Intestinal Permeability in Pediatric Gastroenterology
- 1 January 1992
- journal article
- review article
- Published by Taylor & Francis in Scandinavian Journal of Gastroenterology
- Vol. 27 (sup194), 19-24
- https://doi.org/10.3109/00365529209096021
Abstract
The role of the physiologic barrier function of the small bowel and its possible role in health and disease has attracted much attention over the past decade. The intestinal mucosal barrier for luminal macromolecules and microorganism is the result of non-immunologic and immunologic defense mechanisms. The non-immunologic mechanisms consist of intraluminal factors such as gastric acid, proteolytic activity, and motility and of mucosal surface factors like mucin and the microvillous membrane. The immunologic mechanisms include secretary IgA and cell-mediated immunity. Both types of mechanism are not completely mature at birth. Maturation of this barrier is not finished before the 2nd year of life. One of the aspects of the mucosal barrier function can be estimated by the intestinal permeability (IP) for macromolecules. We use the differential sugar absorption test (SAT), in which the ratio of urinary excretion of a relatively large molecule, lactulose, is compared with that of a relatively small molecule, mannitol, after oral ingestion. Although the small intestine is permeable to certain macromolecules in normal developmental conditions, an increased IP could be involved in the pathophysiology of several diseases, including infectious diarrhea, food allergy, celiac disease, and Crohn's disease. It can be concluded that IP, as measured with the SAT, reflects the state of the mucosal barrier and is altered in several gastrointestinal diseases. The SAT is a non-invasive IP test that can be of diagnostic help to demonstrate alterations in the small-mucosal barrier function and may be useful to evaluate therapeutic interventions. The measurement of IP may lead to greater insight in the role of the small-mucosal barrier in various (pediatric) gastrointestinal diseases.Keywords
This publication has 73 references indexed in Scilit:
- Ontogeny of Digestion and Absorption as Related to Prenatal Changes in Food Composition in InfantsActa Paediatrica, 1989
- Does breast feeding help protect against atopic disease? Biology, methodology, and a golden jubilee of controversyThe Journal of Pediatrics, 1988
- Cellobiose/mannitol test: physiological properties of probe molecules and influence of extraneous factorsClinica Chimica Acta; International Journal of Clinical Chemistry, 1985
- Intestinal permeability changes and excretion of micro-organisms in stools of infants with diarrhoea and vomiting.Archives of Disease in Childhood, 1985
- Intestinal permeability in the newborn.Archives of Disease in Childhood, 1984
- Development of the Gastrointestinal Mucosal BarrierNeonatology, 1984
- A PERSISTENT DEFECT IN INTESTINAL PERMEABILITY IN COELIAC DISEASE DEMONSTRATED BY A 51Cr-LABELLED EDTA ABSORPTION TESTThe Lancet, 1983
- Abnormal Small Intestinal Permeability to Sugars in Patients with Crohn’s Disease of the Terminal Ileum and ColonDigestion, 1983
- Impact of development of the gastrointestinal tract on infant feedingThe Journal of Pediatrics, 1983
- An experimental study of acute neonatal enterocolitis—the importance of breast milkJournal of Pediatric Surgery, 1974