Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, California.
Dumont-UCLA Transplant Center, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California.
J Surg Res. 2019 Jan;233:20-25. doi: 10.1016/j.jss.2018.07.005. Epub 2018 Jul 27.
Loss of intestinal barrier integrity plays a fundamental role in the pathogenesis of various gastrointestinal diseases and is implicated in the onset of sepsis and multiple organ failure. An array of methods to assess different aspects of intestinal barrier function suffers from lack of sensitivity, prolonged periods of specimen collection, or high expense. We have developed a technique to measure the concentration of the food dye FD&C Blue #1 from blood and sought to assess its utility in measuring intestinal barrier function in humans.
Four healthy volunteers and 10 critically ill subjects in the intensive care unit were recruited in accordance with an institutional review board approved protocol. Subjects were given 0.5 mg/kg Blue #1 enterally as an aqueous solution of diluted food coloring. Five blood specimens were drawn per subject: 0 h (before dose), 1, 2, 4, and 8 h. After plasma isolation, organic extracts were analyzed by high-performance liquid chromatography/mass spectrometry detecting the presence of unmodified dye.
We found no baseline detectable absorption in healthy volunteers. After including the subjects in the intensive care unit, we compared dye absorption in the six subjects who met criteria for septic shock with the eight who did not. Septic patients demonstrated significantly greater absorption of Blue #1 after 2 h.
We have developed a novel, easy-to-use method to measure intestinal barrier integrity using a food grade dye detectable by mass spectrometry analysis of patient blood following oral administration.
肠道屏障完整性的丧失在各种胃肠道疾病的发病机制中起着根本性的作用,并与脓毒症和多器官衰竭的发生有关。评估肠道屏障功能的各种方法都存在灵敏度低、标本采集时间长或费用高的问题。我们开发了一种从血液中测量食用染料 FD&C Blue #1 浓度的技术,并试图评估其在人类肠道屏障功能测量中的效用。
根据机构审查委员会批准的方案,招募了 4 名健康志愿者和 10 名重症监护病房的危重症患者。受试者口服 0.5mg/kg 的 Blue #1 水溶液作为食用色素的稀释液。每个受试者抽取 5 份血样:0h(剂量前)、1h、2h、4h 和 8h。在分离血浆后,通过高效液相色谱/质谱法对有机提取物进行分析,检测未修饰染料的存在。
我们在健康志愿者中未发现基线可检测的吸收。在将受试者纳入重症监护病房后,我们比较了符合脓毒症休克标准的 6 名患者和不符合标准的 8 名患者的 Blue #1 吸收情况。脓毒症患者在 2 小时后显示出明显更高的 Blue #1 吸收。
我们开发了一种新的、易于使用的方法,使用质谱分析患者血液中的食用级染料来测量肠道屏障完整性,该染料可通过口服给药后检测到。