Skip to main content
SpringerLink
Log in

Intestinale Permeabilität bei Patienten mit erworbenem Immundefekt — Syndrom (AIDS)

  • Originalien
  • Published:
Klinische Wochenschrift Aims and scope Submit manuscript

Summary

Intestinal permeability has been assessed as a parameter of the small intestinal barrier function in 33 patients with AIDS (WR 6), in 25 healthy volunteers, 32 patients with Crohn's disease, 18 patients with ulcerative colitis and in 12 patients with untreated coeliac disease. Permeability was measured by means of the 5 hour urinary excretion of lactulose and rhamnose after administration of these sugars (1 g rhamnose, 10 g lactulose) which allowed to calculate the urinary lactulose/rhamnose — ratio (L/R-r) as an index of intestinal permeability. Compared to the controls (L/R-r=0,014±0,010) patients with AIDS had significantly increased lactulose/rhamnose — ratios (0,189+0,164;p<0.01) indicating abnormal permeation both of lactulose and rhamnose. This alteration of intestinal permeability was more pronounced than the significant increase of the L/R-r in the patients with either Crohn's disease or coeliac disease. However, intestinal permeability was not altered in the patients with ulcerative colitis.

Among the patients with AIDS, the most abnormal permeability ratios were observed in two subjects with intestinal cryptosporidiosis.

This investigation demonstrates by means of the “double sugar ratio”, that intestinal permeability in patients with AIDS is highly abnormal, the impairment being even more abnormal than in patients with other small intestinal disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Abbreviations

L/R-Q:

Lactulose/Rhamnose-Quotient

AIDS:

Acquired Immunodeficiency Syndrome

HIV:

Humanes Immundefizienz Virus

CDC:

Center for Disease Control

WR:

Walter Reed

Literatur

  1. Andre F, Andre C, Emery Y, Forichon J, Descos L, Minaire Y (1988) Assessment of lactulose-mannitol-test in Crohn's disease. Gut 29:511–515

    Google Scholar 

  2. Argenzio RA, Liacos JA, Levy ML, Meuten DJ, Lecce JG, Powell DW (1990) Villous atrophy, crypt hyperplasia, cellular infiltration, and impaired glucose-Na absorption in enteric cryptosporidiosis of pigs. Gastroenterology 98:1129–1140

    Google Scholar 

  3. Behrens RH, Docherty H, Elia M, Neale G (1984) A simple enzymatic method for the assay of urinary lactulose. Clin Chim Acta 137:361–367

    Google Scholar 

  4. Bjarnason I, Peters TJ, Veall N (1983) A persistent defect in intestinal permeability in coeliac disease demonstrated by a51Cr-labelled EDTA absorption test. Lancet I:323–325

    Google Scholar 

  5. Bjarnason I, Peters TJ, Levi AJ (1986) Intestinal permeability:clinical correlates. Dig Dis 4:83–92

    Google Scholar 

  6. Bjarnason I, Smethurst P, Fenn ChG, Lee CE, Menzies IS, Levi AJ (1989) Misoprostol reduces indomethacin induced changes in small intestinal permeability. Dig Dis Sci 34:407–411

    Google Scholar 

  7. Chadwick VS, Phillips SF, Hofmann AF (1977) Measurements of intestinal permeability using low molecular weight polyethylene glycols (PEG 400). Gastroenterology 73:241–246

    Google Scholar 

  8. Cooper BT, Ukabam SO, O'Brien AD, Hare JPO, Corall RJM (1984) Intestinal permeability in diabetic diarrhoea. Diab Med 4:4–52

    Google Scholar 

  9. Cummins AG, LaBrooy JT, Stanley DP, Rowland R, Shearmen DJC (1990) Quantitative histological study of enteropathy associated with HIV-Infection. Gut 31:317–321

    Google Scholar 

  10. Erickson RA, Epstein RM (1988) Oral chenodesoxycholic acid increases small intestinal permeability to lactulose in humans. Am J Gastroenterol 88:541–544

    Google Scholar 

  11. Falk S, Schmidts HL, Müller H, Berger K, Schneider M, Schlote W, Helm EB, Stille W, Hübner K, Stutte HJ (1987) Autopsy findings in AIDS — a histopathological analysis of fifty cases. Klin Wochenschr 65:654–663

    Google Scholar 

  12. Fordtran JS, Rector FC, Ewton MF, Soter N, Kinney J (1965) Permeability characteristics of the human small intestine. J Clin Invest 65:1935–1944

    Google Scholar 

  13. Hamilton I, Cobdon I, Rothwell J, Axon ATR (1982) Intestinal permeability in coeliac disease:the response to gluten withdrawal and single dose gluten challenge. Gut 23:202–210

    Google Scholar 

  14. Heise W, Mostertz P, Arasteh K, Skörde J, L'Age M (1988) Gastrointestinale Befunde bei der HIV-Infektion. Dtsch Med Wschr 113:1588–1593

    Google Scholar 

  15. Hopfer U (1987) Membrane transport mechanisms for hexoses and amino acids in the small intestine. In:Johnson LR (Ed.):Physiology of the gastrointestinal tract. 2nd ed. Raven Press, New York, p 1389

    Google Scholar 

  16. Hollander D, Vadheim CM, Brettholz E, Pettersen GM, Delahunty Th, Rotter JI (1986) Increased intestinal permeability in patients with Crohn's disease and their relatives. Ann Int Med 105:883–885

    Google Scholar 

  17. Isolauri E, Juntunen M, Wiren S, Vuorinen P, Koivula T (1989) Intestinal permeability changes in acute gastroenteritis:effects of clinical factors and nutritional management. J Pediatr Gastroenterol Nutr 8:466–473

    Google Scholar 

  18. Johansen K, Stintzing G, Magnusson KG, Sundqvist T, Jalil T, Murtaza A, Khan SR, Lindblad BS, Möllby R, Orusild E, Svensson L (1989) Intestinal permeability assessed with polyethylene glycols in children with diarrhea due to rotavirus and common bacterial pathogens in a developing community. J Pediatr Gastroenterol Nutr 9:307–313

    Google Scholar 

  19. Juby LD, Rothwell J, Axon ATR (1989) Lactulose/mannitol test:an ideal screen for celiac disease. Gastroenterology 96:79–85

    Google Scholar 

  20. Kapembwa MS, Fleming SC, Serwadda D (1990) Ileal and jejunal absorptive function in patients with AIDS and enterococcideal infections. J Infection (in press)

  21. Kotler DP, Scholes JV, Tierney AR (1987) Intestinal plasma alterations in aquired immunodeficiency syndrome. Dig Dis Sci 32:129–138

    Google Scholar 

  22. Lake-Bakaar S, Beidas R, El-Sakir S, Iyer S, Straus E (1987) Impaired gastric acid secretion in AIDS. Gastroenterology 92:1488

    Google Scholar 

  23. Menzies IS (1974) Absorption of intact oligosaccharide in health and disease. Biochem Soc Trans 2:1042–1047

    Google Scholar 

  24. Miller ARO, Griffin GE, Batman P (1988) Jejunal mucosal architecture and fat absorption in male homosexuals infected with human immunodeficiency virus. Quart J Med 69:1009–1016

    Google Scholar 

  25. Nelson JA, Wiley CA, Reinolds-Kohler C, Reese ChE, Margaretten W, Levy JA (1988) Human immune deficiency virus detected in bowel epithelium from patients with gastrointestinal symptoms. Lancet 1:259–261

    Google Scholar 

  26. Ott M, Lembcke B, Caspary WF (1990) Ultrasensitiver, vereinfachter Nachweis von Zuckern im Urin mittels HPLC zur intestinalen Permeabilitätsprüfung. Z Gastroenterol 28:512

    Google Scholar 

  27. Pignata C, Budillon G, Monaco G, Nani E, Cuomo R, Parilli G, Ciccimara F (1990) Jejunal bacterial overgrowth and intestinal permeability in children with immunodeficiency syndromes. Gut 31:879–882

    Google Scholar 

  28. Riecken EO, Zeitz M, Ullrich R, L'Age M, Heise W (1988) Nonspecific malabsorption in AIDS-Evidence for a HIVinduced enteropathy. In:Classen M, Dancygier M (eds):AIDS in Gastroenterology and Hepatology. Demeter, Stuttgart, p 21–22

    Google Scholar 

  29. Ukabam SO (1982) Intestinal permeability in health and disease. Med Thesis, Univ Bristol

  30. Ukabam SO, Cooper BT (1984) Small intestinal permeability to mannitol, lactulose and polyethylene glycol 400 in coeliac disease. Dig Dis Sci 29:809–816

    Google Scholar 

  31. Ukabam SO, Clamp JR, Cooper BT (1983) Abnormal small intestinal permeability to sugars in patients with Crohn's disease of the terminal ileum and colon. Digestion 27:70–74

    Google Scholar 

  32. Ullrich R, Zeitz M, Heise W, L'Age M, Höffken G, Riecken EO (1989) Small intestinal structure and function in patients infected with human immunodeficiency virus (HIV):evidence for HIV-induced enteropathy. Ann Int Med 111:15–21

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Zentrum der Inneren Medizin, Johann Wolfgang Goethe-Universität Frankfurt, Deutschland

    M. Ott, B. Lembcke, S. Staszewski, E. B. Helm & W. F. Caspary

Authors
  1. M. Ott
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. B. Lembcke
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. Staszewski
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. E. B. Helm
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. W. F. Caspary
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Die Ergebnisse dieser Arbeit wurden anläßlich der 45. Tagung der deutschen Gesellschaft für Verdauungs und Stoffwechselkrankheiten vorgetragen (Essen 3. Okt. 1990) und als Abstract publiziert [Z. Gastroenterol. (1990) 28:512].

Unterstützt durch das BMFT, AZ III-005-89/B1

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ott, M., Lembcke, B., Staszewski, S. et al. Intestinale Permeabilität bei Patienten mit erworbenem Immundefekt — Syndrom (AIDS). Klin Wochenschr 69, 715–721 (1991). https://doi.org/10.1007/BF01649441

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01649441

Key words

Search

Navigation