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Updated: Dec 30, 2025
Real-time Measurement of Epithelial Barrier Permeability in Human Intestinal Organoids
Published on: December 18, 2017
Intestinal barrier dysfunction in liver cirrhosis assessed by iohexol test
V A Gerova1, D A Svinarov, R V Nakov
1Clinic of Gastroenterology, Tsaritsa Yoanna University Hospital - Medical University of Sofia, Sofia, Bulgaria. radislav.nakov@gmail.com.
Insights
This study found that 23% of liver cirrhosis patients exhibit increased intestinal permeability (IP). This gut barrier dysfunction is more severe in advanced liver disease with ascites and in alcoholic liver cirrhosis.
Area of Science:
- Gastroenterology
- Hepatology
- Internal Medicine
Background:
- Liver cirrhosis (LC) is a severe condition affecting liver function.
- Gut barrier integrity is crucial for overall health and can be compromised in chronic diseases.
- Assessing intestinal permeability (IP) offers insights into gut health in liver disease.
Purpose of the Study:
- To evaluate gut barrier function in liver cirrhosis patients by measuring intestinal permeability (IP).
- To investigate the relationship between IP and the severity and cause of liver cirrhosis.
Main Methods:
- 31 liver cirrhosis patients and 25 healthy controls were enrolled.
- Intestinal permeability (IP) was assessed using the iohexol test after oral administration.
- Serum iohexol concentrations (SIC) were measured at 3 and 6 hours using HPLC-UV.
Main Results:
- Liver cirrhosis patients showed significantly higher serum iohexol concentrations (SIC) compared to controls at 3 and 6 hours.
- 23% of patients demonstrated increased intestinal permeability (IP).
- Higher SIC values correlated with advanced Child-Pugh scores (Child C), presence of ascites, and alcoholic etiology.
Conclusions:
- Increased intestinal permeability (IP) is present in a significant portion of liver cirrhosis patients.
- Gut barrier dysfunction in liver cirrhosis is associated with disease severity, ascites, and alcoholic etiology.
Objective:
To study gut barrier function in patients with liver cirrhosis (LC) by evaluating the intestinal permeability (IP) and its relationship with the severity and etiology of the disease.
Patients And Methods:
The study included 31 patients with LC and 25 healthy controls. Child-Pugh score was used for evaluation of the LC severity. IP was assessed by the rise in levels of iohexol, which was administered orally (25 mL, 350 mg/mL) 2 h after breakfast. Three and six hours later serum (SIC mg/L) and urine (UIC g/mol) iohexol concentrations were determined by a validated HPLC-UV technique.
Results:
Patients with LC had significantly higher mean SIC value compared with control group at 3 h (2.05 ± 1.67 vs. 1.25 ± 1.41 mg/L, p=0.021, as well as at 6 h (2.20 ± 2.65 vs. 1.11 ± 1.06 mg/L, p=0.001) after ingestion. No significant difference was found in mean SIC value of patients at 3 and 6 h. 23% of the patients had an increased IP. The mean iohexol urine recovery of patients was similar to that of the controls both at 3 h and at 6 h. Mean SIC values were significantly higher in patients with advanced Child C class than in healthy controls or the subgroup with Child B class, both at 3 h (2.54 ± 1.95 mg/L vs. 1.11 ± 1.06 mg/L, p=0.007) or (2.57 ± 1.85 mg/L vs. 1.35±1.32 mg/L, p=0.005) and at 6 h (2.57 ± 1.85 mg/L vs. 1.25 ± 1.40 mg/L, p=0.002) or 2.54 ± 1.95 mg/L vs. 1.07 ± 0.35 mg/L, p=0.02). Cirrhotic patients with ascites had significantly higher SIC in comparison with the controls, both at 3 h (2.31 ± 1.74 vs. 1.25 ± 1.41 mg/, p=0.009) and at 6 h (2.20 ± 1.87 vs. 1.11 ± 1.06 mg/l, p=0.007). In the subgroup of patients with alcoholic LC, the mean SIC values at 3 and 6 h (2.29 ± 1.80, 2.33 ± 1.85 mg/L, respectively) were significantly higher (p= 0.016, p=0.003) compared to the control group (1.25 ± 1.41, 1.11 ± 1.06 mg/L, respectively).
Conclusions:
Increased IP is found in 23% of cirrhotic patients. Permeability alterations are significantly more pronounced in patients with advanced LC with the presence of ascites and in those with alcoholic etiology.
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