Analysis of PEG 400 and 4000 in urine for gut permeability assessment using solid phase extraction and gel permeation chromatography with refractometric detection

Loret, Suzanne; Nollevaux, Géraldine; Remacle, R; Klimek, Monique; Barakat, Ibrahim; Deloyer, Patricia; Grandfils, Christian; Dandrifosse, Guy

doi:10.1016/j.jchromb.2004.02.033

Cited by 13 publications

(11 citation statements)

References 37 publications

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“… 1 In the current study, both the PEG probes and the sugar probes are expressed as urinary ratios and as single probe excretion rates. PEG probes are not commonly expressed as excretion ratios, 28 , 29 and since the excretion of all three PEG probes increased after indomethacin consumption, the increase in urinary PEG ratios was not very pronounced in this study. Only the PEG 3350/PEG 400 ratio could detect increased gastrointestinal permeability after indomethacin use with accurate sensitivity and specificity.…”

Section: Discussionmentioning

confidence: 51%

Polyethylene glycol versus dual sugar assay for gastrointestinal permeability analysis: is it time to choose?

Wijck¹,

Bessems²,

Eijk³

et al. 2012

CEG

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BackgroundIncreased intestinal permeability is an important measure of disease activity and prognosis. Currently, many permeability tests are available and no consensus has been reached as to which test is most suitable. The aim of this study was to compare urinary probe excretion and accuracy of a polyethylene glycol (PEG) assay and dual sugar assay in a double-blinded crossover study to evaluate probe excretion and the accuracy of both tests.MethodsGastrointestinal permeability was measured in nine volunteers using PEG 400, PEG 1500, and PEG 3350 or lactulose-rhamnose. On 4 separate days, permeability was analyzed after oral intake of placebo or indomethacin, a drug known to increase intestinal permeability. Plasma intestinal fatty acid binding protein and calprotectin levels were determined to verify compromised intestinal integrity after indomethacin consumption. Urinary samples were collected at baseline, hourly up to 5 hours after probe intake, and between 5 and 24 hours. Urinary excretion of PEG and sugars was determined using high-pressure liquid chromatography-evaporative light scattering detection and liquid chromatography-mass spectrometry, respectively.ResultsIntake of indomethacin increased plasma intestinal fatty acid-binding protein and calprotectin levels, reflecting loss of intestinal integrity and inflammation. In this state of indomethacin-induced gastrointestinal compromise, urinary excretion of the three PEG probes and lactulose increased compared with placebo. Urinary PEG 400 excretion, the PEG 3350/PEG 400 ratio, and the lactulose/rhamnose ratio could accurately detect indomethacin-induced increases in gastrointestinal permeability, especially within 2 hours of probe intake.ConclusionHourly urinary excretion and diagnostic accuracy of PEG and sugar probes show high concordance for detection of indomethacin-induced increases in gastrointestinal permeability. This comparative study improves our knowledge of permeability analysis in man by providing a clear overview of both tests and demonstrates equivalent performance in the current setting.

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Section: Discussionmentioning

confidence: 51%

Polyethylene glycol versus dual sugar assay for gastrointestinal permeability analysis: is it time to choose?

Wijck¹,

Bessems²,

Eijk³

et al. 2012

CEG

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show abstract

“…First, PEG is safe and easy to handle. Second, these polymers cover a wide range of molecular sizes, including those of macromolecules, and last, their chromatographic determination is unaffected by the presence of sugars found in food and urine, and subjects are not required to adapt their diet prior to taking the test 31. PEG has been criticized for not being sufficiently sensitive to assess intestinal permeability in some of the more subtle disorders of barrier function due to the low urine excretion levels of PEG 400 32.…”

Section: Discussionmentioning

confidence: 99%

“…Second, these polymers cover a wide range of molecular sizes, including those of macromolecules, and last, their chromatographic determination is unaffected by the presence of sugars found in food and urine, and subjects are not required to adapt their diet prior to taking the test. 31 PEG has been criticized for not being sufficiently sensitive to assess intestinal permeability in some of the more subtle disorders of barrier function due to the low urine excretion levels of PEG 400. 32 However, our results of intestinal permeability for the normal subjects are in agreement with those of a previous study, 31 and when we checked the intestinal permeability twice for the same subject, we found that this method gave very similar results.…”

Section: Discussionmentioning

confidence: 99%

“… 31 PEG has been criticized for not being sufficiently sensitive to assess intestinal permeability in some of the more subtle disorders of barrier function due to the low urine excretion levels of PEG 400. 32 However, our results of intestinal permeability for the normal subjects are in agreement with those of a previous study, 31 and when we checked the intestinal permeability twice for the same subject, we found that this method gave very similar results. Thus, we could verify the reproducibility of this method.…”

Section: Discussionmentioning

confidence: 99%

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The Relationship between Small-Intestinal Bacterial Overgrowth and Intestinal Permeability in Patients with Irritable Bowel Syndrome

Park¹,

Park²,

Kim³

et al. 2009

Gut Liver

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Background/AimsSmall-intestinal bacterial overgrowth (SIBO) is a frequent finding in patients with irritable bowel syndrome (IBS). Many patients with IBS also have abnormal intestinal permeability, which is probably due to low-grade inflammation in the intestinal mucosa. Our aim was to verify the relationship between SIBO and small-intestinal permeability in IBS patients.MethodsA cohort of 38 IBS patients (20 women and 18 men; age range 16-70 years; mean age 40.2 years) with symptoms that fulfilled Rome-II criteria, and 12 healthy controls (5 women and 7 men; age range 25-52 years; mean age: 37.8 years) were recruited. All subjects underwent lactulose breath tests (LBTs) and intestinal permeability tests using the polyethylene glycol (PEG) 3350/400 retrieval ratio.ResultsA positive LBT was found in 18.4% (7/38) of patients with IBS and 8.3% (1/12) of control subjects. Intestinal permeability was significantly increased in patients with IBS compared with the normal controls (0.82±0.09 vs 0.41±0.05 [mean±SD], respectively; p<0.05). However, the intestinal permeability did not differ significantly between IBS patients with a positive LBT and those with a negative LBT (0.90±0.13 and 0.80±0.11, respectively; p>0.05).ConclusionsIntestinal permeability was increased in patients with IBS, but this finding did not correlated with the occurrence of SIBO.

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“…The simultaneous use of two test marker compounds allows the expression of global intestinal permeability as an index reflecting the transfer value of the less permeable test marker (PEG 3350) relative to the most diffusible probe (PEG 400). Since pre-absorption factors such as gastric emptying, dilution by digestive secretions and post-absorption factors such as systemic distribution and renal clearance are assumed to affect both molecules equally, the value of this index should then be directly comparable from one individual to another [30] . It has been suggested that intestinal permeability markers pass through either a transcellular or a paracellular pathway.…”

Section: Cirrhotics Without Ascites (N = 27)mentioning

confidence: 99%

Increased intestinal macromolecular permeability and urine nitrite excretion associated with liver cirrhosis with ascites

Lee¹,

Son²,

Han³

et al. 2008

WJG

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AIM:To determine intestinal permeability, the serum tumor necrosis factor (TNF)-α level and urine nitric oxide (NO) metabolites are altered in liver cirrhosis (LC) with or without ascites. METHODS: Fifty-three patients with LC and 26 healthy control subjects were enrolled in the study. The intestinal permeability value is expressed as the percentage of polyethylene glycol (PEG) 400 and 3350 retrieval in 8-h urine samples as determined by high performance liquid chromatography. Serum TNF-α concentrations and urine NO metabolites were determined using an enzyme-linked immunosorbent assay (ELISA) and Greiss reaction method, respectively. RESULTS: The intestinal permeability index was significantly higher in patients with LC with ascites than in healthy control subjects or patients with LC without ascites (0.88 ± 0.12 vs 0.52 ± 0.05 or 0.53 ± 0.03, P < 0.05) and correlated with urine nitrite excretion (r = 0.98). Interestingly, the serum TNF-α concentration was significantly higher in LC without ascites than in control subjects or in LC with ascites (198.9 ± 55.8 pg/mL vs 40.9 ± 12.3 pg/mL or 32.1 ± 13.3 pg/mL, P < 0.05). Urine nitrite excretion was significantly higher in LC with ascites than in the control subjects or in LC without ascites (1170.9 ± 28.7 μmol/L vs 903.1 ± 55.1 μmol/L or 956.7 ± 47.7 μmol/L, P < 0.05). CONCLUSION:Increased intestinal macromolecular permeability and NO is probably of importance in the pathophysiology and progression of LC with ascites, but the serum TNF-α concentration was not related to LC with ascites.

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Analysis of PEG 400 and 4000 in urine for gut permeability assessment using solid phase extraction and gel permeation chromatography with refractometric detection

Cited by 13 publications

References 37 publications

Polyethylene glycol versus dual sugar assay for gastrointestinal permeability analysis: is it time to choose?

Polyethylene glycol versus dual sugar assay for gastrointestinal permeability analysis: is it time to choose?

The Relationship between Small-Intestinal Bacterial Overgrowth and Intestinal Permeability in Patients with Irritable Bowel Syndrome

Increased intestinal macromolecular permeability and urine nitrite excretion associated with liver cirrhosis with ascites

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