Abstract
A major function of the colon is the conservation of salt and water and we have previously shown (Jenkins et al GUT 27; 1283, 1986) that in the human infant it plays a major homeostatic role. Colitis may therefore assume greater importance than in later life. We have carried out a detailed study of transport in normal and inflammed isolated human infant colon using an Ussing Chamber and a voltage clamp procedure. Stripped colonic mucosa histologically normal n=6 pairs and inflammed from patients with non-clostridial Hirschsprung's enterocolitis, n=5 pairs was mounted and bathed in Krebs2 solution. Under short-circuit conditions Na+ (3.45±1.53 umol/hr/cm mean ± ISD) and Cl−(0.63±3.61) were absorbed and a residual ion flux consistent with HCO3− secretion approximated Cl− absorption. Short circuit current (ISC) (3.8±0.28) was very similar to net Na+ movement and was markedly reduced by mucosal 10−4 M amiloride (0.61±0.7 p<0.01). Inflammed mucosa generated a lower potential difference (2.44±0.1 vs 6.5±1.0 m V p<0.01) ISC (1.62 ± 0.8 vs 3.87±0.5 p<0.02) and was of lower resistance (67.2±12 vs 104±10 chm p<0.01). Na+ was secreted and anion exchange reversed due to large increases of serosal to mucosal fluxes (Na+ 5.63±0.1 to 15.7±1.2 Cl− 13.86±1.614 to 20.9±3) with no change in nucosal to serosal fluxes. These data show that Na+ is absorbed electrogenically and Cl− electroneutrally in exchange for HCO3. In the presence of inflamnation the electrical and flux changes suggest a decrease in resistance of shunt pathways which dissipate absorbed Na+ and CT−. Inflammation of the infant colon therefore seriously impairs its ability to conserve salt and water, and would thus make an important contribution to a dehydrating diarrhoeal disease.
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Jenkins, H., Schnackenberg, V. & Milla, P. 20 MECHANISMS OF TRANSPORT OF SODIUM AND CHLORIDE AND THE EFFECTS OF INFLAMMATION IN THE HUMAN INFANT COLON. Pediatr Res 24, 408 (1988). https://doi.org/10.1203/00006450-198809000-00043
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DOI: https://doi.org/10.1203/00006450-198809000-00043