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Low-dose methotrexate-induced changes in intestinal permeability determined by polyethylene glycol polymers
1USDA/ARS Children's Nutrition Research Center, Houston, Texas 77030.
Journal of Pediatric Gastroenterology and Nutrition
|October 1, 1989
Summary
Low-dose methotrexate (MTX) significantly increases small bowel permeability in children undergoing leukemia treatment, potentially affecting nutrient absorption. This chemotherapy agent impacts intestinal integrity through paracellular pathways.
Area of Science:
- Pediatric Oncology
- Gastroenterology
- Pharmacology
Background:
- Chemotherapeutic agents' effects on pediatric small bowel mucosa are understudied.
- Methotrexate (MTX) is a common chemotherapy agent used in treating acute lymphocytic leukemia (ALL).
Purpose of the Study:
- To investigate the impact of low-dose methotrexate (MTX) on small bowel permeability and mucosal integrity in children.
- To assess changes in intestinal barrier function following MTX administration.
Main Methods:
- Low molecular weight polyethylene glycol (PEG) recovery test was performed on 19 children with ALL before and after MTX doses.
- Urine samples collected over 6 hours were analyzed to calculate PEG parameters (PCD0 and N1/2).
Main Results:
- A significant increase in PCD0 (indicating increased PEG transmucosal passage) was observed in 15/19 children post-MTX (p < 0.015).
- A decrease in N1/2, potentially indicating reduced enterocyte mass, was noted in 11/38 studies.
Conclusions:
- Low-dose MTX treatment increases intestinal permeability in children via the paracellular pathway.
- This MTX-induced increase in intestinal permeability may alter the absorption of other orally administered substances.