Intestinal permeability is increased in patients with intermittent claudication

Area of Science:

• Vascular Biology
• Gastroenterology
• Exercise Physiology

Background:

• Intermittent claudication is characterized by repeated ischemia-reperfusion injury.
• This injury can lead to increased vascular permeability, affecting the intestines.
• The lactulose mannitol (L/M) test is a standard method to assess intestinal permeability.

Purpose of the Study:

• To evaluate changes in intestinal permeability in patients with intermittent claudication using the L/M test.
• To determine if exercise-induced ischemia in intermittent claudication affects intestinal permeability.
• To assess the impact of arterial reconstruction on intestinal permeability in these patients.

Main Methods:

• The L/M test was administered to 11 patients with intermittent claudication and 11 controls at rest and after treadmill exercise.
• Patients exercised until symptom-limited.
• The L/M test was repeated post-arterial reconstruction, with patients walking a standardized distance.

Main Results:

• Patients with intermittent claudication showed a significantly higher L/M ratio after exercise compared to rest (0.068 vs 0.022, P < .05).
• Control subjects exhibited no significant difference in L/M ratios between rest and exercise.
• Following successful arterial reconstruction, the post-exercise L/M ratio in patients decreased significantly (0.068 to 0.018, P < .05).

Conclusions:

• Exercise significantly increases intestinal permeability in patients with intermittent claudication.
• Successful arterial reconstruction normalizes exercise-induced increases in intestinal permeability.
• The L/M test serves as a novel, noninvasive indicator of lower limb ischemia during exercise.