Brief Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. May 7, 2011; 17(17): 2211-2215
Published online May 7, 2011. doi: 10.3748/wjg.v17.i17.2211
Increased intestinal permeability in inflammatory bowel diseases assessed by iohexol test
Vanya A Gerova, Simeon G Stoynov, Dimitar S Katsarov, Dobrin A Svinarov
Vanya A Gerova, Simeon G Stoynov, Clinical Center of Gastroenterology, University Hospital Queen Joanna, Medical University, Sofia 1527, Bulgaria
Dimitar S Katsarov, Dobrin A Svinarov, Central Laboratory of Therapeutic Drug Monitoring and Clinical Pharmacology, University Hospital Alexandrovska, Medical University, Sofia 1431, Bulgaria
Author contributions: Gerova VA designed the study, enrolled and followed up the patients, provided the requested patient materials and other clinical data, collected and analyzed the data and wrote the manuscript; Katsarov DS performed the research; Stoynov SG and Svinarov DA supervised and participated in the designing of the study, the data interpretation and in the writing and editing of the manuscript; all authors approved the final version of the paper.
Correspondence to: Vanya A Gerova, MD, PhD, Clinical Center of Gastroenterology, University Hospital Queen Joanna, Medical University, 8 Bialo more str, Sofia 1527, Bulgaria. vanger@hotmail.com
Telephone: +359-2-9432103 Fax: +359-2-9432103
Received: July 29, 2010
Revised: November 10, 2010
Accepted: November 17, 2010
Published online: May 7, 2011
Abstract

AIM: To study intestinal permeability (IP) and its relationship to the disease activity in patients with inflammatory bowel diseases (IBD) - Crohn’s disease (CD) and ulcerative colitis (UC).

METHODS: Fifty-eight patients with active IBD (32 with CD and 26 with UC) and 25 healthy controls consented to participate in the study. The clinical activity of CD was estimated using the Crohn’s Disease Activity Index (CDAI), and the endoscopic activity of UC using the Mayo scoring system. IP was assessed by the rise in levels of iohexol, which was administered orally (25 mL, 350 mg/mL) 2 h after breakfast. Three and six hours later serum (SIC mg/L) and urine (UIC g/mol) iohexol concentrations were determined by a validated HPLC-UV technique.

RESULTS: In the CD group, SIC values at 3 h (2.95 ± 2.11 mg/L) and at 6 h after ingestion (2.63 ± 2.18 mg/L) were significantly higher compared to those of healthy subjects (1.25 ± 1.40 mg/L and 1.11 ± 1.10 mg/L, respectively, P < 0.05). UIC (g/mol) values were also higher in patients, but the differences were significant only for UIC at 6 h. Significant positive correlation (P < 0.05) was found between the CDAI and IP, assessed by SIC at 3 h (r = 0.60) and 6 h (r = 0.74) after the ingestion. In comparison to controls, SIC and UIC of UC patients were higher in the two studied periods, but the differences were significant at 6 h only. Significantly higher values of SIC (P < 0.05) were found in patients with severe endoscopic activity of UC compared to those of patients with mild and moderate activity (3.68 ± 3.18 vs 0.92 ± 0.69 mg/L).

CONCLUSION: Serum levels of iohexol at 3 h and 6 h after its ingestion reflect increased IP, which is related to the disease activity in patients with IBD.

Keywords: Intestinal permeability; Iohexol test; Inflammatory bowel disease; Crohn’s disease; Ulcerative colitis