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Novel multi-sugar assay for site-specific gastrointestinal permeability analysis: a randomized controlled crossover
Kim van Wijck1, Thomas J M Verlinden, Hans M H van Eijk
1Top Institute Food and Nutrition, Wageningen, The Netherlands. k.vanwijck@maastrichtuniversity.nl
Clinical Nutrition (Edinburgh, Scotland)
|August 16, 2012
Summary
The multi-sugar (MS) test accurately detects increased gastrointestinal (GI) permeability by analyzing sugar excretion in urine and plasma. This advanced MS test offers site-specific GI permeability insights, unlike the dual sugar (DS) test.
Area of Science:
- Gastroenterology
- Pharmacology
- Analytical Chemistry
Background:
- Increased gastrointestinal (GI) permeability is linked to conditions causing antigen exposure and sepsis.
- Current GI permeability tests face analytical limitations.
- Accurate assessment of GI permeability is crucial for diagnosing and managing various diseases.
Purpose of the Study:
- To compare the accuracy of a novel multi-sugar (MS) test against the classical dual sugar (DS) test for detecting increased GI permeability.
- To evaluate the sensitivity and specificity of both MS and DS tests in analyzing sugar excretion.
- To determine the site-specific information provided by the MS test regarding GI tract segments.
Main Methods:
- Ten volunteers underwent permeability analysis using either the MS test (sucrose, lactulose, sucralose, erythritol, rhamnose) or the DS test (lactulose, rhamnose).
- Participants received either indomethacin or a placebo to induce changes in GI permeability.
- Blood and urine samples were analyzed using isocratic liquid chromatography-mass spectrometry (LC-MS).
Main Results:
- The MS test revealed significantly elevated urinary lactulose/rhamnose ratios post-indomethacin, primarily due to increased lactulose excretion.
- The DS test also showed increased lactulose/rhamnose ratios, but this was influenced by both increased lactulose and decreased rhamnose excretion.
- Both MS and DS tests indicated increased plasma lactulose/rhamnose ratios after indomethacin, with significant correlations between urinary and plasma measurements.
Conclusions:
- Sensitive GI permeability analysis is feasible in both plasma and urine using MS and DS tests.
- The MS test provides accurate, site-specific information on gastroduodenal, small, and large intestinal permeability.
- Unlike the DS test, the MS test avoids decreased monosaccharide excretion, offering a more refined assessment.
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