Gastrointestinal permeability and absorptive capacity in sepsis

Johnston, John D.; Harvey, Christopher J.; Menzies, Ian S.; Treacher, David

doi:10.1097/00003246-199607000-00013

Cited by 83 publications

(61 citation statements)

References 38 publications

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“…The L/R ratio is considered a measure of intestinal permeability, whereas the XYL/OMG and RHA/OMG ratios are used as indices of epithelial absorptive capacity and mediated cellular transport, respectively. L/R ratios, XYL/ OMG ratios, and RHA/OMG ratios of Յ 0.02, 25,26 Ն 0.28, 27 and Ն 0.65, 28 respectively, are considered normal.…”

Section: Urinary Excretion Ratios Of Differential Sptsmentioning

confidence: 99%

Monitoring myeloablative therapy‐induced small bowel toxicity by serum citrulline concentration

Lutgens

Blijlevens

Deutz

et al. 2004

Cancer

140

107

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BACKGROUNDIntestinal mucositis is an important cause of cancer treatment‐related morbidity and mortality, carrying a serious economic burden. Currently, objective parameters are lacking that would enable the monitoring of gut damage in routine clinical practice, thus hindering the development of clinical studies designed to investigate potential new strategies aimed at reducing or preventing this side effect. The authors investigated the characteristics of serum citrulline concentration compared with sugar permeability tests with respect to its use as a marker for cancer treatment‐induced small bowel injury.METHODSIn this prospective study, 10 patients with hematologic malignancies who were receiving myeloablative therapy had gut toxicity assessed with sugar permeability tests. Serum citrulline concentrations also were determined using archival serum samples. The association between both parameters and their respective characteristics were analyzed and compared with data from the literature.RESULTSSensitivity and specificity were better for the citrulline assay compared with sugar permeability tests. Maximum gut damage assessed with the citrulline assay was observed 1–2 weeks earlier compared with the sugar permeability test. Similarly, citrulline indicated recovery of gut damage at 3 weeks after transplantation, whereas most sugar permeability tests remained abnormal.CONCLUSIONSThe simplicity of the method, the low costs, and the lack of drawbacks to the method make the citrulline assay the first choice for measuring and monitoring treatment‐related gut damage and provides an objective parameter for cancer treatment‐related gut toxicity. Cancer 2005. © 2004 American Cancer Society.

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Section: Urinary Excretion Ratios Of Differential Sptsmentioning

confidence: 99%

Monitoring myeloablative therapy‐induced small bowel toxicity by serum citrulline concentration

Lutgens

Blijlevens

Deutz

et al. 2004

Cancer

140

107

View full text Add to dashboard Cite

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“…Arti®cial ventilatory support is instituted and the cardiovascular system is supported with inotropes and vasopressors. Failure of gastrointestinal function, absorption and motility (Johnston et al, 1996), necessitates the use of arti®cial nutritional support, parenteral or enteral, and if renal failure supervenes renal replacement therapy such as haemo®ltration or haemodialysis is required. Rates of urinary nitrogen excretion in MOF are in the region of 20 ga24 h (Streat et al, 1987;Finn et al, 1996;Clark et al, 1996).…”

Section: Substrate Mobilisationmentioning

confidence: 99%

“…High levels of sympathetic activity impair gastric emptying so enteral feeding may have to be given beyond the pylorus (Johnston et al, 1996), a technique that carries risks and may limit the quantities that can be given. Because of impaired gastrointestinal function it may not be possible to provide all the needed nutrients enterally (Kemper et al, 1992).…”

Section: The Delivery Of Nutritional Support In the Critically Illmentioning

confidence: 99%

Limitations of nutrient intake. The effect of stressors: trauma, sepsis and multiple organ failure

1999

Eur J Clin Nutr

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“…For example, clinical correlative studies have established that defective intestinal barrier function is frequently observed in septic patients [9,10]. Here, we characterize bowel pathology after LPS treatment of p50 and 3X mice.…”

Section: Introductionmentioning

confidence: 97%

NF‐κB p50 and p65 subunits control intestinal homeostasis

2007

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Mice which lack the p50 subunit of NF-jB and are heterozygous for the p65 subunit (3X mice), are exquisitely sensitive to LPS-induced shock. Here, we demonstrate that prior to becoming moribund, 3X mice challenged with LPS develop a profound enteropathy. The enteropathy is characterized by defects in intestinal barrier function, increased epithelial apoptosis, and deregulated intestinal cytokine gene expression. The defect that sensitizes 3X mice to LPS-induced enteropathy is located within the innate immune compartment, as LPS induced similar findings in 3X mice lacking lymphocytes (3X/ RAG). TNF-a depletion ameliorated the ability of LPS to induce pathology and TNF-a was able to independently induce similar findings, suggesting that TNF-a plays a critical role in the development of LPS-induced pathology in these mice. These data highlight that NF-jB subunits have essential functions in regulating intestinal homeostasis during acute inflammation.

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Gastrointestinal permeability and absorptive capacity in sepsis

Abstract: Patients with acute sepsis exhibit increased gastrointestinal permeability and decreased gastrointestinal functional absorptive capacity in comparison with healthy control subjects. These abnormalities may contribute to the pathophysiology of sepsis.

Cited by 83 publications

References 38 publications

Monitoring myeloablative therapy‐induced small bowel toxicity by serum citrulline concentration

Monitoring myeloablative therapy‐induced small bowel toxicity by serum citrulline concentration

Limitations of nutrient intake. The effect of stressors: trauma, sepsis and multiple organ failure

NF‐κB p50 and p65 subunits control intestinal homeostasis

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