Effects of luminal antigen on intestinal albumin and hyaluronan permeability and ion transport in atopic patients.

BACKGROUND

Increased luminal transport of proteins and fluid is part of the inflammatory reaction in inflammatory disease of the bowel and of the airways in allergic diseases and asthma. The objective of this study was to determine intestinal appearance rates of albumin and hyaluronan in vivo in atopic patients allergic to birch, as well as changes in net jejunal transport of monovalent ions and water induced by the antigen.

METHODS

Secretion studies were performed with the use of a segmental jejunal perfusion system with a small two-balloon, six-channel tube. The intestinal mucosa was challenged with birch allergen in patients allergic to birch and in matched control subjects (n = 12 in both groups).

RESULTS

In patients, but not in control subjects, the luminal antigen induced a net increase in albumin of 2689 +/- 567 micrograms/cm/hr and in hyaluronan of 2609 +/- 737 ng/cm/hr (p < 0.01 vs control subjects in both cases). Furthermore, basal net absorption of Cl- ions, Na+ ions, and water was converted to a net secretion after antigen challenge.

CONCLUSION

Exposure to antigen normally acting on the respiratory tract induced increased permeability of the gastrointestinal mucosa. This would suggest less organ specificity and more general allergic recognition shared by several immunocompetent tissues in the body, probably mediated by circulating IgE antibodies.