Dysprosium Chloride as a Nonabsorbable Gastrointestinal Marker for Studies of Stable Isotope-Labeled Triglyceride Excretion in Man

Schuette, Sally A.; Janghorbani, Morteza; Cohen, Mitchell B.; Krug, Susan; Schindler, Terri; Wagner, David; Morris, Steven

doi:10.1080/07315724.2003.10719321

Cited by 9 publications

(9 citation statements)

References 13 publications

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“…There was a very high linear correlation of fractional excretion of dysprosium and 13 C-labeled triglyceride in individual stools in pwCF who exhibited a wide range of steatorrhea; thus, dysprosium alone could be used to measure fat excretion. Excretion based on the analysis of only the first 2 stools to appear after ingestion of an oral blue dye (partial pool method) was not different from those based on the analysis of all stools collected over 3 to 4 days 45 …”

Section: Resultsmentioning

confidence: 81%

“…Excretion based on the analysis of only the first 2 stools to appear after ingestion of an oral blue dye (partial pool method) was not different from those based on the analysis of all stools collected over 3 to 4 days. 45 • Behenic acid stool test: A different method using an oral marker explored use of behenic acid, a nonabsorbable lipid marker. However, there was poor correlation with CFA.…”

Section: Sparse Stoolmentioning

confidence: 99%

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Coefficient of Fat Absorption to Measure the Efficacy of Pancreatic Enzyme Replacement Therapy in People With Cystic Fibrosis

et al. 2022

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Objectives: We sought data on the validity, reliability, responsiveness, and feasibility of the coefficient of fat absorption (CFA) as a measure of pancreatic enzyme replacement therapy (PERT) efficacy in people with cystic fibrosis (pwCF) and reviewed the literature for alternative measures. Methods:We searched PubMed for the Medical Subject Heading cystic fibrosis and the key words cystic fibrosis, fat absorption, CFA, and fecal fat imbalance; historical articles; and citations in bibliographies. Results:The lower the CFA, the greater its variability; thus, it is less variable in healthy individuals who have higher CFA than pwCF. In addition, the test-retest values for CFA are more variable in pwCF than the general population. There is no correlation between CFA and body mass index or PERT dose but CFA is related to gastrointestinal signs and symptoms. Research-quality CFA studies are expensive, time consuming, and odious to pwCF and research staff. Sparse stool tests, breath tests, and blood tests of fat absorption have been studied as potential alternatives to CFA to measure PERT efficacy.Conclusions: Based on the evidence, we conclude that CFA as a measure of the efficacy of PERT is more of a "coal standard" than a gold standard; developing suitable alternatives should be a priority.

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Section: Resultsmentioning

confidence: 81%

Section: Sparse Stoolmentioning

confidence: 99%

Coefficient of Fat Absorption to Measure the Efficacy of Pancreatic Enzyme Replacement Therapy in People With Cystic Fibrosis

et al. 2022

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“…Since it has been recommended that non-PEG-based bowel preparations are used in WGLF studies, however, appropriate normalization methods should be established for these. Some non-absorbable markers that have been employed in fecal studies that could potentially be added to the bowel preparation as a marker in studies include various rare earth elements [29], dysprosium chloride [30], and acid insoluble ash [31].…”

Section: Methods Of Normalizationmentioning

confidence: 99%

Rectal Effluent as a Research Tool

2014

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Studies of localized secretions are generally superior to those of blood because they contain higher concentrations of molecules specific to the organ of interest. A common method used to analyze localized secretions is lavage. The flow of fluid over the lining of a cavity picks up both cells and soluble factors, and the effluent can be collected for study. Gastrointestinal (GI) lavage is easily and noninvasively performed by the administration of gut lavage solutions such as those routinely given to patients prior to colonoscopy, with GI lavage fluid being the copious, watery rectal effluent subsequently induced. Residual effluent is currently suctioned from the colon and discarded during colonoscopy. With millions of routine colonoscopies performed per year, GI lavage fluid is a rich and largely untapped resource for basic and clinical research. Rectal effluent can also be easily collected in a toilet receptacle without need for a colonoscopy. Rectal effluent generated in this manner has been used to study diarrheal disease, mucosal immunology, inflammatory bowel disease, celiac disease, and cancer. It is often referred to as gut lavage, colon lavage, GI lavage, or whole gut lavage fluid, which makes it challenging to locate previous studies in the literature and there are currently no comprehensive reviews of its use as a research tool. This review attempts to fill this void by discussing previous applications of rectal effluent in research and the methods that have been developed for its collection, stabilization, and analysis.

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“…Another method for determining fat excretion on a spot stool specimen relies on the co-administration of a 13 C-labeled triglyceride, dysprosium chloride (a nonabsorbable marker) and a stool dye marker [20]. Assuming that the three substances transit the intestine at the same rate, the ratio of fecal 13 C-labeled trigyceride and dysprosium is determined in a stool specimen (that is colored by the dye marker), permitting quantitation of triglyceride excretion.…”

Section: Efficacy Outcome Measuresmentioning

confidence: 99%

Study design considerations for evaluating the efficacy and safety of pancreatic enzyme replacement therapy in patients with cystic fibrosis

Konstan

Borowitz

Mayer-Hamblett

et al. 2013

Clinical Investigation

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In 2006, the US FDA issued a ‘Guidance for Industry’ regarding submission of New Drug Applications for pancreatic enzyme replacement therapy (PERT) products. Five oral delayed-release PERT products have been approved by the FDA, and several others are under development and/ or evaluation for New Drug Application submission. We present in this paper recommendations of the Cystic Fibrosis Foundation's Cystic Fibrosis (CF) Therapeutics Development Network and Data Safety Monitoring Board regarding study design considerations for evaluating PERT products in patients with CF. Careful attention to study design and accuracy of the outcome measures has confirmed our understanding of the efficacy and safety of PERT for the treatment of exocrine pancreatic insufficiency of CF.

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Dysprosium Chloride as a Nonabsorbable Gastrointestinal Marker for Studies of Stable Isotope-Labeled Triglyceride Excretion in Man

Cited by 9 publications

References 13 publications

Coefficient of Fat Absorption to Measure the Efficacy of Pancreatic Enzyme Replacement Therapy in People With Cystic Fibrosis

Coefficient of Fat Absorption to Measure the Efficacy of Pancreatic Enzyme Replacement Therapy in People With Cystic Fibrosis

Rectal Effluent as a Research Tool

Study design considerations for evaluating the efficacy and safety of pancreatic enzyme replacement therapy in patients with cystic fibrosis

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