Intestinal permeability in children/adolescents with functional dyspepsia

Nancy A Neilan, Uttam C Garg, Jennifer Verrill Schurman, Craig A Friesen, Nancy A Neilan, Uttam C Garg, Jennifer Verrill Schurman, Craig A Friesen

Abstract

Background: An altered intestinal mucosal barrier has been demonstrated in subsets of patients with IBS and FAP and may be an additional biological factor contributing to symptom generation in children with FD. The objective of this study was to determine if intestinal permeability is increased in children/adolescents with functional dyspepsia (FD) and whether intestinal permeability is correlated with mucosal inflammation and/or symptoms of anxiety or depression in this population.

Methods: A sugar absorption test was performed in 19 patients with FD and 19 controls. Anxiety and depression were assessed in both groups utilizing a standard questionnaire. In FD patients, duodenal mean and peak mast cell and eosinophil densities were determined.

Results: Intestinal permeability as measured by the sugar absorption test did not differ between children with FD and controls. In children with FD, there was no correlation between permeability and mast cell density, eosinophil density, anxiety scores, or depression scores, respectively.

Conclusions: Pediatric FD does not appear to be associated with increased small bowel intestinal permeability, however, there are some limitations to the current study.

Trial registration: ClinicalTrials.gov; NCT00363597.

References

    1. Hyams JS, Burke G, Davis PM, Rzepski B, Andrulonis PA. Abdominal pain and irritable bowel syndrome in adolescents: a community-based study. Pediatrics. 1996;129:220–226. doi: 10.1016/S0022-3476(96)70246-9.
    1. Walker LS, Lipani TA, Greene JW, Caines K, Stutts J, Polk DB, Caplan A, Rasquin-Weber A. Recurrent abdominal pain: symptom subtypes based on Rome II criteria for pediatric functional gastrointestinal disorders. J Pediatr Gastroenterol Nutr. 2004;38:187–191. doi: 10.1097/00005176-200402000-00016.
    1. Schurman JV, Friesen CA, Danda CE, Andre L, Welchert E, Lavenbarg T, Cocjin JT, Hyman PE. Diagnosing functional abdominal pain with the Rome II criteria: parent, child, and clinician agreement. J Pediatr Gastroenterol Nutr. 2005;41:291–295. doi: 10.1097/01.mpg.0000178438.64675.c4.
    1. Rasquin A, DiLorenzo C, Forbes D, Guiraldes E, Hyams JS, Staiano A, Walker LS. Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterology. 2006;130:1527–1537. doi: 10.1053/j.gastro.2005.08.063.
    1. Camilleri M, Gorman H. Intestinal permeability and irritable bowel syndrome. Neurogastroenterol Motil. 2007;19:545–552. doi: 10.1111/j.1365-2982.2007.00925.x.
    1. Schulman RJ, Eakin MN, Czyzewski DI, Jarrett M, Ou C-N. Increased gastrointestinal permeability and gut inflammation in children with functional abdominal pain and irritable bowel syndrome. J Pediatr. 2008;153:646–650. doi: 10.1016/j.jpeds.2008.04.062.
    1. Francavilla R, Miniello V, Magistá AM, De Canio A, Bucci N, Gagliardi F, Lionetti E, Castellaneta S, Polimeno L, Peccarisi L, Indrio F, Cavallo L. A randomized controlled trial of lactobacillus GG in children with functional abdominal pain. Pediatrics. 2010;126:e1445–e1452. doi: 10.1542/peds.2010-0467.
    1. Järvinen KM, Konstantinou GN, Pilapil M, Arrieta MC, Noone S, Sampson HA, Meddings J, Nowak-Wegrzyn A. Intestinal permeability in children with food allergy on specific elimination diets. Pediatr Allergy Immunol. 2013;24:589–595. doi: 10.1111/pai.12106.
    1. Reynolds CR, Kamphaus RW. Behavior assessment for children (BASC) American Guidances Service: Circle Pines, MN; 1992.
    1. Keita ÅV, Söderholm JD. The intestinal barrier and its regulation by neuroimmune factors. Neurogastroenterol Motil. 2010;22:718–733. doi: 10.1111/j.1365-2982.2010.01498.x.
    1. Wyatt J, Oberhuber G, Pongratz S, Püspök A, Moser G, Novacek G, Lochs H, Vogelsang H. Increased gastric and intestinal permeability in patients with crohn’s disease. Am J Gastroenterol. 1997;92:1891–1896.
    1. Sanderson IR, Boulton P, Menzies I, Walker-Smith JA. Improvement of abnormal lactulose/rhamnose permeability in active crohn’s disease of the small bowel by an elemental diet. Gut. 1987;28:1073–1076. doi: 10.1136/gut.28.9.1073.
    1. Duerksen DR, Wilhelm-Boyles C, Parry DM. Intestinal permeability in long-term follow-up of patients with celiac disease on a gluten-free diet. Dig Dis Sci. 2005;50:785–790. doi: 10.1007/s10620-005-2574-0.
    1. Talley NJ, Walker MM, Aro P, Ronkainen J, Storskrubb T, Hindley LA, Harmsen WS, Zinsmeister AR, Agréus L. Non-ulcer dyspepsia and duodenal eosinophilia: an adult endoscopic population-based case–control study. Clin Gastroenterol Hepatol. 2007;5:1175–1183. doi: 10.1016/j.cgh.2007.05.015.
    1. Friesen CA, Neilan NA, Schurman JV, Taylor DL, Kearns GL, Abdel-Rahman SM. Montelukast in the treatment of duodenal eosinophilia in children with dyspepsia: effect on eosinophil density and activation in relation to pharmacokinetics. BMC Gastroenterol. 2009;9:32. doi: 10.1186/1471-230X-9-32.
    1. Hall W, Buckley M, Crotty P, O’Morain CA. Gastric mucosal mast cells are increased in helicobacter pylori-negative functional dyspepsia. Clin Gastroenterol Hepatol. 2003;1:363–369. doi: 10.1053/S1542-3565(03)00184-8.
    1. Yang PC, Jury J, Soderholm JD, Sherman PM, KcKay DM, Perdue MH. Chronic psychological stress in rats induces intestinal sensitization to luminal antigens. Am J Pathol. 2006;168:104–114. doi: 10.2353/ajpath.2006.050575.
    1. Vicario M, Guilarte M, Alonso C, Yang P, Martinez C, Ramos L, Lobo B, González A, Guilà M, Pigrau M, Saperas E, Azpiroz F, Santos J. Chronological assessment of mast cell-mediated gut dysfunction and mucosal inflammation in a rat model of chronic psychosocial stress. Brain Behav Immun. 2010;24:1166–1175. doi: 10.1016/j.bbi.2010.06.002.
    1. Santos J, Benjamin M, Yang P-C, Prior T, Perdue MH. Chronic stress impairs rat growth and jejunal epithelial barrier function: role of mast cells. Am J Physiol Gastrointest Liver Physiol. 2000;278:G847–G854.
    1. Söderholm JD, Yang PC, Ceponis P, Vohra A, Riddell R, Sherman PM, Perdue MH. Chronic stress induces mast cell-dependent bacterial adherence and initiates mucosal inflammation in rat intestine. Gastroenterology. 2002;123:1099–1108. doi: 10.1053/gast.2002.36019.
    1. Santos J, Saperas E, Nogueiras C, Mourelle M, Antolin M, Cadahia A, Malagelada JR. Release of mast cell mediators into the jejunum by cold stress in humans. Gastroenterology. 1998;114:640–648. doi: 10.1016/S0016-5085(98)70577-3.

Source: PubMed

3
Suscribir