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Small intestinal permeability and orocaecal transit time in cystic fibrosis
A M Dalzell1, N S Freestone, D Billington
1Royal Liverpool Children's Hospital.
Insights
Children with cystic fibrosis exhibit increased intestinal permeability to disaccharides like cellobiose, but not monosaccharides such as mannitol. Gastric emptying and intestinal transit times were also evaluated in this study.
Area of Science:
- Gastroenterology
- Pediatrics
- Pulmonology
Background:
- Cystic fibrosis (CF) is a genetic disorder affecting multiple organs, including the gastrointestinal tract.
- Intestinal permeability and transit are crucial for nutrient absorption and overall health.
- Previous studies suggest potential gastrointestinal dysfunctions in CF patients.
Purpose of the Study:
- To investigate intestinal permeability using disaccharide (cellobiose) and monosaccharide (mannitol) probe molecules in children with CF.
- To evaluate orocaecal transit time in children with CF using the lactulose/hydrogen breath test.
- To determine the relationship between intestinal permeability and transit time in CF.
Main Methods:
- Intestinal permeability was assessed in 36 children with CF and 25 controls using cellobiose and mannitol.
- Orocaecal transit time was measured using the lactulose/hydrogen breath test.
- Excretion of probe molecules was quantified to determine permeability.
Main Results:
- A fourfold increase in intestinal permeability to cellobiose was observed in CF patients compared to controls.
- Intestinal permeability to mannitol was similar between CF patients and controls.
- Orocaecal transit time was prolonged in CF patients but showed no correlation with cellobiose or mannitol excretion.
Conclusions:
- Children with cystic fibrosis demonstrate significantly increased intestinal permeability to disaccharides.
- Monosaccharide permeability remains unaffected, suggesting a selective defect in CF.
- Delayed orocaecal transit in CF is independent of the observed changes in intestinal permeability.
Abstract:
Cellobiose and mannitol were used as probe molecules to measure intestinal permeability in 36 children with cystic fibrosis, and 25 age matched controls. Orocaecal transit was also evaluated for each subject using the lactulose/hydrogen breath test. There was a fourfold increase in permeability to disaccharide (cellobiose) in patients with cystic fibrosis, but permeability to the monosaccharide (mannitol) was similar to controls. The orocaecal transit time of lactulose was prolonged in patients with cystic fibrosis, but was unrelated to the percentage excretion of cellobiose or mannitol in cystic fibrosis patients or control subjects.