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Gut regulatory peptides and intestinal permeability in acute infantile gastroenteritis
G R Lawson1, R Nelson, M F Laker
1Department of Child Health, University of Newcastle upon Tyne.
Insights
Infants with acute gastroenteritis showed significantly elevated gut regulatory peptides, including enteroglucagon and motilin, during illness. Some peptide levels, like motilin, remained high even after recovery, suggesting a role in infant gastroenteritis pathophysiology.
Area of Science:
- Gastroenterology
- Endocrinology
- Pediatrics
Background:
- Acute gastroenteritis is a common illness in infants.
- Gut regulatory peptides play a crucial role in gastrointestinal function.
- Altered peptide levels may contribute to the pathophysiology of gastroenteritis.
Purpose of the Study:
- To investigate plasma concentrations of gut regulatory peptides in infants with acute gastroenteritis.
- To compare peptide levels during acute illness, refeeding, and recovery with healthy controls.
- To assess the relationship between peptide levels, gut permeability, and gastroenteritis.
Main Methods:
- Measurement of plasma concentrations of seven gut regulatory peptides (enteroglucagon, pancreatic glucagon, peptide tyrosine tyrosine, motilin, vasoactive intestinal polypeptide, neurotensin, pancreatic polypeptide).
- Sampling at acute illness, reintroduction of feeding, and three months post-recovery.
- Assessment of intestinal permeability using the urinary lactulose to mannitol ratio.
Main Results:
- Significantly elevated fasting plasma concentrations of enteroglucagon, pancreatic glucagon, peptide tyrosine tyrosine, and motilin were observed during acute gastroenteritis compared to controls.
- Elevated preprandial motilin levels persisted at three months post-recovery.
- Increased intestinal permeability was detected during acute diarrhea, indicating gut damage.
Conclusions:
- Gut regulatory peptides, particularly enteroglucagon and motilin, are significantly altered during acute infant gastroenteritis.
- Persistent elevation of motilin post-recovery suggests a potential long-term impact or role in the disease process.
- Altered peptide profiles and increased intestinal permeability are implicated in the pathophysiology of infant gastroenteritis.
Abstract:
The plasma concentrations of seven gut regulatory peptides were measured in 11 infants suffering from acute gastroenteritis. Samples were taken at the time of the acute illness, upon reintroduction of feeding, and three months after recovery. These results were compared with controls. In the infants with diarrhoea, a massive increase in the fasting plasma mean (SEM) concentrations of enteroglucagon was found at the time of illness (1292 (312) v 79 (27) pmol/l), with concentrations of pancreatic glucagon, peptide tyrosine tyrosine, and motilin also being increased (17.8 (3.1) v 6.3 (1.1) pmol/l, 114.6 (15.2) v 37.0 (11.0) pmol/l, 217.6 (44.1) v 98.5 (18.3 pmol/l) respectively). The preprandial concentrations of motilin were found to be still increased at recovery (183.9 (35.4) pmol/l), but the concentrations of the other three peptides had returned to normal values. No differences in plasma concentrations of vasoactive intestinal polypeptide, neurotensin, or pancreatic polypeptide were found. An increased intestinal permeability was demonstrated at the time of diarrhoea by the urinary ratio of lactulose to mannitol, suggesting simultaneous gut damage. The effects of regulatory peptides may be relevant to the pathophysiology of gastroenteritis in infants.