Brush border enzymes and absorptive capacity in extrahepatic portal venous obstruction in children

Abstract

Background and objective Portal hypertension may affect intestinal functions, brush border enzymes and absorption parameters. Information about these in extrahepatic portal venous obstruction (EHPVO) in children is limited and poorly reported. We therefore studied the brush border enzymes and absorptive capacity in EHPVO in children. Methods The study was conducted on 52 children of EHPVO. The diagnosis of EHPVO was made on the basis of clinical presentation and ultrasound examination. All patients underwent upper gastrointestinal endoscopy. Endoscopic tissue biopsies from duodenum were taken on aluminum foils and kept immediately at -20°C for estimation of brush border enzymes. Tissue biopsies were homogenized in sodium maleate buffer, 0.1 M pH 6.0, by a homogenizer and processed for the enzymes: lactase, maltase, and sucrase. Enzyme levels were compared to normal healthy controls (n = 20). D-Xylose test, stool acid steatocrit for fat excretion in stools and stool alpha-1 antitrypsin were done to know about the absorptive parameters. Results Enzyme levels of lactase (6.21 ± 5.67 IU/mg) and sucrase (37.07 ± 21.06 IU/mg) in EHPVO group were significantly lower as compared to lactase (23.32 ± 10.48 IU/mg) and sucrase (95.96 ± 46.55 IU/mg) in normal healthy controls. Maltase levels were lower, but difference was not statistically significant in EHPVO group (56.90 ± 28.65 IU/mg) as compared to normal controls (63.28 ± 22.88 IU/mg). There was no significant difference of urinary D-xylose and stool fat in patients with normal or short stature EHPVO patients. Conclusion EHPVO leads to decrease in levels of brush border enzymes in small bowel but their absorption capacity remains normal.

Trehalase as a possible marker of intestinal ischemia--reperfusion injury.

“…Most of the disaccharidase studies in adults have focused on chronic conditions such as the alcohol intake effect on the brush border enzymes, their contribution to malnutrition or their role in infants with portal venous obstruction or chronic diarrhea (Sidhu et al, 2010). Whilst in the human population, sucrase and maltase show consistent activity that of lactase varies depending on several factors, for example the age.…”