Abnormalities of Jejunal Mucosal Enzymes in Ulcerative Colitis and Crohn’s Disease

Abstract

Jejunal mucosal function and structure was examined in 31 patients with ulcerative colitis and 29 patients with Crohn’s disease with ileal, ileocolonic or colonic involvement. A significant reduction of the specific activity of disaccharidases (lactase, sucrase and trehalase) in jejunal mucosal homogenate occurred in patients with inflammatory bowel disease. Similarly, alkaline phosphatase was reduced in ulcerative colitis. Several dipeptidases such as glycyl-leucine, leucyl-glycine, glycyl-glycine and valyl-proline hydrolase activities were lower in patients with inflammatory bowel disease than in controls. Histological changes in jejunal mucosal biopsies occurred in 71% of patients with ulcerative colitis and 61% with Crohn’s disease. These changes ranged from mild abnormalities of villus architecture to marked reduction of villus height. Most patients with a reduction in mucosal enzymes had concommitant morphological changes in jejunal mucosal biopsy. The results of this study indicate that functional and structural abnormalities of the jejunal mucosa frequently occur in patients with inflammatory bowel disease without radiologic evidence of proximal small bowel involvement.

Role of CD8 + and CD4 + T Lymphocytes in Jejunal Mucosal Injury during Murine Giardiasis

“…These abnormalities result in maldigestion, malabsorption, and diarrhea. Similar pathophysiological processes also occur in food anaphylaxis (11,18), celiac disease (40), Crohn's disease (2,12,14,36), and bacterial enteritis (7,19). The fact that similar mucosal structural and functional changes are seen in diseases with or without microbial involvement has led to the hypothesis that host factors are implicated in the pathogenesis of these disorders.…”

Localized colonic inflammation increases cytokine levels in distant small intestinal segments in the rat

“…Colitis in humans and experimental animals, however, may be associated with small bowel dysfunction, including altered motility and malabsorption of fat, carbohydrates, proteins, minerals, vitamins, water and D-xylose (Andersson et al, 1971; Barada et al, 2001;Binder and Ptak, 1970;Chakravarti et al, 1973;Mourad et al, 2006;Salem and Truelove, 1965;Zetzel et al, 1942). Furthermore, decreased expression of small intestinal disaccharidases was reported in ulcerative colitis (Arvanitakis, 1979). We have demonstrated before that induction of inflammation in the colon of experimental animals was associated with decreased jejunal absorption of alanine, glucose, and fluid without evident signs of inflammation (Barada et al, 2001;Mourad et al, 2006).…”

Abnormal Small Intestinal Permeability to Sugars in Patients with Crohn’s Disease of the Terminal Ileum and Colon

“…There is evidence that macroscopically normal proximal small intestine in patients with Crohn's disease affecting the distal small intestine or colon may be abnormal bio chemically [ 1,2] or physiologically [3,4], and may show minor morphological abnormali ties [1,2], suggesting that the bowel in Crohn's disease may be more extensively in volved than is apparent from the radiological or macroscopical appearance. We have stud ied the permeability of the small intestine to lactulose and mannitol in patients with Crohn's disease apparently limited to the dis tal ileum and/or colon.…”