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Updated: Aug 8, 2026
An Intravital Microscopy-Based Approach to Assess Intestinal Permeability and Epithelial Cell Shedding Performance
Published on: December 3, 2020
Gastrointestinal permeability changes in the preterm neonate
Insights
Neonatal bowel permeability to sugars changes after birth. Healthy preterm infants show increased permeability early in life, which matures over time, unlike infants experiencing trauma.
Area of Science:
- Neonatal physiology
- Gastrointestinal research
- Pediatric medicine
Background:
- The neonatal gut barrier's permeability is crucial for infant health.
- Understanding changes in gut permeability is vital for preterm infant care.
Purpose of the Study:
- To assess neonatal bowel permeability to large and small molecules.
- To investigate the impact of gestational age and health status on gut permeability.
Main Methods:
- Utilized the lactulose/L-rhamnose urinary excretion ratio as an index of intestinal permeability.
- Administered milk containing both sugars via continuous infusion to infants.
- Monitored sugar excretion ratios at different time points post-birth.
Main Results:
- Healthy infants (31-36 weeks gestational age) exhibited heightened permeability in the first week, with ratios decreasing by days 9-16.
- Infants experiencing asphyxia or sepsis showed less pronounced permeability changes.
- Preterm infants (26-29 weeks gestational age) had mature permeability at birth, followed by a transient increase around 3-4 weeks.
Conclusions:
- Enhanced permeability to larger molecules appears to be a temporary, specific condition in the neonatal gut.
- Further research is needed to establish the immunological implications of this phenomenon in human infants.
Abstract:
The lactulose/L-rhamnose urinary excretion ratio during continued infusion of milks containing both sugars was used as an index of the permeability of the neonatal bowel to large and small molecules. Healthy infants of gestational age 31-36 weeks proved to have a period of enhanced permeability to lactulose during the first week of life, the lactulose/L-rhamnose excretion ratio being significantly higher on day 2 than on days 9 or 16 when a mature pattern of permeability could be seen. In infants traumatised by asphyxia or sepsis this change was much less pronounced. Healthy preterm infants of gestational age 26-29 weeks showed a 'mature' pattern of permeability at birth, followed by a temporary period of enhanced permeability after 3-4 weeks of life. It is proposed that enhanced permeability to larger molecules is a specific temporary condition of the neonatal bowel in man as in other mammals, but the immunological implications in man remain to be established.
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