Alimentary TractEpithelial permeability to proteins in the noninflamed ileum of Crohn's disease?☆,☆☆
Section snippets
Patients and endoscopy
Mucosal specimens from the terminal ileum in 12 patients with ileal CD and 7 patients who underwent right hemicolectomy for colonic cancer were investigated. Patient data are given in Table 1.
Empty Cell CD (n = 12) Colon cancer (n = 7) Age (yr)a 40 (19–60) 67 (50–76) Sex (M/F) 7/5 4/3 Disease location Ileum 10 Tumors in the cecum or ascending colonb Ileum and colon 2 Disease duration (yr)a 13 (1–24) Previous bowel resection 7 0 Medication None 4 2 Steroids ± mesalamine 7 0 Azathioprine 1 0
Characterization of specimens by electrophysiology and morphometry
PDt at the start of the experiments was above 6 mV in 11 (85%) of 13 specimens of noninflamed mucosa from CD patients, in 23 (72%) of 32 specimens from inflamed CD mucosa, and in 21 (88%) of 24 specimens from colon cancer patients. This yielded the following material for the study: 11 noninflamed ileal specimens from 5 patients with CD, 23 inflamed ileal specimens from 8 patients with CD, and 21 ileal specimens from 7 patients with colon cancer (both noninflamed and inflamed mucosa were
Discussion
This is the first study of epithelial permeability to protein-sized macromolecules in the ileal mucosa in CD. Our data suggest that noninflamed ileal mucosa in patients with CD has a previously unrecognized increase in protein permeation. An increased transmucosal permeability to undegraded ovalbumin was seen in the noninflamed ileal mucosa from patients with CD compared with patients with colon cancer, whereas permeability to dextran 40,000 was equal in the groups. Ovalbumin permeability was
Acknowledgements
The authors thank Lisbeth Hedman and Inger Matsson for excellent laboratory work.
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2021, GastroenterologyCitation Excerpt :In IBD, many of these factors break down. The intestinal epithelium becomes more permeable due to defects or downregulation of processes that regulate tight junctions, mucus produced by goblet cells, transepithelial transport, nutrient digestion and absorption, and mucosal restitution.54,97–100 The defective intestinal barrier allows for increased penetration of bacteria and closer contact with the intestinal epithelial surface and beyond.
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Supported by grants from the County Council of Östergötland; “Förenade liv” Mutual Group Life Insurance Company, Stockholm; Swedish Society for Medical Research, Swedish Society of Medicine; and Swedish Medical Research Council (projects 05983 and 12618).
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Address requests for reprints to: Johan D. Söderholm, M.D., Ph.D., Department of Surgery, University Hospital, S-581 85 Linköping, Sweden. e-mail: [email protected]; fax: (46) 13-22-35-70.