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Modifications of Intestinal Permeability to Large Molecules During Oral Provocation Tests in Children with Cow’s Milk Sensitive Enteropathy and Atopic Dermatitis

  • C. Dupont
  • E. Barau
  • P. Molkhou
Conference paper

Abstract

The gut is characterized by a certain degree of leakiness, as a result of which molecules and macromolecules that are not actively absorbed may permeate passively through the intestinal wall. The degree of leakiness in, or rate of permeation across, the intestinal wall depends upon many factors, including the size of the molecule and the state of the mucosa [9, 15]. Practical methods to measure this permeability of the mucosa to molecules and macromolecules have been developed, based on measurement of the urinary excretion of orally absorbed non-meta-bolizable markers. The use of two probe molecules of different molecular sizes, such as mannitol and lactulose, exploits the principle of differential absorption, namely that the two markers behave similarly in all respects except in their rate of permeation across the mucosa. Expressing the relative rates of urinary excretion of the markers as a ratio thus allows the researcher to overcome the effects of the many non-relevant variables that may influence individual markers [10] and to compare results of repeat procedures performed under different clinical conditions. The aim of this study was to use a non-invasive technique to detect the food-induced alterations of mucosal integrity under conditions of cow’s milk protein sensitive enteropathy (CMPSE) and atopic dermatitis (AD). The relationships of these conditions to food allergy, although still controversial, have been widely substantiated [2, 4, 13, 17, 20, 22].

Keywords

Celiac Disease Food Allergy Coeliac Disease Intestinal Permeability Sodium Cromoglycate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Andre C (1986) Allergie alimentaire. Diagnostic objectif et test de l’efficacité thérapeutique par mesure de la perméabilité intestinale. Presse Méd 15:105–108PubMedGoogle Scholar
  2. 2.
    Atherton DJ, Sewell M, Soothill JF, Wells RS, Chilvers CED (1978) A doubleblind controlled crossover trial of an antigen avoidance diet in atopic eczema. Lancet 1:401–403PubMedCrossRefGoogle Scholar
  3. 3.
    Beach RC (1984) Changes in gastro-intestinal permeability in the human neonate. MD Thesis, University of London, London, pp 145–158Google Scholar
  4. 4.
    Businco L, Businco E, Cantani A, Galli E, Infussi R, Benicori N (1982) Results of a milk and/or egg free diet in children with atopic dermatitis. Allergol Immunopathol 10:283–285Google Scholar
  5. 5.
    Cobden I, Dickinson RJ, Rothwell J, Axon ATR (1978) Intestinal permeability assessed by the excretion ratio of two molecules results in celiac disease. Br Med J ii: 1060–1063CrossRefGoogle Scholar
  6. 6.
    Dupont C, Barau E, Dehennin L, Molkhou P (1987) Mesure de la perméabilité intestinale aux sucres: application au diagnostic de la maladie coeliaque et de l’entéropathie aux protéines du lait de vache. Pathol Biol 35:1179–1182PubMedGoogle Scholar
  7. 7.
    Dupont C, Dehennin L, Navarro J, Canlorbe P (1987) Identification des syndromes de malabsorption par mesure de la perméabilité intestinale. Son application à la maladie coeliaque de l’enfant. Presse Méd 16:778PubMedGoogle Scholar
  8. 8.
    Du Mont GCL, Beach RC, Menzies IS (1984) Gastrointestinal permeability in food-allergic eczematous children. Clin Allergy 14:55–59PubMedCrossRefGoogle Scholar
  9. 9.
    Ford RPK, Menzies IS, Phillips AD, Walker-Smith JA, Turner MW (1985) Intestinal sugar permeability: relationship to diarrhoeal disease and small bowel morphology. J Pediatr Gastroenterol Nutr 4:568–574PubMedCrossRefGoogle Scholar
  10. 10.
    Ford RPK, Walker-Smith JA (1986) Food hypersensitivity and gut permeability. Frontiers of Gastrointestinal Research 13:69–81Google Scholar
  11. 11.
    Forget P, Sodoyez-Goffaux F, Zappitelli A (1985) Permeability of the small intestine to 51Cr EDTA in children with acute gastroenteritis or eczema. J Pediatr Gastroenterol Nutr 4:393–396PubMedCrossRefGoogle Scholar
  12. 12.
    Jackson PG, Lessof MH, Baker RWR, Ferrett J, McDonald DM (1981) Intestinal permeability in patients with eczema and food allergy. Lancet i: 1285–1286CrossRefGoogle Scholar
  13. 13.
    Juto P, Engberg S, Wimberg J (1978) Treatment of infantile atopic dermatitis with a strict elimination diet. Clin Allergy 8:493–500PubMedCrossRefGoogle Scholar
  14. 14.
    McCalla F, Savilahti E, Perkkio M, Kuitunen P, Backman A (1980) Morphology of the jejunum in children with eczema due to food allergy. Allergy 35:563–571PubMedCrossRefGoogle Scholar
  15. 15.
    Menzies IS (1983) Transmucosal passage of inert molecules in health and disease. In: Skadhauge E, Heintze K (eds) Intestinal absorption and secretion. MTP Press, London, pp 527–543Google Scholar
  16. 16.
    Menzies IS, Laker MF, Pounder R (1975) Abnormal permeability to sugars in villous atrophy. Lancet ii: 1107–1109Google Scholar
  17. 17.
    Molkhou P, Waguet JC (1981) Food allergy and atopic dermatitis in children: treatment with oral sodium cromoglycate. Ann Allergy 47:173–175PubMedGoogle Scholar
  18. 18.
    Pearson ADJ, Eastham EJ, Laker MF, Craft AW, Nelson R (1982) Intestinal permeability in children with Crohn’s disease and celiac disease. Br Med J 285:20–21CrossRefGoogle Scholar
  19. 19.
    Pike MG, Heddle RJ, Boulton P, Turner MW, Atherton DJ (1986) Increased intestinal permeability in atopic eczema. J Invest Dermatol 86:101–104PubMedCrossRefGoogle Scholar
  20. 20.
    Sampson HA (1983) Role of immediate food hypersensitivity in the pathogenis of atopic dermatitis. J Allerg Clin Immunol 71:473–480CrossRefGoogle Scholar
  21. 21.
    Shiner M, Ballard J, Smith ME (1975) The small-intestinal mucosa in cow’s milk allergy. Lancet i: 136–140CrossRefGoogle Scholar
  22. 22.
    Van Asperen PP, Lewis M, Rogers M, Kemp AS, Thompson S (1983) Experience with an elimination diet in children with atopic dermatitis. Clin. Allergy 13:479–485PubMedCrossRefGoogle Scholar
  23. 23.
    Weaver LT, Laker MF, Nelson R, Lucas A (1987) Milk feeding and changes in intestinal permeability and morphology of the newborn. J Pediatr Gastroenterol Nutr 6:351–358PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1989

Authors and Affiliations

  • C. Dupont
  • E. Barau
  • P. Molkhou

There are no affiliations available

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