Effect of total starvation and very low calorie diets on intestinal permeability in man

1987 ◽  
Vol 73 (2) ◽  
pp. 205-210 ◽  
Author(s):  
M. Elia ◽  
A. Goren ◽  
R. Behrens ◽  
R. W. Barber ◽  
G. Neale
Keyword(s):  
Intestinal Permeability ◽  
Transit Time ◽  
Low Calorie ◽  
51Cr Edta ◽  
Very Low Calorie Diets ◽  
Total Starvation ◽  
Obese Subjects ◽  
Group 3 ◽  
Small Intestinal ◽  
Group 2

1. The effect of total starvation for 4–5 days on the intestinal uptake and urinary excretion of markers from an orally administered mixture of mannitol (5 g), [14C]mannitol (0.5 μCi), lactulose (10 g) and 51Cr-labelled ethylenediaminetetra-acetate (51Cr-EDTA) (30 μCi), was assessed in five lean (group 1) and four obese (group 2) subjects. The effect of a very low calorie diet for 1 week and of a subsequent 5 day period of total starvation on intestinal permeability was assessed in a similar way in another group of obese subjects (group 3). Transit time from mouth to caecum of the fastest component of the oral mixture was assessed by the appearance of hydrogen in breath (all subjects), and the configuration of the transit spectrum through various segments of the gastrointestinal tract, was assessed by a radionuclide scan method (group 2 subjects only). The effect of starvation on plasma/renal clearance of these markers in subjects of group 2 was assessed with the use of a bolus intravenous injection of a mixture of mannitol (2 g), [14C]mannitol (10 μCi), lactulose (0.1 g) and 51Cr-EDTA (5 μCi). 2. The uptake and urinary excretion of orally administered mannitol was decreased by total starvation. The mean decrease was 47% in the lean subjects (P < 0.025), 33% in group 2 obese subjects (P < 0.05) and 41% in group 3 obese subjects P > 0.05). In contrast, starvation produced no significant change in either the excretion of 51Cr-EDTA or lactulose. 3. There was no significant effect of starvation on transit time, whether assessed by the increase in breath hydrogen concentration in expired air or by radionuclide scanning. 4. Starvation produced no significant change in the clearance of the intravenously administered markers from the plasma. Oxidation of intravenous mannitol was estimated to account for about 1% of the clearance both before and during starvation. 5. The data provide evidence of a selective decrease in the absorption and excretion of mannitol during short-term total starvation. The changes in the excretion of mannitol are not due to alterations in renal function or gastrointestinal transit time, or to changes in the oxidation and plasma clearance of mannitol. They are likely to reflect changes in the small intestinal mucosa during early starvation. In contrast, very low calorie diets taken for at least 1 week prevent changes in small intestinal permeability.

Intestinal Permeability to 51Cr-EDTA and Orocecal Transit Time in Cystic Fibrosis

1992 ◽  
Vol 14 (2) ◽  
pp. 204-207 ◽  
Author(s):  
H. Escobar ◽  
M. Perdomo ◽  
F. Vasconez ◽  
C. Camarero ◽  
M. T. del Olmo ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Intestinal Permeability ◽  
Transit Time ◽  
Orocecal Transit Time ◽  
51Cr Edta ◽  
Orocecal Transit

scholarly journals Correlation between Preoperative Coronary Artery Stenosis Severity Measured by Instantaneous Wave-Free Ratio and Intraoperative Transit Time Flow Measurement of Attached Grafts

Medicina ◽  
2020 ◽  
Vol 56 (12) ◽  
pp. 714
Author(s):  
Almas Tolegenuly ◽  
Rasa Ordiene ◽  
Arslan Mamedov ◽  
Ramunas Unikas ◽  
Rimantas Benetis
Keyword(s):  
Coronary Artery ◽  
Transit Time ◽  
Flow Measurement ◽  
Coronary Artery Stenosis ◽  
Artery Stenosis ◽  
Time Flow ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background and Objectives: To assess the correlation between the degree of target coronary artery stenosis measured by instantaneous wave-free ratio (iFR) and the intraoperative transit time flow measurement (TTFM) of attached grafts as well as evaluate flow competition between the native coronary artery and the attached graft according to the severity of stenosis. Materials and Methods: In total, 89 grafts were subjected to intraoperative transit time flow measurement after coronary artery bypass grafting (CABG) in 25 patients with multivessel coronary artery disease (CAD). The iFR was evaluated for all coronary arteries with grafts. The coronary artery stenoses were divided into three groups based on the iFR value: iFR < 0.86 (group 1); iFR 0.86–0.90 (group 2); and iFR > 0.90 (group 3). Results: The mean graft flow (MGF) was 46.9 ± 18.4 mL/min for group 1, 45.3 ± 20.9 mL/min for group 2, and 31.3 ± 18.5 mL/min for group 3. A statistically significant difference was confirmed between groups 1 and 3 (p = 0.002) and between groups 2 and 3 (p = 0.025). The pulsatility index (PI) was 2.49 ± 1.20 for group 1, 2.66 ± 2.13 for group 2, and 4.70 ± 3.66 for group 3. A statistically significant difference was found between groups 1 and 3 (p = 0.006) and between groups 2 and 3 (p = 0.032). Backward flow was detected in 7.5% of grafts for group 1, in 16.6% of grafts for group 2, and in 16% of grafts for group 3. A statistically significant difference was found between groups 1 and 2 (p = 0.025) and between groups 1 and 3 (p = 0.029). Conclusions: The iFR is a useful tool for predicting the impact of competitive flow observed between a native artery and an attached graft. The effect of competitive flow significantly increases when the graft is attached to a vessel with mild coronary stenosis. In a coronary artery where the iFR was not hemodynamically significant, the MGF was lower, the PI was higher, and a larger proportion of grafts with backward flow (BF) was detected compared to when there was significant stenosis (iFR < 0.86).

Postoperative Dysphagia versus Neurogenic Dysphagia: Scintigraphic Assessment

2003 ◽  
Vol 112 (1) ◽  
pp. 20-28 ◽  
Author(s):  
Venanzio Valenza ◽  
AnaMaria Samanes Gajate ◽  
Jacopo Galli ◽  
Lucia D'Alatri ◽  
Stefano Di Girolamo ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Transit Time ◽  
Retention Index ◽  
Normal Subjects ◽  
Mean Value ◽  
Esophageal Transit ◽  
Maximum Value ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

In order to differentiate the features of dysphagia that occur after supraglottic horizontal laryngectomy from those that occur during neurologic diseases, we divided 38 subjects into 3 groups and submitted them to oropharyngoesophageal scintigraphy. Group 1 (control group) included 15 healthy volunteeers; group 2 comprised 8 patients who had residual dysphagia at least 1 year after supraglottic laryngectomy; and group 3 included 15 patients with various neurologic and neuromuscular disorders. In group 1, the mean values (±2 SD) of selected semiquantitative parameters were consistent with those reported in the literature for normal subjects. In group 2, oral, pharyngeal, and esophageal transit times were not significantly altered, and moderate tracheobronchial postdeglutitive aspiration was present (maximum value, 6.7%; mean value, 2.04%). The pharyngeal retention index was significantly increased (p = .0003) as compared to normal subjects in all cases (maximum value, 40%; mean value, 23%) and was associated in all cases with slight but consistent postdeglutitive aspiration. In group 3, the oral and esophageal phases were significantly prolonged and the retention indices were significantly increased. Statistical analysis documented a significant increase in oral transit time (p = .003), esophageal transit time (p = .01), oral retention index (p = .006), pharyngeal retention index (p = .0007), and esophageal retention index (p = .009) as compared to normal subjects. The swallowing pattern was also altered by 1) an early loss of the bolus from the oral cavity; 2) bolus fragmentation due to double or triple deglutition, reduced lingual propulsion, or the return of a small part of the bolus into the oral cavity during deglutition; and/or 3) double pharyngeal peaks in the activity-time curves. Tracheobronchial aspiration (maximum value, 90%; mean value, 9.70%) was present in some cases, mainly in patients affected by post-stroke dysphagia. On the basis of the obtained results and considering the low doses of radiation delivered to the patient (0.043 Gy), the limited invasiveness, and the excellent patient tolerance, scintigraphy appears to be clinically valid in the functional study of swallowing and in identifying different deglutition disorders.

scholarly journals A45 INFLAMMATION AND INTESTINAL PERMEABILITY IN PEDIATRIC SHORT BOWEL SYNDROME

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 53-54
Author(s):  
J K Dowhaniuk ◽  
S Chorlton ◽  
G Teskey ◽  
D Loukov ◽  
C Verschoor ◽  
...  
Keyword(s):  
Intestinal Permeability ◽  
Fecal Calprotectin ◽  
Intestinal Epithelial ◽  
Epithelial Barrier Function ◽  
Group 4 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Group 1 ◽  
Bacterial Products

Abstract Background Both intestinal dysbiosis and central-line associated blood stream infections (CLABSI) have been well documented in children with short bowel syndrome (SBS). Gastrointestinal microbiota prime and regulate mucosal immunity, therefore we hypothesize children with SBS may have longstanding increased intestinal permeability which could lead to mucosal inflammation and predispose to bacteremia. Aims We sought to investigate intestinal permeability as well as both intestinal and systemic activation of the inflammatory cascade in children with SBS. Methods Two cohorts of children with SBS were consented; with Group 1 including children with SBS requiring central venous catheter (CVC) for parenteral nutrition, and Group 2 including children with SBS without CVC. SBS groups were compared to three control groups including age and sex-matched children with CVC for hematologic disease (Group 3), children without a CVC (Group 4) and healthy adult controls (Group 5). To evaluate intestinal permeability, we quantified circulating bacterial products LPS and MDP through the binding of their respective receptors, TLR4 and NOD2. To determine colonic inflammation, fecal calprotectin was quantified from a single stool sample. Cytokine profiles included IFN-γ, IL-Iβ, IL-8, IL-10, IL-17, TNFα were quantified by Multiplex Immunoassay while gene expression of transcription factors FoxP3+, RORγT, TLR2, and TLR4, were determined by RNA extraction and quantitative PCR. Results 22 children were recruited in the study (Group 1 n=6, Group 2 n=6, Group 3 n=5, Group 4 n=5) as well as 10 adult control samples (Group 5). The median age of Group 1 was 67 months with a residual small intestine of 26.5cm (IQR 24.7–40) while those in Group 2 were 51 months with a residual small intestine of 55cm (IQR 31.2–89). Circulating bacterial products of LPS and MDP were not different between SBS groups and control children. Serum analysis of cytokine TNFα was significant (p&lt;0.005) however multiple comparator analysis did not identify within group differences. Other cytokines did not differ between groups. Fecal calprotectin levels were not elevated however statistically lower in Group 1 (median 12.8mg/kg; IQR 9.3- 34.9) compared to in Group 2 (median 96mg/kg, IQR 71.6–188.2;) p &lt;0.01. Relative quantification of RNA expression of FoxP3+, RORγT, TLR2, and TLR4 did not differ between groups. Conclusions Despite concern of compromised intestinal epithelial barrier function in children with SBS, this study did not detect differences in circulating bacterial products compared to control children as an assessment of intestinal permeability nor increased systemic inflammation. Further research is required to investigate intestinal epithelial barrier function over time and the mechanism of bacteremia in children with SBS. Funding Agencies CAGRegional Medical Associates of Hamilton

Evaluation of mannitol, lactulose and 51Cr-labelled ethylenediaminetetra-acetate as markers of intestinal permeability in man

1987 ◽  
Vol 73 (2) ◽  
pp. 197-204 ◽  
Author(s):  
M. Elia ◽  
R. Behrens ◽  
C. Northrop ◽  
P. Wraight ◽  
G. Neale
Keyword(s):  
Urinary Excretion ◽  
Intestinal Permeability ◽  
Large Bowel ◽  
Normal Subjects ◽  
Distribution Volume ◽  
The Body ◽  
Factors Affecting ◽  
51Cr Edta ◽  
Small Intestinal ◽  
Radionuclide Scanning

1. Factors affecting the intestinal uptake and urinary excretion of mannitol, lactulose and 51Cr-labelled ethylenediaminetetra-acetate (51Cr-EDTA), have been investigated in normal subjects and three patients with ileostomy. 2. The distribution volume of markers within the body, the rate of disappearance from plasma and renal clearance were assessed after an intravenous injection of a mixture of mannitol (2 g), [14C]mannitol (10 μCi), lactulose (0.1 g) and 51Cr-EDTA (5 μCi). 3. The urinary recovery of all the intravenously administered markers was close to 100%. Distribution volumes and patterns of excretion were virtually identical. Oxidation of intravenously administered mannitol accounted for only about 1% of the dose. 4. The passage of an orally administered mixture of markers was traced through the intestine and into urine. Transit time through the gastrointestinal tract was measured by the breath hydrogen method and by radionuclide scanning. 5. The passage of markers from mouth to the large bowel was essentially complete by 3.5 h. In some subjects the marker appeared in the large bowel as early as 30–40 min but in others it took three times as long. 6. After an oral dose the urinary excretion of mannitol fell progressively from 2 to 6 h, whereas the excretion of lactulose and 51Cr-EDTA increased slightly. As a consequence the lactulose/mannitol and 51Cr-EDTA/mannitol ratios in urine collected between 0 and 2 h were more than twofold higher than in urine collected between 4 and 6 h (P < 0.001). After 6 h, the urinary excretion of mannitol and lactulose declined rapidly in all subjects, and was similar to the pattern of excretion of 51Cr-EDTA in subjects with an ileostomy. In contrast, in normal subjects, the excretion of 51Cr-EDTA did not decline rapidly but continued for 24–48 h. 7. Differences in the excretion of mannitol, lactulose and 51Cr-EDTA after oral dosing is due to differences in the temporal pattern of absorption of these markers and not to differences in their distribution volume, oxidation or their clearance by the kidney. 8. The data suggest that the uptake of lactulose by the small intestine persists for longer than the uptake of mannitol, and show that 51Cr-EDTA is readily absorbed in the colon. This study indicates factors which must be considered in the design and interpretation of tests of small intestinal permeability.

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