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Effect of hyperbilirubinemia on intestinal permeability in healthy term newborns

Flavia Indrio1, Francesco Raimondi, Nicola Laforgia

  • 1Department of Pediatrics, Neonatology Section, University of Bari, Bari I-70124, Italy. f.indrio@neonatologia.uniba.it

Acta Paediatrica (Oslo, Norway : 1992)
|December 26, 2006
PubMed

Insights

High serum bilirubin levels in newborns directly increase intestinal permeability. This suggests unconjugated bilirubin may compromise the gut barrier, potentially increasing sensitization risks.

Area of Science:

  • Neonatal physiology
  • Gastroenterology
  • Immunology

Background:

  • Intestinal permeability (IP) is crucial for nutrient absorption and immune tolerance in neonates.
  • Elevated serum bilirubin (SB) is common in newborns, but its effect on IP is not well understood.
  • Understanding SB's impact on IP is vital for assessing neonatal health and potential complications.

Purpose of the Study:

  • To investigate the effect of serum bilirubin (SB) on intestinal permeability (IP) in healthy term newborns.
  • To determine if unconjugated bilirubin (UCB) directly impacts the gut epithelial barrier.
  • To assess the relationship between SB levels and IP before initiating phototherapy.

Main Methods:

  • Utilized a dual probe (lactulose/mannitol) sugar absorption test (SAT) to measure IP.
  • Compared 12 jaundiced newborns (SB > 249 micromol/L) with 12 matched non-jaundiced controls.
  • Performed SAT on the third day of life prior to phototherapy treatment.

Main Results:

  • Jaundiced newborns exhibited significantly higher lactulose/mannitol (La/Ma) ratios compared to non-jaundiced newborns (0.31 vs. 0.053; p < 0.0004).
  • A significant positive correlation was observed between serum bilirubin levels and the La/Ma ratio (r = 0.56; p < 0.006).
  • These findings indicate increased intestinal permeability in jaundiced neonates.

Conclusions:

  • This study demonstrates a direct effect of unconjugated bilirubin (UCB) on the gut epithelial barrier in term newborns.
  • UCB appears to be responsible for altering intestinal permeability, potentially increasing the passage of macromolecules.
  • This alteration in IP may theoretically increase the risk of sensitization in neonates.
Abstract

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