Gastrointestinal permeability in ovarian cancer and breast cancer patients treated with paclitaxel and platinum

Melichar, Bohuslav; Hyšpler, Radomı́r; Dvořák, Josef; Kalábová, Hana; Tichá, Alena

doi:10.1186/1471-2407-7-155

Cited by 16 publications

(18 citation statements)

References 25 publications

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“…Therefore, this method may not be used to assess intestinal permeability in the colon, and the results may be invalidated by significant bacterial overgrowth in the small intestine. Although this situation may be in some instances an oversimplification, intestinal permeability is thought to represent a passive process of diffusion across 48 Gastrointestinal symptoms the mucosa. Although only nonmetabolized sugars are used to assess the intestinal permeability in the small intestine, the degradation of sucrose in the small intestine may be exploited for the use of this marker to assess the permeability of the stomach mucosa [12].…”

Section: Intestinal Permeability: Theory and Methodsmentioning

confidence: 99%

“…An increase of lactulose/mannitol ratio has been described after treatment with gefitinib, an oral agent targeting epidermal growth factor receptor [52 ]. In some studies, changes of intestinal permeability have been accompanied by increased sucrose/mannitol ratio indicating associated disturbance of the permeability of gastric mucosa [48].…”

Section: Intestinal Permeability Studies In Cancer Patientsmentioning

confidence: 99%

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The significance of altered gastrointestinal permeability in cancer patients

Melichar

Zezulová

2011

Current Opinion in Supportive &Amp; Palliative Care

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Section: Intestinal Permeability: Theory and Methodsmentioning

confidence: 99%

Section: Intestinal Permeability Studies In Cancer Patientsmentioning

confidence: 99%

The significance of altered gastrointestinal permeability in cancer patients

Melichar

Zezulová

2011

Current Opinion in Supportive &Amp; Palliative Care

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“…An increased disaccharide/monosaccharide ratio and decreased xylose absorption have been described in experimental animal models [6] and patients with GI cancer [7] treated with different cytotoxic agents [8]. Notwithstanding, there is still much to learn about the occurrence of chemotherapy-induced alterations for extra-GI neoplasms [9] and in particular with recent FEC60 regimen (fluorouracil, epirubicin, and cyclophosphamide) [10]. Furthermore, the mechanisms underlying these alterations in neoplastic patients are not fully elucidated, since there is still a lack of information concerning all of the players actively implicated in the regulation of intestinal barrier function.…”

Section: Introductionmentioning

confidence: 99%

The effects of fluorouracil, epirubicin, and cyclophosphamide (FEC60) on the intestinal barrier function and gut peptides in breast cancer patients: an observational study

et al. 2013

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BackgroundSeveral GI peptides linked to intestinal barrier function could be involved in the modification of intestinal permeability and the onset of diarrhea during adjuvant chemotherapy. The aim of the study was to evaluate the circulating levels of zonulin, glucagon-like peptide-2 (GLP-2), epidermal growth factor (EGF) and ghrelin and their relationship with intestinal permeability and chemotherapy induced diarrhea (CTD).MethodsSixty breast cancer patients undergoing an FEC60 regimen were enrolled, 37 patients completed the study. CTD(+) patients were discriminated by appropriate questionnaire and criteria. During chemotherapy, intestinal permeability was assessed by lactulose/mannitol urinary test on day 0 and day 14. Zonulin, GLP-2, EGF and ghrelin circulating levels were evaluated by ELISA tests at five time-points (days 0, 3, 10, 14, and 21).ResultsDuring FEC60 administration, the lactulose/mannitol ratio was significantly higher on day 14 than at baseline. Zonulin levels were not affected by chemotherapy, whereas GLP-2 and EGF levels decreased significantly. GLP-2 levels on day 14 were significantly lower than those on day 0 and day 3, while EGF values were significantly lower on day 10 than at the baseline. In contrast, the total concentrations of ghrelin increased significantly at day 3 compared to days 0 and 21, respectively. Ten patients (27%) suffered from diarrhea. On day 14 of chemotherapy, a significant increase of the La/Ma ratio occurred in CTD(+) patients compared to CTD(−) patients. With regards to circulating gut peptides, the AUCg of GLP-2 and ghrelin were significantly lower and higher in CTD(+) patients than CTD(−) ones, respectively. Finally in CTD(+) patients a significant and inverse correlation between GLP-2 and La/Ma ratio was found on day 14.ConclusionsBreast cancer patients undergoing FEC60 showed alterations in the intestinal permeability, which was associated with modifications in the levels of GLP-2, ghrelin and EGF. In CTD(+) patients, a different GI peptide profile and increased intestinal permeability was found in comparison to CTD(−) patients. This evidence deserves further studies for investigating the potentially different intestinal luminal and microbiota conditions.Trial registrationClinical trial NCT01382667

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“…More recently, we have demonstrated that increased lactulose/mannitol ratio may predict the toxicity of cytotoxic chemotherapy (9). The measurement of gastrointestinal permeability could thus represent a useful laboratory method for follow up of cancer patients.…”

Section: Resultsmentioning

confidence: 99%

Gastrointestinal Permeability - a Parameter of Possible Prognostic Importance in Metastatic Colorectal Carcinoma

et al. 2008

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Recently, we have observed in patients with ovarian carcinoma an association between intestinal permeability and prognosis and a correlation between urinary neopterin and parameters of intestinal permeability. In order to examine prognostic significance of intestinal permeability in a different group of patients, we have retrospectively analyzed pretreatment parameters of gastrointestinal permeability and urinary neopterin in 21 consecutive patients with metastatic colorectal carcinoma treated with the combination of cetuximab, irinotecan, leucovorin and 5-fluorouracil. Neopterin was determined by high-performance liquid chromatography, and gastrointestinal permeability was assessed by measuring, using capillary gas chromatography, urinary sucrose, lactulose, xylose, mannitol and sucralose after oral challenge. Pretreatment sucrose/mannitol ratio equal or above 0.04 (median survival 10.6 vs. 18.4 months; p = 0.03), sucrose/xylose equal or above 0.02 (12.1 vs. 19 months; p = 0.04) and urinary neopterin equal or above 220 µmol/mol creatinine (10.6 vs. 18.4 months; p = 0.02) were indicative of poor survival. A significant correlation was observed between urinary neopterin and sucrose/xylose ratio (rs = 0.57, p = 0.007), while correlation between urinary neopterin and sucrose/mannitol ratio (rs = 0.38, p = 0.096) was of borderline significance. In conclusion, present data demonstrate that gastrointestinal permeability is associated with systemic immune activation and may be of prognostic significance in patients with metastatic colorectal carcinoma.

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Gastrointestinal permeability in ovarian cancer and breast cancer patients treated with paclitaxel and platinum

Cited by 16 publications

References 25 publications

The significance of altered gastrointestinal permeability in cancer patients

The significance of altered gastrointestinal permeability in cancer patients

The effects of fluorouracil, epirubicin, and cyclophosphamide (FEC60) on the intestinal barrier function and gut peptides in breast cancer patients: an observational study

Gastrointestinal Permeability - a Parameter of Possible Prognostic Importance in Metastatic Colorectal Carcinoma

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