TY - JOUR
T1 - Lactulose - Mannitol intestinal permeability test in children with diarrhea caused by rotavirus and Cryptosporidium
AU - Zhang, Ying
AU - Lee, Ben
AU - Thompson, Matthew
AU - Glass, Roger
AU - Lee, Rosa Cama
AU - Figueroa, Dante
AU - Gilman, Robert
AU - Taylor, David
AU - Stephenson, Charles
PY - 2000/7/1
Y1 - 2000/7/1
N2 - Background: The relationship between intestinal permeability and acute secretory diarrheal syndromes caused by rotavirus and Cryptosporidium parvum in infants less than 36 months of age was studied using the lactulose- mannitol excretion assay. Methods: An oral solution containing 0.4 g/kg lactulose and 0.1 g/kg mannitol was administered to 15 infants with rotavirus, 7 with Cryptosporidium infection and a control group of 7 with secretory diarrhea admitted to the Oral Rehydration Unit of the National Children's Hospital in Lima, Peru. Urinary sugar excretion was measured using an enzymatic spectrophotometric method. The ratio of urinary excretion of lactulose to mannitol was used to measure intestinal mucosal permeability, with higher ratios indicative of increased intestinal permeability. Infants in all three groups were retested 20 days after the initial test. Results: The (mean ± SE) lactulose:mannitol (L:M) excretion ratios during the acute phase (day 1) of diarrhea in infants with rotavirus or Cryptosporidium and control infants were 0.67 ± 0.1, 0.76 ± 0.16, and 0.26 ± 0.04, respectively. In the convalescent phase (day 20) the ratios were 0.19 ± 0.02, 0.28 ± 0.05, and 0.29 ± 0.07, respectively. Significant reductions in L:M ratios were noted in rotavirus patients between days 1 and 20 (paired t- test; P < 0.01), Cryptosporidium patients between days 1 and 20 (paired t- test; P < 0.05), and between control subjects on day 1 and rotavirus patients on day 1 and Cryptosporidium patients on day 1 (unpaired t-tests; P < 0.05 for both). There were no significant differences in control subjects between days 1 and 20, control subjects and rotavirus patients on day 20, or control subjects and Cryptosporidium patients on day 20. Conclusions: The results indicate that increased intestinal permeability caused by rotavirus or cryptosporidium infections in Peruvian infants less than 36 months of age is a significant but reversible phenomenon. The temporal relationship observed in the current study and the contribution of such alterations in intestinal mucosal integrity to the burden of diarrheal disease and the development of malnutrition in developing countries is discussed. (C) 2000 Lippincott Williams and Wilkins, Inc.
AB - Background: The relationship between intestinal permeability and acute secretory diarrheal syndromes caused by rotavirus and Cryptosporidium parvum in infants less than 36 months of age was studied using the lactulose- mannitol excretion assay. Methods: An oral solution containing 0.4 g/kg lactulose and 0.1 g/kg mannitol was administered to 15 infants with rotavirus, 7 with Cryptosporidium infection and a control group of 7 with secretory diarrhea admitted to the Oral Rehydration Unit of the National Children's Hospital in Lima, Peru. Urinary sugar excretion was measured using an enzymatic spectrophotometric method. The ratio of urinary excretion of lactulose to mannitol was used to measure intestinal mucosal permeability, with higher ratios indicative of increased intestinal permeability. Infants in all three groups were retested 20 days after the initial test. Results: The (mean ± SE) lactulose:mannitol (L:M) excretion ratios during the acute phase (day 1) of diarrhea in infants with rotavirus or Cryptosporidium and control infants were 0.67 ± 0.1, 0.76 ± 0.16, and 0.26 ± 0.04, respectively. In the convalescent phase (day 20) the ratios were 0.19 ± 0.02, 0.28 ± 0.05, and 0.29 ± 0.07, respectively. Significant reductions in L:M ratios were noted in rotavirus patients between days 1 and 20 (paired t- test; P < 0.01), Cryptosporidium patients between days 1 and 20 (paired t- test; P < 0.05), and between control subjects on day 1 and rotavirus patients on day 1 and Cryptosporidium patients on day 1 (unpaired t-tests; P < 0.05 for both). There were no significant differences in control subjects between days 1 and 20, control subjects and rotavirus patients on day 20, or control subjects and Cryptosporidium patients on day 20. Conclusions: The results indicate that increased intestinal permeability caused by rotavirus or cryptosporidium infections in Peruvian infants less than 36 months of age is a significant but reversible phenomenon. The temporal relationship observed in the current study and the contribution of such alterations in intestinal mucosal integrity to the burden of diarrheal disease and the development of malnutrition in developing countries is discussed. (C) 2000 Lippincott Williams and Wilkins, Inc.
KW - Cryptosporidium
KW - Diarrhea
KW - Intestinal permeability
KW - Lactulose
KW - Mannitol
KW - Rotavirus
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U2 - 10.1097/00005176-200007000-00006
DO - 10.1097/00005176-200007000-00006
M3 - Article
C2 - 10896065
AN - SCOPUS:0033937322
VL - 31
SP - 16
EP - 21
JO - Journal of Pediatric Gastroenterology and Nutrition
JF - Journal of Pediatric Gastroenterology and Nutrition
SN - 0277-2116
IS - 1
ER -