Related Experiment Videos
Intestinal permeability tests in coeliac disease.
S D Johnston1, M Smye, R P Watson
1Department of Gastroenterology, Belfast City Hospital, Northern Ireland. sjohnston@potblack.thegap.com
Clinical Laboratory
|April 11, 2001
Summary
Intestinal permeability tests using dual sugar probes like lactulose and mannitol effectively screen for coeliac disease. This noninvasive method enhances diagnostic accuracy for small intestinal conditions.
Area of Science:
- Gastroenterology
- Clinical Diagnostics
- Biochemistry
Background:
- Intestinal permeability tests are crucial for diagnosing small intestinal diseases such as coeliac disease and enteric infections.
- Various probe molecules (monosaccharides, disaccharides, 51Cr-EDTA, polyethyleneglycol) have been employed to assess intestinal permeability.
- Extraneous factors can influence test results, necessitating robust methodologies.
Purpose of the Study:
- To evaluate the efficacy of dual sugar intestinal permeability tests, specifically using lactulose and mannitol, in diagnosing coeliac disease.
- To explore methods for minimizing extraneous factors affecting test accuracy.
- To investigate the potential of serum measurements and sucrose permeability as noninvasive diagnostic markers.
Main Methods:
- Utilizing dual probe molecules (lactulose and mannitol) and expressing results as a ratio to minimize extraneous factor effects.
- Administering hyperosmolar test solutions to increase sensitivity in coeliac disease detection.
- Analyzing serum measurements of probe molecules and sucrose permeability as potential noninvasive markers.
Main Results:
- Dual sugar intestinal permeability tests demonstrate high sensitivity (up to 96%) for untreated coeliac disease.
- Elevated intestinal permeability in coeliac disease is characterized by increased lactulose absorption (paracellular) and reduced mannitol absorption (transcellular) due to villous atrophy.
- Serum measurements and sucrose permeability show promise as noninvasive diagnostic tools, particularly for pediatric and adult coeliac disease, respectively.
Conclusions:
- Dual sugar intestinal permeability testing is a sensitive and reliable method for screening coeliac disease and guiding jejunal biopsy.
- Raised intestinal permeability may play a role in the pathogenesis of coeliac disease.
- Noninvasive methods like serum probe molecule measurements and sucrose permeability offer future diagnostic potential.