Noninvasive Diagnosis of Hypolactasia With 4-Galactosylxylose (Gaxilose)

Aragón, J. L.; Hermida, Carmen; Martı́nez-Costa, Oscar H.; Sánchez, Valentina; Martín, Igor; Sánchez, José Juan Alemán; Codoceo, Rosa; Cano, Juan-Carlos; Cano, A.; Crespo, Laura Varela; Torres, Yolanda; García, Francisco J.; Fernández-Mayoralas, Alfonso; Solera, Jesús; Martinez, P Gonzalez

doi:10.1097/mcg.0b013e318297fb10

Cited by 23 publications

(19 citation statements)

References 14 publications

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“…This interfering substance remains unidentified. Despite this fact, the diagnostic performance of the gaxilose test with phloroglucinol xylose quantification was calculated in a phase IIb/III clinical trial, obtaining excellent sensitivity and specificity values [11]. …”

Section: Resultsmentioning

confidence: 99%

“…Patients with a xylose amount lower than this cut-off value are diagnosed with hypolactasia [10, 11]. The bias observed between the two analytical procedures represents 42.5% of this reference value, indicating that a new cut-off would be necessary to correctly diagnose hypolactasia when xylose is quantified with the new enzymatic method.…”

Section: Resultsmentioning

confidence: 99%

“…Hypolactasia diagnosis for each patient had already been performed in each of the hospitals, quantifying xylose total amount in the collected urine by the phloroglucinol method. Patients with a xylose amount lower than 37.87 mg were diagnosed with hypolactasia [10, 11, 21]. Each hospital anonymously provided aliquots of urine samples, with the consent of the laboratory authorizing exclusively d -xylose measurement for the comparison of both analytical procedures.…”

Section: Methodsmentioning

confidence: 99%

“…Galactose is transformed into glucose in the liver, while xylose, which is passively absorbed [8], is partially endogenously metabolized, with the rest appearing in blood and being finally excreted in urine. Total xylose amount determined in urine and xylose concentration in blood represent a measure of total lactase activity in vivo [6, 9–11]. …”

Section: Introductionmentioning

confidence: 99%

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Analytical Validation of a New Enzymatic and Automatable Method for d-Xylose Measurement in Human Urine Samples

Sánchez-Moreno

Monsalve-Hernando

Godino

et al. 2017

BioMed Research International

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Hypolactasia, or intestinal lactase deficiency, affects more than half of the world population. Currently, xylose quantification in urine after gaxilose oral administration for the noninvasive diagnosis of hypolactasia is performed with the hand-operated nonautomatable phloroglucinol reaction. This work demonstrates that a new enzymatic xylose quantification method, based on the activity of xylose dehydrogenase from Caulobacter crescentus, represents an excellent alternative to the manual phloroglucinol reaction. The new method is automatable and facilitates the use of the gaxilose test for hypolactasia diagnosis in the clinical practice. The analytical validation of the new technique was performed in three different autoanalyzers, using buffer or urine samples spiked with different xylose concentrations. For the comparison between the phloroglucinol and the enzymatic assays, 224 urine samples of patients to whom the gaxilose test had been prescribed were assayed by both methods. A mean bias of −16.08 mg of xylose was observed when comparing the results obtained by both techniques. After adjusting the cut-off of the enzymatic method to 19.18 mg of xylose, the Kappa coefficient was found to be 0.9531, indicating an excellent level of agreement between both analytical procedures. This new assay represents the first automatable enzymatic technique validated for xylose quantification in urine.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Analytical Validation of a New Enzymatic and Automatable Method for d-Xylose Measurement in Human Urine Samples

Sánchez-Moreno

Monsalve-Hernando

Godino

et al. 2017

BioMed Research International

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“…It should be noted that the presence of the lactase non-persistent gene does not imply the simultaneous presence of lactose intolerance that may appear later in the life. More recently, a test based on the measurement of D-xylose after lactase cleavage of orally administered 4-galactosylxylose (Gaxilose) has been investigated in a large multicenter study in adults, with good sensitivity and specificity for lactase deficiency as determined in biopsy specimens [ 51 ].…”

Section: Genetic Etiology With Late-onset Carbohydrate Intolerancementioning

confidence: 99%

Diagnosing and Treating Intolerance to Carbohydrates in Children

et al. 2016

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Intolerance to carbohydrates is relatively common in childhood, but still poorly recognized and managed. Over recent years it has come to the forefront because of progresses in our knowledge on the mechanisms and treatment of these conditions. Children with intolerance to carbohydrates often present with unexplained signs and symptoms. Here, we examine the most up-to-date research on these intolerances, discuss controversies relating to the diagnostic approach, including the role of molecular analysis, and provide new insights into modern management in the pediatric age, including the most recent evidence for correct dietary treatment.

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