Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
PLoS One. 2019 Feb 7;14(2):e0211973. doi: 10.1371/journal.pone.0211973. eCollection 2019.
Intestinal permeability can be assessed by monitoring renal excretion of orally administered radioactively 51Cr-labeled ethylenediaminetetraacetic acid (51Cr-EDTA). Although considered safe, patient participation in using radio-labeled tracers is low. Here, we used orally administered 52Cr-EDTA as non-radioactive alternative to assess intestinal permeability in CD and analyzed the association with disease activity, disease location and gut microbial dysbiosis.
60 CD patients with low (n = 25) and increased (n = 35) fecal calprotectin levels (cut-off: 100 μg/g feces) ingested 20 mL 52Cr-EDTA (20 mmol/L) solution whereafter 24-h urine was collected. Urinary 52Cr-EDTA concentrations were quantified using Inductively Coupled Plasma Mass Spectrometry (ICP-MS). Fecal Enterobacteriaceae and Faecalibacterium prausnitzii were quantified using FISH. Correlations between urinary 52Cr-EDTA excretion and other parameters were established using nonparametric Spearman's correlation coefficients (ρ).
CD patients with increased fecal calprotectin levels (> 100 μg/g) demonstrated an elevated urinary 52Cr-EDTA/creatinine ratio (772 vs. 636 μmol/mol, P = 0.132). Patients with primarily colonic disease showed the highest 52Cr-EDTA excretion. Importantly, a positive correlation was observed for the urinary 52Cr-EDTA/creatinine ratio and fecal calprotectin levels (ρ = 0.325, P < 0.05). Finally, urinary 52Cr-EDTA/creatinine ratio negatively correlated with the relative abundance of Faecalibacterium prausnitzii (ρ = -0.221, P = 0.092), while positively correlating with Enterobacteriaceae (ρ = 0.202, P = 0.126).
Orally administered and renal excreted 52Cr-EDTA may be used to assess intestinal permeability in CD and correlates with fecal calprotectin levels and bacterial species relevant to CD. This test may improve non-invasive detection of disease exacerbations and help monitor disease activity.
肠通透性可通过监测口服放射性 51Cr 标记乙二胺四乙酸（51Cr-EDTA）在尿液中的排泄来评估。尽管被认为是安全的，但患者参与放射性示踪剂的使用意愿较低。在这里，我们使用口服 52Cr-EDTA 作为非放射性替代物来评估 CD 中的肠通透性，并分析其与疾病活动度、疾病部位和肠道微生物失调的关系。
60 例 CD 患者（低水平粪便钙卫蛋白组，n=25；高水平粪便钙卫蛋白组，n=35）摄入 20mL 52Cr-EDTA（20mmol/L）溶液，随后收集 24 小时尿液。使用电感耦合等离子体质谱法（ICP-MS）定量检测尿液中的 52Cr-EDTA 浓度。使用荧光原位杂交法（FISH）定量检测粪便肠杆菌科和普拉梭菌丰度。使用非参数 Spearman 相关系数（ρ）建立尿 52Cr-EDTA 排泄与其他参数之间的相关性。
粪便钙卫蛋白水平升高（>100μg/g）的 CD 患者尿 52Cr-EDTA/肌酐比值升高（772 vs. 636μmol/mol，P=0.132）。主要发生在结肠的疾病患者 52Cr-EDTA 排泄量最高。重要的是，尿 52Cr-EDTA/肌酐比值与粪便钙卫蛋白水平呈正相关（ρ=0.325，P<0.05）。最后，尿 52Cr-EDTA/肌酐比值与普拉梭菌丰度呈负相关（ρ=-0.221，P=0.092），与肠杆菌科呈正相关（ρ=0.202，P=0.126）。
口服和肾脏排泄的 52Cr-EDTA 可用于评估 CD 中的肠通透性，并与粪便钙卫蛋白水平和与 CD 相关的细菌种类相关。该检测方法可能有助于提高疾病恶化的非侵入性检测，并有助于监测疾病活动度。
