Increased small intestinal permeability in ulcerative colitis: Rather genetic than environmental and a risk factor for extensive disease?
| Autor: | Sabine Buhner, Matthias Prager, Andreas Sturm, Daniel C. Baumgart, Herbert Lochs, Carsten Büning, Nora Geissler, Janine Büttner, Verena Haas |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Sucrose Pancolitis medicine.medical_specialty Colon Azathioprine Gastroenterology Permeability Risk Factors Internal medicine Intestine Small medicine Humans Immunology and Allergy Genetic Predisposition to Disease Proctitis Tissue Distribution Colitis Risk factor Spouses Intestinal permeability Mercaptopurine business.industry Remission Induction Case-control study medicine.disease Ulcerative colitis Intestinal Absorption Case-Control Studies Colitis Ulcerative Female medicine.symptom business Immunosuppressive Agents medicine.drug |
| Zdroj: | Inflammatory Bowel Diseases. 18:1932-1939 |
| ISSN: | 1078-0998 |
| DOI: | 10.1002/ibd.22909 |
| Popis: | Background: A disturbed epithelial barrier could play a pivotal role in ulcerative colitis (UC). We performed a family-based study analyzing in vivo gastrointestinal permeability in patients with UC, their healthy relatives, spouses, and controls. Methods: In total, 89 patients with UC in remission, 35 first-degree relatives (UC-R), 24 nonrelated spouses (UC-NR), and 99 healthy controls (HC) were studied. Permeability was assessed by a sugar-drink test using sucrose (gastroduodenal permeability), lactulose/mannitol (intestinal permeability), and sucralose (colonic permeability). Data were correlated with clinical characteristics including medical treatment. Results: Increased intestinal permeability was detected significantly more often in UC patients in remission (25/89, 28.1%) compared with HC (6/99, 6.1%; P < 0.001). Similar results were obtained in UC-R (7/35, 20.0%; P = 0.01 compared with HC) regardless of sharing the same household with the patients or not. No difference was found between UC-NR (3/24, 12.5%) and HC. Notably, in UC patients increased intestinal permeability was found in 12/28 patients (42.9%) with pancolitis, 7/30 (23.3%) patients with left-sided colitis, and in 2/19 (10.5%) patients with proctitis (P = 0.04). Gastroduodenal and colonic permeability were similar in all groups. Among patients on azathioprine, increased intestinal permeability was only seen in 1/18 (5.6%) patients. In contrast, in 24/70 (34.3%) patients without azathioprine, an increased intestinal permeability was found (P = 0.005). Conclusions: An increased intestinal but not colonic permeability was found in UC patients in clinical remission that could mark a new risk factor for extensive disease location. Similar findings in healthy relatives but not spouses suggest that this barrier defect is genetically determined. (Inflamm Bowel Dis 2012) |
| Databáze: | OpenAIRE |
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