INTESTINAL PERMEABILITY IN PATIENTS WITH CROHNS-DISEASE AND THEIR HEALTHY RELATIVES
INTESTINAL PERMEABILITY IN PATIENTS WITH CROHNS-DISEASE AND THEIR HEALTHY RELATIVES
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DOI：
10.1016/0016-5085(89)91499-6
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发表时间：
1989-10-01
期刊：
影响因子：
29.4
通讯作者：
ROTTER, JI
中科院分区：
文献类型：
--
作者：
KATZ, KD;HOLLANDER, D;ROTTER, JI
先前发现克罗恩病患者的健康亲属对聚乙二醇400的肠道通透性增加。为了确定这种异常通透性是否只能通过聚乙二醇400检测到，我们研究了三种新的探针（乳果糖、鼠李糖和甘露醇）在25名克罗恩病患者、41名其健康亲属以及29名无炎症性肠病家族史的正常对照者中的肠道通透性。与亲属或对照者相比，克罗恩病患者的乳果糖通透性增加。克罗恩病患者的乳果糖吸收率为0.41%±0.07%（平均值±标准误），而其亲属和无亲属关系的对照者的吸收率分别为0.28%±0.03%和0.26%±0.03%。亲属和对照者之间无显著差异，但这两组与患者均有差异（分别为p < 0.05和p < 0.025）。患者的乳果糖/鼠李糖比率为70.5%±9.2%，而亲属为37.2%±3.3%，无亲属关系的对照者为40.6%±5.7%（分别为p < 0.0005和p < 0.0025）。两种中等大小的探针，鼠李糖和甘露醇，未检测到三组之间的通透性差异。乳果糖、鼠李糖或甘露醇无法检测到克罗恩病患者健康亲属的通透性异常，这表明这些探针穿透肠道屏障的途径或机制与聚乙二醇400不同。特别是乳果糖可检测到肠道炎症患者的通透性变化，而聚乙二醇400能够检测到我们患者健康亲属的通透性变化。这些数据表明，通透性异常可能是炎症的继发性结果，也可能是原发性遗传异常的结果。
The healthy relatives of patients with Crohn''s disease were previously found to have increased intestinal permeability to polyethylene glycol 400. To determine whether the abnormal permeability is uniquely detectable by polyethylene glycol 400, we studied the intestinal permeability of three new probes (lactulose, rhamnose, and mannitol) in 25 patients with Crohn''s disease, 41 of their healthy relatives, and 29 normal controls without a family history fo inflammatory bowel disease. Patients with Crohn''s disease had increased lactulose permeability when compared with relatives or controls. Lactulose absorption by patients with Crohn''s disease was 0.41% .+-. 0.07% (mean .+-. SE), whereas that of their relatives and unrelated controls was 0.28% .+-. 0.03% and 0.26% .+-. 0.03%, respectively. There was no significant difference between the relatives and controls, but both groups differed from the patients (p < 0.05 and p < 0.025, respectively). The patients'' lactulose/rhamnose ratio was 70.5% .+-. 9.2% vs. 37.2% .+-. 3.3% in relatives and 40.6% .+-. 5.7% in unrelated controls (p < 0.0005 and p < 0.0025, respectively). The two intermediate-sized probes, rhamnose and mannitol, did not detect permeability differences among the three groups. The inability of lactulose, rhamnose, or mannitol to detect permeability abnormalities in healthy relatives of patients with Crohn''s disease suggests that these probes penetrate the intestinal barrier by routes of mechanisms that are different from those of polyethylene glycol 400. Lactulose, in particular, detects permeability changes in patients with intestinal inflammation, and polyethylene glycol 400 is able to detect permeability changes in the healthy relatives of our patients. These data indicate that permeability may be abnormal as a secondary result of inflammation, or as a result of a primary genetic abnormality.