Hamilton I, Cobden I, Rothwell J, Axon A T
Gut. 1982 Mar;23(3):202-10. doi: 10.1136/gut.23.3.202.
Intestinal permeability has been studied in 21 patients with coeliac disease in relapse and after gluten withdrawal using an oral test of intestinal permeability based on the simultaneous oral administration of two probe molecules. The increased absorption of the larger molecule (cellobiose) and the decreased absorption of the smaller (mannitol) found in untreated coeliac disease both returned to normal within five months of starting treatment, the abnormality in cellobiose absorption correcting more rapidly than that of mannitol. After exposure to a single oral dose of gluten, the intestinal permeability of six patients with treated coeliac disease became transiently abnormal with an increased absorption of cellobiose, returning to normal within one week. The possible structural and functional implications of these findings are discussed. The cellobiose/mannitol ratio appears to be of value in assessing the response to gluten withdrawal in coeliac disease, and also in monitoring patients who are already established on a gluten free diet by detecting dietary lapses and 'non-responding coeliac disease'. It may also offer an alternative to jejunal biopsy in patients subjected to gluten challenge.
通过基于同时口服两种探针分子的肠道通透性口服试验，对21例乳糜泻复发患者和戒食麸质后患者的肠道通透性进行了研究。在未经治疗的乳糜泻中发现的较大分子（纤维二糖）吸收增加和较小分子（甘露醇）吸收减少的情况，在开始治疗后的五个月内均恢复正常，纤维二糖吸收异常的纠正比甘露醇更快。在单次口服麸质后，6例接受治疗的乳糜泻患者的肠道通透性出现短暂异常，纤维二糖吸收增加，一周内恢复正常。讨论了这些发现可能的结构和功能意义。纤维二糖/甘露醇比值似乎在评估乳糜泻患者对戒食麸质的反应方面具有价值，并且在通过检测饮食失误和“无反应性乳糜泻”来监测已采用无麸质饮食的患者方面也具有价值。它还可能为接受麸质激发试验的患者提供空肠活检的替代方法。
