Intestinal permeability to [51Cr]EDTA in infectious diarrhea

Abstract

Orally administered [51Cr]EDTA was used to measure intestinal permeability in subjects with infectious diarrhea and in those without gastrointestinal complaints. [51Cr]EDTA was given to 87 subjects: 63 controls (32 normal controls, and 31 disease controls), and 24 patients with infectious diarrhea. Approximately 100 microCi of [51Cr]EDTA was given orally after an overnight fast. Urine was collected for the following 24 hr. Intestinal permeability to [51Cr]EDTA in both normal volunteers and in patients with a variety of diseases not associated with intestinal injury was low and results were in a relatively narrow range. Mean 24-hr urinary excretion of [51Cr]EDTA, calculated as a percent of the administered dose, in controls was 1.6% (0.2-3.5%). Patients with infectious diarrhea associated with invasive pathogens and/or intestinal inflammation had increased excretion of [51Cr]EDTA (mean 6.1%, P < 0.0001), with elevated excretions in 75%. These results demonstrate that intestinal infections must be considered as possible causes for increased intestinal permeability as assessed by the [51Cr]EDTA test.

Geography of intestinal permeability and absorption

“…9 20 21 25Intestinal permeability assessed by differential urinary sugar excretion29-32 or 51 Cr-EDTA33 34 is known to be increased in patients with diarrhoea due to such infections. The possibility that increased intestinal permeability and reduced absorption currently seen in some tropical areas may be due to HIV infection also needs to be considered as such changes have also been described in this condition,35 36 usually in association with diarrhoea.…”

Crosstalk at the mucosal border: importance of the gut microenvironment in IBS

“…An acute bacterial infection results in a transient increase in intestinal permeability. 140,141 This phenomenon seems to be highly persistent in patients who develop postinfectious IBS, 141,142 but altered intestinal permeability does not seem to be confined to postinfectious IBS alone, as the different subtypes of IBS all seem to have a proportion of patients with increased gut permeability. 143 As an example, both patients with IBS-D who had postinfectious IBS as well as those with onset unrelated to an infectious event have been reported to have increased small intestinal permeability.…”

Intestinal permeability in strongyloidiasis

“…Impaired barrier function intensifies antigen access, which in turn leads to an exaggerated immune stimulation that initiates or perpetuates inflammation (2). Increased intestinal permeability has been described in inflammatory bowel disease (3)(4)(5)(6)(7)(8)(9)(10)(11), atopic eczema (12), celiac disease and dermatitis herpetiformis (13), cystic fibrosis (14,15), alcohol consumption (16), use of nonsteroidal antiinflammatory drugs (17)(18)(19)(20), and acute infectious diarrhea (12,21). On the other hand, decreased intestinal permeability has been demonstrated in Blastocystis hominis infection (22).…”