Measurement of Sugar Probes in Serum, and Their Application in the Assessment of Intestinal Permeability

Fleming, SC; Duncan, A.; Russell, IR

doi:10.1042/cs045015pa_pt2

Cited by 5 publications

(14 citation statements)

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“…The fact that the 5 h cumulative lactulose excretion reported in one study of subjects with frank coeliac disease was lower than those in our studies and their mannitol excretions higher giving LMRs of 0.146 [42] and 0.018 [40] is further testament to the variability of the LMR and the variability of the excretion of component sugars with differing inflammatory stimuli. These examples likely indicate that inflammation from a disease and from a pro-inflammatory stimulus such as aspirin can have differing outcomes that may be better identified by comparisons based on the temporal profiles of the two probes rather than the ratios of cumulative excretion.…”

Section: Discussioncontrasting

confidence: 65%

“…To assess whether any differences in the cumulative recoveries of each sugar could influence the LMR in healthy individuals and in patients with IBDs, we compared the results of our work with those of published studies on subjects with Coeliac or Crohn’s disease [40]–[42] that employed similar protocols and doses of lactulose and mannitol. We determined cumulative recoveries over a 5 h period for each sugar, both after dosage with placebo and after dosage with aspirin, to allow meaningful comparisons with the five hour recoveries reported in these studies.…”

Section: Methodsmentioning

confidence: 99%

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Standardising the Lactulose Mannitol Test of Gut Permeability to Minimise Error and Promote Comparability

et al. 2014

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BackgroundLactulose mannitol ratio tests are clinically useful for assessing disorders characterised by changes in gut permeability and for assessing mixing in the intestinal lumen. Variations between currently used test protocols preclude meaningful comparisons between studies. We determined the optimal sampling period and related this to intestinal residence.MethodsHalf-hourly lactulose and mannitol urinary excretions were determined over 6 hours in 40 healthy female volunteers after administration of either 600 mg aspirin or placebo, in randomised order at weekly intervals. Gastric and small intestinal transit times were assessed by the SmartPill in 6 subjects from the same population. Half-hourly percentage recoveries of lactulose and mannitol were grouped on a basis of compartment transit time. The rate of increase or decrease of each sugar within each group was explored by simple linear regression to assess the optimal period of sampling.Key ResultsThe between subject standard errors for each half-hourly lactulose and mannitol excretion were lowest, the correlation of the quantity of each sugar excreted with time was optimal and the difference between the two sugars in this temporal relationship maximal during the period from 2½-4 h after ingestion. Half-hourly lactulose excretions were generally increased after dosage with aspirin whilst those of mannitol were unchanged as was the temporal pattern and period of lowest between subject standard error for both sugars.ConclusionThe results indicate that between subject variation in the percentage excretion of the two sugars would be minimised and the differences in the temporal patterns of excretion would be maximised if the period of collection of urine used in clinical tests of small intestinal permeability were restricted to 2½-4 h post dosage. This period corresponds to a period when the column of digesta column containing the probes is passing from the small to the large intestine.

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Section: Discussioncontrasting

confidence: 65%

Section: Methodsmentioning

confidence: 99%

Standardising the Lactulose Mannitol Test of Gut Permeability to Minimise Error and Promote Comparability

et al. 2014

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“…L : M values discriminated well between subjects with normal biopsy and those with villous atrophy. Fleming et al (1996) successfully measured L and M by HPLC in serum 90 min after intake, while other workers have used automated enzymic assays (Lunn et al 1989;Northrop et al 1990). The HPLC results agree well with L : M values determined enzymically following a 5 h urine collection (r 0·88, P = 0·05), hence the two methods can be used interchangeably.…”

Section: Gastrointestinal Tractsupporting

confidence: 64%

The effect of vitamin A on epithelial integrity

1999

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Vitamin A is the generic term for a variety of fat-soluble substances including retinol, retinyl palmitate and the provitamin A carotenoids such as all-trans-β-carotene. Vitamin A is commonly known as the anti-infective vitamin and has an essential role in vision and cellular differentiation, the latter providing a unique core mechanism helping to explain the influence of vitamin A on epithelial barriers. Alterations in the epithelial lining of vital organs occur early in deficiency, suggesting a potentially important role for the barrier function. Vitamin A deficiency (VAD) is most commonly recognized in the eye. The conjunctival-impression cytology test detects the presence of larger irregular keratinized cells and the absence of mucous-secreting goblet cells, indicative of VAD. The method is simple, quick and sensitive in populations where VAD is present. In the respiratory tract, observational studies all show an association with VAD, although vitamin A supplementation studies appear to have little effect on respiratory disease. Organ-specific targeting may improve success rates. The dual-sugar intestinal-permeability test allows the effect of vitamin A supplementation to be monitored on the gastrointestinal tract. Two vitamin A supplementation studies were carried out recently in Orissa State, India. Healthy infants of weaning age were administered orally eight weekly doses of 5.0 mg retinol equivalents and hospitalized infants received one large oral dose 60 mg retinol equivalents in the form of retinyl palmitate. Improvements in gut integrity and haematological status were observed in both studies. In summary, the response of the eye to vitamin A supplementation is well established; the present review highlights some of the more recent observations examining the effects of vitamin A.

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“…Simultaneous use of sucrose and lactulose/mannitol probes allows non-invasive detection of gastric and enteric damage, respectively (Meddings and Gibbons, 1998). The plasma (or serum) ratio between orally administered disaccharide lactulose and monosaccharide mannitol expressed as the lactulose/mannitol (L/M) index may be used as the indicator of intestinal permeability (Fleming et al, 1996;Van der Hulst et al, 1998;Bruet et al, 2008). Intestinal permeability increases with increasing L/M index.…”

Section: Resultsmentioning

confidence: 99%

“…The administration of site specific permeability probes, such as monosaccharides and disaccharides, to detect permeability defects at different levels of the gastrointestinal tract represent a single screening test for assessment of the functional integrity of the gastrointestinal mucosa (Meddings and Gibbons, 1998). One or more sugar probes are given orally and the excretion of the probe(s) is than measured in the urine, plasma or serum (Meddings et al, 1993;Bijlsma et al, 1995;Van Elburg et al, 1995;Fleming et al, 1996;Cox et al, 1997;Sorensen et al, 1997;Johnston et al, 2000;Uil et al, 2000;Smecuol et al, 2001;Craven et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Effect of meloxicam and meloxicam with misoprostol on serum prostaglandins and gastrointestinal permeability in healthy beagle dogs

Roškar¹,

Nemec²,

Jerin³

et al. 2011

Acta vet. (Beogr.)

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The aim of the present study was to investigate the effect of meloxicam and meloxicam with misoprostol on prostaglandin E2 (PGE2) and prostaglandin I2 (PGI2) serum concentration, as well as on gastrointestinal permeability. NSAIDs, such as meloxicam, have gastrointestinal side effects, which are due to prostaglandins depletion and topical damage. Seven adult beagle dogs were included in the study. Three different 20 days long treatments were carried out (placebo, meloxicam and meloxicam with misoprostol). The same seven dogs participated in all three treatments. On days 1 to 10 the dogs received placebo, meloxicam or meloxicam together with misoprostol PO. Dogs were than monitored from day 11 to 20. Samples for serum PGE2 and PGI2 concentration and plasma lactulose, mannitol and sucrose concentration determination were drawn on day 0, 2, 6, 11 and 20. Lactulose/mannitol (L/M) index was calculated. Treatment with meloxicam and meloxicam with misoprostol resulted in lower PGE2 and PGI2 serum concentrations in comparison to the placebo. L/M index and sucrose plasma concentration were increased in both groups in comparison to the placebo. According to the results of the study, meloxicam has altered gastrointestinal permeability and depleted prostaglandins production. Misoprostol was shown to be an effective preventing treatment

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Measurement of Sugar Probes in Serum, and Their Application in the Assessment of Intestinal Permeability

Cited by 5 publications

References 0 publications

Standardising the Lactulose Mannitol Test of Gut Permeability to Minimise Error and Promote Comparability

Standardising the Lactulose Mannitol Test of Gut Permeability to Minimise Error and Promote Comparability

The effect of vitamin A on epithelial integrity

Effect of meloxicam and meloxicam with misoprostol on serum prostaglandins and gastrointestinal permeability in healthy beagle dogs

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