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01-03-2010 | Original Article

Intestinal Permeability in Irritable Bowel Syndrome Patients: Effects of NSAIDs

Authors: Angèle P. M. Kerckhoffs, Louis M. A. Akkermans, Martin B. M. de Smet, Marc G. H. Besselink, Falco Hietbrink, Imke H. Bartelink, Wim B. Busschers, Melvin Samsom, Willem Renooij

Published in: Digestive Diseases and Sciences | Issue 3/2010

Abstract

Intestinal permeability and the effect of NSAIDs on permeability were investigated in 14 irritable bowel syndrome (IBS) patients and 15 healthy subjects. In the study, 24-h urinary recoveries of orally administered polyethylene glycols (PEGs 400, 1500, and 4000) were not significantly different in healthy subjects and IBS patients before or after NSAID ingestion. Lactulose mannitol ratios in healthy subjects and IBS patients were not significantly different. Only time-dependent monitoring of PEG excretion showed that NSAIDs enhanced intestinal permeability for PEG 4000 in healthy subjects (P = 0.050) and for PEGs 400, 1500, and 4000 in IBS patients (P = 0.012, P = 0.041, and P = 0.012, respectively). These results show that intestinal permeability in IBS patients is not different from that in healthy subjects; NSAIDs compromise intestinal permeability in IBS patients to a greater extent than in healthy subjects, which suggests that IBS is associated with an altered response of the intestinal barrier to noxious agents.

Mayer EA, Collins SM. Evolving pathophysiologic models of functional gastrointestinal disorders. Gastroenterology. 2002;122(7):2032–2048. doi:10.1053/gast.2002.33584.CrossRefPubMed

Rodriguez LA, Ruigomez A. Increased risk of irritable bowel syndrome after bacterial gastroenteritis: cohort study. BMJ. 1999;318(7183):565–566.PubMed

Barbara G, Stanghellini V, De Giorgio R, et al. Activated mast cells in proximity to colonic nerves correlate with abdominal pain in irritable bowel syndrome. Gastroenterology. 2004;126(3):693–702. doi:10.1053/j.gastro.2003.11.055.CrossRefPubMed

Spiller RC, Jenkins D, Thornley JP, et al. Increased rectal mucosal enteroendocrine cells, T lymphocytes, and increased gut permeability following acute Campylobacter enteritis and in post-dysenteric irritable bowel syndrome. Gut. 2000;47(6):804–811. doi:10.1136/gut.47.6.804.CrossRefPubMed

Marshall JK, Thabane M, Garg AX, Clark W, Meddings J, Collins SM. Intestinal permeability in patients with irritable bowel syndrome after a waterborne outbreak of acute gastroenteritis in Walkerton, Ontario. Aliment Pharmacol Ther. 2004;20(11–12):1317–1322. doi:10.1111/j.1365-2036.2004.02284.x.CrossRefPubMed

Parry S, Forgacs I. Intestinal infection and irritable bowel syndrome. Eur J Gastroenterol Hepatol. 2005;17(1):5–9. doi:10.1097/00042737-200501000-00002.CrossRefPubMed

Minocha A, Johnson WD, Abell TL, Wigington WC. Prevalence, sociodemography, and quality of life of older versus younger patients with irritable bowel syndrome: a population-based study. Dig Dis Sci. 2006;51(3):446–453. doi:10.1007/s10620-006-3153-8.CrossRefPubMed

Dunlop SP, Hebden J, Campbell E, et al. Abnormal intestinal permeability in subgroups of diarrhea-predominant irritable bowel syndromes. Am J Gastroenterol. 2006;101(6):1288–1294. doi:10.1111/j.1572-0241.2006.00672.x.CrossRefPubMed

Tibble JA, Sigthorsson G, Foster R, Forgacs I, Bjarnason I. Use of surrogate markers of inflammation and Rome criteria to distinguish organic from nonorganic intestinal disease. Gastroenterology. 2002;123(2):450–460. doi:10.1053/gast.2002.34755.CrossRefPubMed

10.

Di L V, D’Inca R, Diaz-Granado N, et al. Lactulose/mannitol test has high efficacy for excluding organic causes of chronic diarrhea. Am J Gastroenterol. 2003;98(10):2245–2252.CrossRef

11.

Lundin P, Lofgren L, Agerforz P, Abrahamsson H, Simren M. Intestinal permeability in IBS patients and healthy subjects. Scand J Gastroenterol. 2006;41:42. doi:10.1080/00365520510023945.CrossRef

12.

Locke GR III, Zinsmeister AR, Talley NJ, Fett SL, Melton LJ. Risk factors for irritable bowel syndrome: role of analgesics and food sensitivities. Am J Gastroenterol. 2000;95(1):157–165. doi:10.1111/j.1572-0241.2000.01678.x.CrossRefPubMed

13.

Kalantar JS, Locke GR III, Talley NJ, Zinsmeister AR, Fett SL, Melton LJ III. Is irritable bowel syndrome more likely to be persistent in those with relatives who suffer from gastrointestinal symptoms? A population-based study at three time points. Aliment Pharmacol Ther. 2003;17(11):1389–1397. doi:10.1046/j.1365-2036.2003.01591.x.CrossRefPubMed

14.

Talley NJ, Spiller R. Irritable bowel syndrome: a little understood organic bowel disease? Lancet. 2002;360(9332):555–564. doi:10.1016/S0140-6736(02)09712-X.CrossRefPubMed

15.

Holtmann G, Gschossmann J, Buenger L, Gerken G, Talley NJ. Do changes in visceral sensory function determine the development of dyspepsia during treatment with aspirin? Gastroenterology. 2002;123(5):1451–1458. doi:10.1053/gast.2002.36556.CrossRefPubMed

16.

Brunsden AM, Grundy D. Sensitization of visceral afferents to bradykinin in rat jejunum in vitro. J Physiol. 1999;521(Pt 2):517–527. doi:10.1111/j.1469-7793.1999.00517.x.CrossRefPubMed

17.

Bjarnason I, Williams P, Smethurst P, Peters TJ, Levi AJ. Effect of non-steroidal anti-inflammatory drugs and prostaglandins on the permeability of the human small intestine. Gut. 1986;27(11):1292–1297. doi:10.1136/gut.27.11.1292.CrossRefPubMed

18.

Bjarnason I, Hayllar J, MacPherson AJ, Russell AS. Side effects of nonsteroidal anti-inflammatory drugs on the small and large intestine in humans. Gastroenterology. 1993;104(6):1832–1847.PubMed

19.

Barbara G, De Giorgio R, Stanghellini V, Cremon C, Corinaldesi R. A role for inflammation in irritable bowel syndrome? Gut. 2002;51(Suppl 1):i41–i44. doi:10.1136/gut.51.suppl_1.i41.CrossRefPubMed

20.

Smecuol E, Bai JC, Sugai E, et al. Acute gastrointestinal permeability responses to different non-steroidal anti-inflammatory drugs. Gut. 2001;49(5):650–655. doi:10.1136/gut.49.5.650.CrossRefPubMed

21.

Bjarnason I, MacPherson A, Hollander D. Intestinal permeability: an overview. Gastroenterology. 1995;108(5):1566–1581. doi:10.1016/0016-5085(95)90708-4.CrossRefPubMed

22.

Parlesak A, Bode JC, Bode C. Parallel determination of gut permeability in man with M(r) 400, M(r) 1500, M(r) 4000 and M(r) 10000 polyethylene glycol. Eur J Clin Chem Clin Biochem. 1994;32(11):813–820.PubMed

23.

Parlesak A, Schafer C, Schutz T, Bode JC, Bode C. Increased intestinal permeability to macromolecules and endotoxemia in patients with chronic alcohol abuse in different stages of alcohol-induced liver disease. J Hepatol. 2000;32(5):742–747. doi:10.1016/S0168-8278(00)80242-1.CrossRefPubMed

24.

Goldman RC, Leive L. Heterogeneity of antigenic-side-chain length in lipopolysaccharide from Escherichia coli 0111 and Salmonella typhimurium LT2. Eur J Biochem. 1980;107(1):145–153. doi:10.1111/j.1432-1033.1980.tb04635.x.CrossRefPubMed

25.

Kanda T, Fujii H, Tani T, et al. Intestinal fatty acid-binding protein is a useful diagnostic marker for mesenteric infarction in humans. Gastroenterology. 1996;110(2):339–343. doi:10.1053/gast.1996.v110.pm8566578.CrossRefPubMed

26.

Kanda T, Fujii H, Fujita M, Sakai Y, Ono T, Hatakeyama K. Intestinal fatty acid binding protein is available for diagnosis of intestinal ischaemia: immunochemical analysis of two patients with ischaemic intestinal diseases. Gut. 1995;36(5):788–791. doi:10.1136/gut.36.5.788.CrossRefPubMed

27.

Kanda T, Nakatomi Y, Ishikawa H, et al. Intestinal fatty acid-binding protein as a sensitive marker of intestinal ischemia. Dig Dis Sci. 1992;37(9):1362–1367. doi:10.1007/BF01296004.CrossRefPubMed

28.

Thompson WG, Longstreth GF, Drossman DA, Heaton KW, Irvine EJ, Muller-Lissner SA. Functional bowel disorders and functional abdominal pain. Gut. 1999;45(Suppl 2):II43–II47.PubMedCrossRef

29.

Uil JJ, van Elburg RM, van Overbeek FM, Mulder CJ, VanBerge-Henegouwen GP, Heymans HS. Clinical implications of the sugar absorption test: intestinal permeability test to assess mucosal barrier function. Scand J Gastroenterol Suppl. 1997;223:70–78.PubMed

30.

Rissler K. Improved separation of polyethylene glycols widely differing in molecular weight range by reversed-phase high performance liquid chromatography and evaporative light scattering detection. Chromatographia. 1999;49(11–12):615–620. doi:10.1007/BF02466902.CrossRef

31.

Megoulas NC, Koupparis MA. Twenty years of evaporative light scattering detection. Crit Rev Anal Chem.. 2005;35:301–316. doi:10.1080/10408340500431306.CrossRef

32.

Duerksen DR, Wilhelm-Boyles C, Parry DM. Intestinal permeability in long-term follow-up of patients with celiac disease on a gluten-free diet. Dig Dis Sci. 2005;50(4):785–790. doi:10.1007/s10620-005-2574-0.CrossRefPubMed

33.

Pearson AD, Eastham EJ, Laker MF, Craft AW, Nelson R. Intestinal permeability in children with Crohn’s disease and coeliac disease. Br Med J (Clin Res Ed). 1982;285(6334):20–21.CrossRef

34.

Shah AA, Thjodleifsson B, Murray FE, et al. Selective inhibition of COX-2 in humans is associated with less gastrointestinal injury: a comparison of nimesulide and naproxen. Gut. 2001;48(3):339–346. doi:10.1136/gut.48.3.339.CrossRefPubMed

35.

Berni Canani R, Terrin G, Rapacciuolo L, et al. Faecal calprotectin as reliable non-invasive marker to assess the severity of mucosal inflammation in children with inflammatory bowel disease. Dig Liver Dis. 2008;40(7):533–547. doi:10.1016/j.dld.2008.01.017.

36.

Berkes J, Viswanathan VK, Savkovic SD, Hecht G. Intestinal epithelial responses to enteric pathogens: effects on the tight junction barrier, ion transport, and inflammation. Gut. 2003;52(3):439–451. doi:10.1136/gut.52.3.439.CrossRefPubMed

37.

Serrander R, Magnusson KE, Kihlstrom E, Sundqvist T. Acute Yersinia infections in man increase intestinal permeability for low-molecular weight polyethylene glycols (PEG 400). Scand J Infect Dis. 1986;18(5):409–413. doi:10.3109/00365548609032356.CrossRefPubMed

38.

Santos J, Yang PC, Söderholm JD, Benjamin M, Perdue MH. Role of mast cells in chronic stress-induced colonic epithelial barrier dysfunction in the rat. Gut. 2001;48(5):630–636. doi:10.1136/gut.48.5.630.CrossRefPubMed

39.

Söderholm JD, Yang PC, Ceponis P, et al. Chronic stress induces mast cell-dependent bacterial adherence and initiates mucosal inflammation in rat intestine. Gastroenterology. 2002;123(4):1099–1108. doi:10.1053/gast.2002.36019.CrossRefPubMed

40.

McDermott JR, Bartram RE, Knight PA, Miller HR, Garrod DR, Grencis RK. Mast cells disrupt epithelial barrier function during enteric nematode infection. Proc Natl Acad Sci USA. 2003;100(13):7761–7766. doi:10.1073/pnas.1231488100.CrossRefPubMed

41.

O’Sullivan M, Clayton N, Breslin NP, et al. Increased mast cells in the irritable bowel syndrome. Neurogastroenterol Motil. 2000;12(5):449–457. doi:10.1046/j.1365-2982.2000.00221.x.CrossRefPubMed

42.

Weston AP, Biddle WL, Bhatia PS, Miner P B Jr. Terminal ileal mucosal mast cells in irritable bowel syndrome. Dig Dis Sci. 1993;38(9):1590–1595. doi:10.1007/BF01303164.CrossRefPubMed

43.

Dunlop SP, Jenkins D, Spiller RC. Distinctive clinical, psychological, and histological features of postinfective irritable bowel syndrome. Am J Gastroenterol. 2003;98(7):1578–1583. doi:10.1111/j.1572-0241.2003.07542.x.CrossRefPubMed

44.

Jacob C, Yang PC, Darmoul D, et al. Mast cell tryptase controls paracellular permeability of the intestine. Role of protease-activated receptor 2 and beta-arrestins. J Biol Chem. 2005;280(36):31936–31948. doi:10.1074/jbc.M506338200.CrossRefPubMed

45.

Serrander R, Magnusson KE, Sundqvist T. Acute infections with Giardia lamblia and rotavirus decrease intestinal permeability to low-molecular weight polyethylene glycols (PEG 400). Scand J Infect Dis. 1984;16(4):339–344.CrossRefPubMed

46.

Krugliak P, Hollander D, Le K, Ma T, Dadufalza VD, Katz KD. Regulation of polyethylene glycol 400 intestinal permeability by endogenous and exogenous prostanoids. Influence of non-steroidal anti-inflammatory drugs. Gut. 1990;31(4):417–421. doi:10.1136/gut.31.4.417.CrossRefPubMed

47.

Allen A, Hutton DA, Leonard AJ, Pearson JP, Sellers LA. The role of mucus in the protection of the gastroduodenal mucosa. Scand J Gastroenterol Suppl. 1986;125:71–78. doi:10.3109/00365528609093820.CrossRefPubMed

48.

Somasundaram S, Sigthorsson G, Simpson RJ, et al. Uncoupling of intestinal mitochondrial oxidative phosphorylation and inhibition of cyclooxygenase are required for the development of NSAID-enteropathy in the rat. Aliment Pharmacol Ther. 2000;14(5):639–650. doi:10.1046/j.1365-2036.2000.00723.x.CrossRefPubMed

49.

Bjarnason I, Takeuchi K, Bjarnason A, Adler SN, Teahon K. The G.U.T. of gut. Scand J Gastroenterol. 2004;39(9):807–815. doi:10.1080/00365520410003326.CrossRefPubMed

Title: Intestinal Permeability in Irritable Bowel Syndrome Patients: Effects of NSAIDs
Authors: Angèle P. M. Kerckhoffs
Louis M. A. Akkermans
Martin B. M. de Smet
Marc G. H. Besselink
Falco Hietbrink
Imke H. Bartelink
Wim B. Busschers
Melvin Samsom
Willem Renooij
Publication date: 01-03-2010
Publisher: Springer US
Published in: Digestive Diseases and Sciences / Issue 3/2010
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI: https://doi.org/10.1007/s10620-009-0765-9

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