Abstract
The purpose of this study was to compare the changes in intestinal permeability produced by villous atrophy with those produced by the administration of a cytotoxic drug. PEG (mol wt 200-600, ethylene units 5–13), a marker for intestinal permeability, was administered orally as an isotonic solution at a dose of 172 mg/kg to 26 children with celiac disease (CD) (ages 1-18 yr) and to 6 children (8-12 yr) treated for leukemia with 20 mg/m2 of methotrexate (MTX). Urine was collected for 6 h. Children with CD were studied at the time of presentation (p), while on a gluten (G)-free diet (GFD), and/or when challenged with a G-containing diet (GCD). Children with leukemia were tested before and after MTX. PEG polymers were isolated, derivatized, and analysed by gas chromatography (J Lab Clin Med 107: 290, 1986). The 6-h urine % recovery of each polymer and the length of the polymer whose recovery was maximal (PCDO) were determined. The theoretical ethylene unit length of the polymer whose recovery was 50% of the polymer which was recovered maximally (N1/2) was calculated by a curve-fitting program. Normal N1/2) ≥ 12. Mean N1/2 for children with CD at P was 7.3 ± 3.7, on GFD: 12.8±0.6, and on GCD:11,4 ± 2 (p < 0.05) indicating significantly less recovery of the longer polymers at P compared to GFD and GCD. No relationship was found between G intake and PCDO. In children treated with MTX, a mean increase in PCDO of 127% (range 49-195, p = 0.05) was observed following the ingestion of the drug compared to pre-treatment levels.
Conclusion: This study shows that in cases of intestinal villous atrophy permeability to the longer chain PEG polymers decreases while treatment with MTX produces an enhanced permeation to all of the PEG polymers.
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Lifschitz, C., Polanco, I., Mahoney, D. et al. CHANGES IN INTESTINAL PERMEABILITY DEMONSTRATED BY LOW MOLECULAR WEIGHT POLYETHYLENE GLYCOL (PEG) POLYMERS. Pediatr Res 22, 372 (1987). https://doi.org/10.1203/00006450-198709000-00051
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DOI: https://doi.org/10.1203/00006450-198709000-00051