Abstract
The authors review some of the more fundamental principles underlying the noninvasive assessment of intestinal permeability in humans, the choice of test markers and their analyses, and the practical aspects of test dose composition and how these can be changed to allow the specific assessment of regional permeability changes and other intestinal functions. The implications of increased intestinal permeability in the pathogenesis of human disease is discussed in relation to findings in patients with Crohn’s disease. A common feature of increased intestinal permeability is the development of a low grade enteropathy, and while quantitatively similar changes may be found in Crohn’s disease these seem to predict relapse of disease. Moreover, factors associated with relapse of Crohn’s disease have in common an action to increase intestinal permeability. While increased intestinal permeability does not seem to be important in the etiology of Crohn’s disease it may be a central mechanism in the clinical relapse of disease.
Highlights
RÉSUMÉ : Les auteurs passent en revue certains des principes les plus fondamentaux de l’évaluation non effractive de la perméabilité intestinale chez l’humain, le choix des marqueurs diagnostiques et leur analyse, et les aspects pratiques de la composition des doses utilisées et de la façon dont elles peuvent être modifiées pour permettre une évaluation spécifique des changements régionaux de perméabilité et autres fonctions intestinales
Acceptance of the technique was initially slow, mainly because of the confusion around the use of polyethylene glycol (PEG 400) [2,3], but in the past few years there has been a proliferation of published studies, from a wide range of research workers, that have used these tests to assess various aspects of gastrointestinal diseases
The data show that 65% of patients on long term nonsteroidal anti-inflammatory drugs (NSAIDs) develop small intestinal inflammation
Summary
Many practical problems encountered when setting up the necessary clinical and laboratory procedures require attention to special details. It is important to discuss these issues to ensure that such noninvasive test procedures may be successfully exploited to assess intestinal permeability and related aspects of intestinal function
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