Alterations of Intestinal Permeability to Sugars in Infants Following Neonatal Surgery

Dupont, Christophe; Goutail-Flaud, M F

doi:10.1097/00005176-199007000-00014

Cited by 15 publications

(6 citation statements)

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“…One potential triggering mechanism to allergic GI disease in IF is increased intestinal permeability (17). Although animal studies have not consistently demonstrated increased mucosal permeability in IF models, clinical studies have supported this relation (18)(19)(20). Furthermore, elemental diets have also been associated with improved outcomes in infants with IF in multiple small case series, suggesting that intestinal adaptation may be enhanced by diets low in intact protein antigens (21,22).…”

Section: Discussionmentioning

confidence: 99%

High Prevalence of Eosinophilic Gastrointestinal Disease in Children With Intestinal Failure

Stamm¹,

Hait²,

Litman

et al. 2016

J. pediatr. gastroenterol. nutr.

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Objectives To describe the prevalence and clinical features of gastrointestinal eosinophilic inflammation among pediatric patients with intestinal failure (IF). Methods Medical records of all patients followed in our institution's intestinal failure program who underwent GI endoscopy over a 15 year period were reviewed and clinical, pathologic, nutrition and laboratory data collected. Results One hundred and five patients underwent 208 GI endoscopic procedures with biopsy. The overall prevalence of eosinophilic inflammation, defined as increased eosinophils in at least one tissue type on at least one endoscopy, was 39/105 (37%). The tissue-specific prevalence of eosinophilic inflammation ranged widely, with the colon/rectosigmoid being the most common (18/68, 26%), followed by the esophagus (17/83, 20%), ileum (9/54, 17%), duodenum (4/83, 5%), and stomach (3/83, 4%). Higher peripheral eosinophil count and hematochezia were associated with eosinophilic inflammation in the colon (p=0.002 and 0.0004, respectively). The use of a strict elemental diet for 3 months prior to endoscopy was not associated with a decreased frequency of eosinophilic inflammation in any tissue. Conclusions Eosinophilic inflammation is a common histopathologic finding in IF patients. Colonic eosinophilic inflammation is associated with clinical symptoms of GI blood loss, and peripheral eosinophilia, and was not abrogated by a strict elemental diet.

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Section: Discussionmentioning

confidence: 99%

High Prevalence of Eosinophilic Gastrointestinal Disease in Children With Intestinal Failure

Stamm¹,

Hait²,

Litman

et al. 2016

J. pediatr. gastroenterol. nutr.

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“…This reduction occurred despite an oral galactose challenge that was sufficiently high to trigger possible changes in tight junctions and open the paracellular pathway of absorption. Moreover, other studies have shown that NEC increases plasma concentrations of inflammatory cytokines, such as tumor necrosis factor-␣ (TNF-␣), Interleukin (IL)-1␤, IL-6, and IL-8 (24,26,27), which disrupt tight junctions (28,29), are associated with increased paracellular permeability (30), lead to failure of the gut barrier (26), and coincide with increased mucosal permeability to sugars (31). Collectively, these findings lead to the prediction that NEC should increase paracellular movement of solutes, including galactose.…”

Section: Discussionmentioning

confidence: 99%

Aldohexose Malabsorption in Preterm Pigs Is Directly Related to the Severity of Necrotizing Enterocolitis

et al. 2008

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Necrotizing enterocolitis (NEC) causes morbidity and mortality among preterm infants and is associated with nutrient malabsorption. Therefore, a preterm pig model that spontaneously develops NEC was used to investigate the relationship between severity of NEC lesions and galactose absorption in vivo and carriermediated glucose absorption by intact mid small intestine. Preterm pigs collected by caesarian section at 92% of gestation received parenteral nutrition with and without minimal enteral nutrition for 48 h before conversion to enteral nutrition with colostrum or an enteral formula. Pigs were killed when symptoms of NEC were observed or after 36 -40 h of enteral nutrition. NEC lesions decreased in vivo absorption of galactose and mannitol by more than 50% and abolished carrier-mediated glucose uptake by tissues with lesions. Moreover, when NEC lesions were restricted to the colon, small intestinal tissues that seemed clinically healthy had decreased in vitro glucose absorption due to reduced uptake via the sodiumdependent glucose transporter with little or no involvement of the apical facilitative glucose carrier. The present findings reveal a direct relationship between the severity of NEC lesions and the magnitude of sugar malabsorption that is detectable before clinical symptoms are evident. (Pediatr Res 63: 382-387, 2008)

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“…Comparative measurement of the urinary excretion of orally absorbed non-metabolizable sugars, lactulose or lactitol (L), a marker of larger molecule absorption and mannitol (M), a marker of small molecule absorption, allows the detection of alteration of intestinal permeability (IP) in intestinal conditions such as cystic brosis, in ammatory bowel disease, coeliac disease, digestive surgery, small-bowel bacterial overgrowth, parasitic or infectious gastroenteritis and diabetes mellitus type I (1)(2)(3)(4)(5)(6)(7)(8)(9).…”

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confidence: 99%

Intestinal permeability in children: variation with age and reliability in the diagnosis of cow's milk allergy

et al. 2001

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Kalach N, Rocchiccioli F, de Boissieu D, Benhamou PH, Dupont C. Intestinal permeability in children: variation with age and reliability in the diagnosis of cow's milk allergy. Acta Paediatr 2001; 90: 499-504. Stockholm. ISSN 0803-5253 Objective: To analyse to what extent age may alter intestinal permeability (IP) in children and to assess its reliability according to clinical manifestations in cow's milk allergy (CMA). Design: A routine prospective study was performed in 200 children (12.5 § 23 mo, 0.5-168 mo) presenting with clinical manifestations suggesting CMA. Controls (n = 105) were those with a negative cow's milk challenge, whereas CMA children (n = 95) ful lled ESPGHAN criteria. Permeability was measured as a percentage of urinary excretion of lactitol (L, %) and mannitol (M, %) (0.1 g/kg for each, oral absorption after a 6 h fast, 5 h urine collection, analysis by gas chromatography) and determination of the L/M ratio (L/M, %). Results: In control children, L/M correlated negatively with age (r ¡0.33, p = 0.0006), whereas in those with CMA no correlation was found. Median L/M was signi cantly higher in CMA children (n = 95) than in controls (n = 105), 4.35 § 7.57% (95% CI 5.30-8.39%) vs 1.97 § 0.87% (95% CI 1.76-2.09%), (p = 0.0001). With a L/M cut-off value de ned as mean ‡ 2 SD of controls, in CMA IP exhibited a 68% sensitivity and a 77% negative predictive value. The highest sensitivity (70%) was seen at ages 6-12 mo and the lowest (58%) at age more than 3 y. An abnormal IP was seen in 80% of CMA children with digestive manifestations, in 43% with extra-digestive, 68% with mixed and 40% with anaphylactic manifestations.Conclusion: IP correlates negatively with age in control children and is altered in children with CMA. The test is at its most accurate in the diagnosis of CMA when done at ages 6-12 mo, when there are digestive manifestations.

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Alterations of Intestinal Permeability to Sugars in Infants Following Neonatal Surgery

Cited by 15 publications

References 0 publications

High Prevalence of Eosinophilic Gastrointestinal Disease in Children With Intestinal Failure

High Prevalence of Eosinophilic Gastrointestinal Disease in Children With Intestinal Failure

Aldohexose Malabsorption in Preterm Pigs Is Directly Related to the Severity of Necrotizing Enterocolitis

Intestinal permeability in children: variation with age and reliability in the diagnosis of cow's milk allergy

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