Improvement in intestinal permeability precedes morphometric recovery of the small intestine in coeliac disease
| Autor: | John Cassidy, Peter C. Wilson, Fiona M. Thompson, David Gillis, Mark Lorenzetti, Emma K. Southcott, Ross N. Butler, Adrian G. Cummins |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
medicine.medical_specialty
Intestinal permeability medicine.diagnostic_test Diet therapy business.industry General Medicine medicine.disease Gastroenterology Coeliac disease Intestinal absorption Small intestine Lactulose medicine.anatomical_structure Internal medicine Biopsy Duodenum medicine business medicine.drug |
| Zdroj: | Clinical Science. 100:379-386 |
| ISSN: | 1470-8736 0143-5221 |
| DOI: | 10.1042/cs1000379 |
| Popis: | It is often difficult to assess small bowel recovery in adults with coeliac disease on a gluten-free diet (GFD). This prospective study compares changes in intestinal permeability with changes in intestinal biopsy at various intervals after commencing a GFD. Intestinal permeability was measured by lactulose/rhamnose absorption from 1 week to 24 months after commencing a GFD. Intestinal morphometry was measured by villus area, crypt length and mitotic count per crypt at diagnosis and after commencing a GFD. Median intestinal permeability values decreased from 0.47 (n = 35) at diagnosis to 0.25 (n = 17) after 1 week and to 0.16 (n = 18) after 2 months of a GFD. Rhamnose absorption improved significantly at an early stage, from 6.6% (untreated) to 15.4% at 3 months of a GFD, whereas the decrease in lactulose permeation took longer: from 3.4% (untreated) to 0.8% after 12 months of a GFD. Mean villus area (n = 29) was reduced to 16% of control values at diagnosis, and improved to a maximum of 48% after 6 months on a GFD, but did not change thereafter. Mean crypt length and mitotic count per crypt were increased by 222% and 356% respectively at diagnosis, and these parameters remained elevated at 172% and 216% above control values after 6 months of a GFD. We conclude that intestinal permeability improves within 2 months after starting a GFD, but that measurable intestinal biopsy improvement requires ingestion of a GFD for at least 3–6 months, and even then remains incomplete. |
| Databáze: | OpenAIRE |
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