, our group standardized the estimation of lactulose and mannitol in urine by 1H-NMR spectroscopy for assessment of SIP.…”

Section: 17mentioning

confidence: 99%

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Frequency and factors associated with increased small intestinal permeability in patients with portal hypertension

Goyal¹

2013

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Aim: Cirrhosis with portal hypertension (PHT) may be associated with increased small intestinal permeability (SIP), predisposing to malnutrition and bacterial translocation causing septicaemia, endotoxaemia and spontaneous bacterial peritonitis. However, data on SIP in extrahepatic portal venous obstruction (EHPVO), in which PHT occurs without hepatic dysfunction, are scanty. Such studies would help to know the effect of PHT on SIP independent of hepatic dysfunction; hence, we undertook this study.Methods: A total of 96 patients with PHT (cirrhosis 71, EHPVO 25) underwent evaluation of SIP using urinary lactulose/mannitol excretion ratio over 6 hours after oral administration of 15 mL (10 g) lactulose and 5 g mannitol using 1H-NMR spectroscopy by a method described by us previously.Results: Gender of patients with EHPVO and cirrhosis was comparable but patients with EHPVO were younger in age. The causes of cirrhosis were cryptogenic (n=22), alcohol (n=20), post-viral (n=21) and others (n=8). Twenty-seven (38%) patients with cirrhosis had ascites. Abnormal SIP was detected in 47 (49%) patients (40/71, 56% with cirrhosis vs. 7/25, 28% with EHPVO, p=0.01). Patients with cirrhosis had a higher urinary lactulose/mannitol excretion ratio than those with EHPVO (0.09, range 0-0.87 mmol vs. 0.05, 0-0.19 mmol; p=0.008). Patients with abnormal SIP had a higher Child score, and more often had cirrhosis than EHPVO, ascites and deranged liver function. On multivariate analysis, presence of cirrhosis, ascites, high serum bilirubin level and prothrombin time were associated with abnormal SIP. Conclusions: Cirrhosis was associated with abnormal SIP, which was related to liver dysfunction. However, SIP was normal in patients with EHPVO.

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Abnormal Small Intestinal Permeability in Patients with Idiopathic Malabsorption in Tropics (Tropical Sprue) Does Not Change Even After Successful Treatment

Abstract: SIP is often abnormal in TS and remains unchanged even after successful treatment that was associated with less weight gain and more frequent stool.

Cited by 17 publications

References 36 publications

Fast and Accurate Quantitative Metabolic Profiling of Body Fluids by Nonlinear Sampling of ¹H–¹³C Two-Dimensional Nuclear Magnetic Resonance Spectroscopy

Fast and Accurate Quantitative Metabolic Profiling of Body Fluids by Nonlinear Sampling of ¹H–¹³C Two-Dimensional Nuclear Magnetic Resonance Spectroscopy

Frequency and factors associated with increased small intestinal permeability in patients with portal hypertension

Frequency and factors associated with increased small intestinal permeability in patients with portal hypertension

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Abnormal Small Intestinal Permeability in Patients with Idiopathic Malabsorption in Tropics (Tropical Sprue) Does Not Change Even After Successful Treatment

Abstract: SIP is often abnormal in TS and remains unchanged even after successful treatment that was associated with less weight gain and more frequent stool.

Cited by 17 publications

References 36 publications

Fast and Accurate Quantitative Metabolic Profiling of Body Fluids by Nonlinear Sampling of 1H–13C Two-Dimensional Nuclear Magnetic Resonance Spectroscopy

Fast and Accurate Quantitative Metabolic Profiling of Body Fluids by Nonlinear Sampling of 1H–13C Two-Dimensional Nuclear Magnetic Resonance Spectroscopy

Frequency and factors associated with increased small intestinal permeability in patients with portal hypertension

Frequency and factors associated with increased small intestinal permeability in patients with portal hypertension

Contact Info

Product

Resources

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Fast and Accurate Quantitative Metabolic Profiling of Body Fluids by Nonlinear Sampling of ¹H–¹³C Two-Dimensional Nuclear Magnetic Resonance Spectroscopy

Fast and Accurate Quantitative Metabolic Profiling of Body Fluids by Nonlinear Sampling of ¹H–¹³C Two-Dimensional Nuclear Magnetic Resonance Spectroscopy