Evaluation of mannitol, lactulose and 51Cr-labelled ethylenediaminetetra-acetate as markers of intestinal permeability in man

Elia, Marinos; Behrens, Ronald H.; Northrop, Christine A.; Wraight, Paul R; Neale, G.

doi:10.1042/cs0730197

Cited by 118 publications

(49 citation statements)

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“…However, where the mucosa is damaged, larger amounts of lactulose cross the intestinal barrier into the blood, so lactulose uptake can be regarded as an index of leakiness (Ford et al 1985). Within the body both probes remain intact, they remain in the extracellular fluid compartment and both are rapidly excreted by the kidneys (Elia et al 1987). Consequently, the amounts found in the urine reflect the amounts taken up by the two different routes in the small intestine.…”

Section: Malnutrition: Gastrointestinal Enteropathy: Intestinementioning

confidence: 99%

The impact of infection and nutrition on gut function and growth in childhood

2000

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Poor growth performance during infancy and early childhood is a frequent fact of life in most developing countries. Work in The Gambia has demonstrated that more than 43 % of observed growth faltering during the first 15 months of life can be explained by the presence of a mucosal enteropathy in the small intestine. Within communities the illness is very common: in the area investigated more than 95 % of infants above 8 months of age were affected, and on average they suffered a growth-limiting enteropathy for more than 75 % of their first year of life. Two mechanisms of weight loss have been defined. First, partial villus atrophy reduces absorption and digestion of lactose and probably other nutrients. Second, and more importantly, damage to the mucosal barrier allows translocation of macromolecules into the mucosa and blood, triggering both local and systemic immune and inflammatory mechanisms. Given the severity of the enteropathy it is not surprising that infants fail to grow at a normal rate. Recent findings suggest that these lesions continue throughout childhood and into adulthood. Thus, a persistence of chronic, local and systemic inflammation throughout childhood may be responsible for continued poor growth during this period. Although the nature of the enteropathy and the mechanisms of growth failure have been defined, the factors involved in the initiation and persistence of the intestinal lesion remain uncertain, making clinical management difficult. More work is clearly required to elucidate these factors and to define interventions to prevent or treat the enteropathy.

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Section: Malnutrition: Gastrointestinal Enteropathy: Intestinementioning

confidence: 99%

The impact of infection and nutrition on gut function and growth in childhood

2000

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“…ingestion of lactulose and rhamnose showed that during kwashiorkor, abnormal intestinal permeability correlated with disease severity and improved only slowly with nutritional rehabilitation (Brewster et al 1997). Elia et al (1987) investigated the factors affecting the intestinal uptake and urinary excretion of mannitol (M), lactulose (L) and Cr-EDTA in normal subjects and three patients with ileostomy. They suggested that the uptake of L is slower than that of M, and Cr-EDTA is readily absorbed in the colon.…”

Section: Gastrointestinal Tractmentioning

confidence: 99%

The effect of vitamin A on epithelial integrity

1999

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Vitamin A is the generic term for a variety of fat-soluble substances including retinol, retinyl palmitate and the provitamin A carotenoids such as all-trans-β-carotene. Vitamin A is commonly known as the anti-infective vitamin and has an essential role in vision and cellular differentiation, the latter providing a unique core mechanism helping to explain the influence of vitamin A on epithelial barriers. Alterations in the epithelial lining of vital organs occur early in deficiency, suggesting a potentially important role for the barrier function. Vitamin A deficiency (VAD) is most commonly recognized in the eye. The conjunctival-impression cytology test detects the presence of larger irregular keratinized cells and the absence of mucous-secreting goblet cells, indicative of VAD. The method is simple, quick and sensitive in populations where VAD is present. In the respiratory tract, observational studies all show an association with VAD, although vitamin A supplementation studies appear to have little effect on respiratory disease. Organ-specific targeting may improve success rates. The dual-sugar intestinal-permeability test allows the effect of vitamin A supplementation to be monitored on the gastrointestinal tract. Two vitamin A supplementation studies were carried out recently in Orissa State, India. Healthy infants of weaning age were administered orally eight weekly doses of 5.0 mg retinol equivalents and hospitalized infants received one large oral dose 60 mg retinol equivalents in the form of retinyl palmitate. Improvements in gut integrity and haematological status were observed in both studies. In summary, the response of the eye to vitamin A supplementation is well established; the present review highlights some of the more recent observations examining the effects of vitamin A.

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“…This value is close to that found using the 51 Cr-EDTA radiomarker in rats (2.8%; Ramage et al, 1988) but higher than the excretion recorded in humans (0.44-0.85%; Maxton et al, 1986;André et al, 1990). The 24-h recovery of Cr-EDTA in urine seems to represent marker absorption in both small and large intestines (Maxton et al, 1986;Elia et al, 1987). It is between 1.2 and 2.6% in healthy humans (Maxton et al, 1986;André et al, 1990) and close to 12% in dogs (Hall etal, 1989; (Haeney etal, 1978;Lim etal, 1993), 12-16% in preruminant calves (Seegraber and Morrill, 1986;Dawson et al, 1988) and 10% in mares (Bolton et al, 1976).…”

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confidence: 99%

Assessment of gastrointestinal permeability to small marker probes in the preruminant calf

Pardal¹,

Lallès²,

André³

et al. 1995

Reprod. Nutr. Dev.

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Summary ― The intestinal permeability to markers was assessed in preruminant calves fed different milk substitutes containing skimmed milk powder or whey and soyabean products of differing antigenic activity as the protein sources. In Experiment 1, the 6 h urinary excretion of lactulose transiently decreased with the antigenic soyabean product but not that of sucrose or D -mannitol. In Experiment 2, the 6 h urinary excretion of sucrose and D -mannitol averaged 1-3%, regardless of age and dietary treatment. Cr-EDTA was recovered at rates of 2 and 4% after 6 and 24 h of urinary collection, respectively. The 24 h excretion of Cr-EDTA was lower in the calves fed the antigenic flour than in the controls after 2 weeks of experimental feeding (2.9 vs 6.0%, P < 0.05) but not thereafter. This transient decrease was also observed using D -xylose with the antigenic flour and with the non-antigenic concentrate (17 and 22% respectively vs 37%, P < 0.05). The

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Evaluation of mannitol, lactulose and 51Cr-labelled ethylenediaminetetra-acetate as markers of intestinal permeability in man

Cited by 118 publications

References 0 publications

The impact of infection and nutrition on gut function and growth in childhood

The impact of infection and nutrition on gut function and growth in childhood

The effect of vitamin A on epithelial integrity

Assessment of gastrointestinal permeability to small marker probes in the preruminant calf

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