Abstract
To investigate permeability alterations of the macroscopically normal jejunum in Crohn's disease, the permeation of two probes was measured during perfusion of an isolated jejunal segment. The data were compared with the results obtained by the standard per oral test in the same patients. Test probes were PEG-400 and [51Cr]EDTA. Ten normal individuals, 12 patients with Crohn's ileitis or ileocolitis, and seven patients with isolated Crohn's colitis all with normal jejunum on x-ray series were studied. Upon perfusion of the proximal small bowel, the 3-hr [51Cr]EDTA excretion was significantly increased in ileitis patients (P=0.023) as compared to normals. The excretion exceeded the highest value of normals in eight of 12 ileitis patients. The excretion in Crohn's colitis patients was not significantly increased (P=0.24) and abnormal excretion was found only in one of the Crohn's colitis patients. PEG-400 permeation during perfusion did not differentiate between the groups, but five of the seven patients with isolated Crohn's colitis had PEG-400 excretion exceeding the highest value in normals. Overall, 13 of the 19 patients had increased permeation of one of the two probes through jejunal mucosa during perfusion. These data suggest that the permeability is increased in the majority of patients even in segments that seem normal on x-ray.
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References
Grybosky JD, Thayer WR, Gabrielsson IW, Spiro HM: Disacchariduria in gastrointestinal disease. Gastroenterology 45:633–637, 1963
Ukabam SO, Cooper BT: Small intestinal permeability to mannitol, lactulose and polyethyleneglycol 400 in celiac disease: Dig Dis Sci 29:809–816, 1984
Katz KD, Hollander D, Vadheim CM, McElree C, Delahunty T, Dadufalza VD, Krugliak P, Rotter JI: Intestinal permeability in patients with Crohn's disease and their healthy relatives. Gastroenterology 97:927–931, 1989
Elia M, Behrens R, Northrop C, Wraight P, Neale G: Evaluation of mannitol, lactulose and51Cr-labelled ethylenediaminetetraacetate as marker of intestinal permeability in man. Clin Sci 73:197–204, 1987
Marin ML, Greenstein AJ, Geller SA, Gordon RE, Aufses AH: A freeze fracture study of Crohn's disease of the terminal ileum: Changes in epithelial tight junction organisation. Am J Gastroenterol 78:537–547, 1983
Jenkins RT, Jones DB, Goodacre RL, Collins SM, Coates G, Hunt RH, Bienenstock J: Reversibility of increased intestinal permeability to51Cr-EDTA in patients with gastrointestinal inflammatory diseases. Am J Gastroenterol 82:1159–1164, 1987
Howden CW, Robertson C, Duncan A, Morris AJ, Russell RI: Comparison of different measurements of intestinal permeability in inflammatory bowel disease. Am J Gastroenterol 86:1445–1449, 1991
Hollander D, Vadheim CM, Brettholtz E, Petersen GM, Delahunty T, Rotter JI: Increased permeability in patients with Crohn's disease and their healthy relatives—a possible aetiological factor. Ann Intern Med 105:883–885, 1986
Ainsworth M, Eriksen J, Rasmussen WJ, Schaffalitzky de Muckadell OB: Intestinal permeability of51Cr-labelled ethylenediaminetetraacetic acid in patients with Crohn's disease and their healthy relatives. Scand J Gastroenterol 24:993–998, 1989
Teahon K, Smethurst P, Levi AJ, Menzies IS, Bjarnason I: Intestinal permeability in patients with Crohn's disease and their first degree relatives. Gut 33:320–323, 1992
Ruttenberg D, Young G, Wright J, Isaacs S: PEG-400 excretion in patients with Crohn's disease, their first degree relatives, and healthy volunteers. Dig Dis Sci 37:705–708, 1992
May GR, Sutherland LR, Meddings JB: Is small intestinal permeability really increased in relatives of patients with Crohn's disease? Gastroenterology 104:1627–1632, 1993
Chadwick VS, Phillips SF, Hofmann AF: Measurements of intestinal permeability using low molecular weight polyethyleneglycols (PEG 400). Gastroenterology 73:241–251, 1977
Jenkins RT, Goodacre RL, Rooney PJ, Bienenstock J, Sivakumaran TH, Walker WH: Studies of intestinal permeability in inflammatory diseases using polyethylene glycol 400. Clin Biochem 19:298–302, 1986
Hugon JS, Borgers M: Absorption of horseradish peroxidase by the mucosal cells of the duodenum of mouse. I. The fasting animal. J Histochem Cytochem 16:229–236, 1968
Pappenheimer JR: Paracellular intestinal absorption of glucose, creatinine and mannitol in normal animals: relation to body size. Am J Physiol 259:290–299, 1990
Madara JL, Moore R, Carlson S: Alteration of intestinal tight junction structure and permeability by cytoskeletal contraction. Am J Physiol 253:854–861, 1987
Hollander D: The intestinal permeability barrier. A hypothesis as to its regulation and involvement in Crohn's disease. Scand J Gastroenterol 27:721–726, 1992
Scadding G, Bjarnason I, Brostoff J, Levi AJ, Peters TJ: Intestinal permeability to51Cr-labelled ethylenediaminetetraacetate in food-intolerant subjects. Digestion 42:104–109, 1989
Aabakken L:51Cr-Ethylenediaminetetraacetic acid absorption test. Methodologic aspects. Scand J Gastroenterol 24:351–358, 1989
Ma T, Hollander D, Krugliak P, Katz K: PEG 400, a hydrophylic molecular probe for measuring intestinal permeability. Gastroenterology 98:39–46, 1990
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This study has been supported by grant 3.0061.92, FWGO, Brussels.
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Peeters, M., Ghoos, Y., Maes, B. et al. Increased permeability of macroscopically normal small bowel in Crohn's disease. Digest Dis Sci 39, 2170–2176 (1994). https://doi.org/10.1007/BF02090367
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DOI: https://doi.org/10.1007/BF02090367