Abstract
Studies of intestinal mucosal immunity and inflammation are limited by the relative inaccessibility of most of the small intestine. Any new method of studying mucosal immunity and inflammation in patients should be minimally invasive, cost-effective, and provide information not readily available using current methods. Gaspari et al. (1) described gut lavage with 3 to 4 L of nonabsorbable, commercially available polyethylene glycol (PEG)-based bowel cleansing fluid as a method for analyzing human intestinal secretions for antibody content. Peroral gastrointestinal (GI) lavage is widely used to cleanse the GI tract prior to colonoscopy, barium enema examination, or colonic surgery. Whole gut lavage fluid (WGLF) therefore often becomes available without subjecting a patient to any additional investigation. This method is also often more acceptable to healthy volunteers than almost any other method of studying small intestinal secretions. Over the past decade, we have found that WGLFs from patients (both adults and children) suffering from a variety of intestinal diseases contain immunoglobulins (Igs) and antibodies, hemoglobin, plasma-derived proteins, cytokines, inflammatory cells, and their granule-derived proteins and growth factors (2,3). In this chapter, we describe our experience of the use of WGLF to study mucosal immunity and inflammation.
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References
Gaspari, M. M., Brennan, P. T., Soloman, S. M., and Elson, C. O. (1988) A method of obtaining, processing, and analysing human intestinal secretions for antibody content. J. Immunol. Methods 110, 85–91.
Ferguson, A., Ghosh, S., Handy, L. M., Choudari, C., Mwantembe, O., and McIntyre, M. A. (1994) Analysis of disease distribution, activity and complications in the patient with inflammatory bowel disease. Scand. J. Gastroenterol. 29(Suppl. 203), 15–19.
Ferguson, A. and Ghosh, S. (1998) Mucosal immunity and immune-mediated injury in Crohn’s disease: relevance of disease distribution, in Systemic Manifestations of IBD: The Pending Challenge for Subtle Diagnosis and Treatment (Lembcke, B., Kruis, W., and Sartor, R. B., eds.), Kluwer Academic, Lancaster, UK, pp. 306–312.
Ferguson, A., Ghosh, S., and Brydon, W. G. (1996) Use of whole gut lavage fluid to measure occult GI bleeding and protein-losing enteropathy. Z. Gastroenterol. 34(Suppl. 4), 60-64.
Ferguson, A., Sallam, J., O’Mahoney, S., and Poxton, I. (1995) Clinical investigation of gut immune responses: review on non-parenteral vaccines. Adv. Drug Delivery Rev. 18, 53–71.
Ferguson, A., Croft, N., and Humphreys, K. (1995) Technical report: results of immunological tests on faecal extracts are likely to be extremely misleading. Clin. Exp. Immunol. 99, 70–75.
O’Mahoney, S., Choudari, C. P., Barton, J. R., Walker, S., and Ferguson, A. (1991) Gut lavage fluid proteins as markers of activity of inflammatory bowel disease. Scand. J. Gastroenterol. 26, 940–944.
Choudari, C. P., O’Mahoney, S., Brydon, G., Mwantembe, O., and Ferguson, A. (1993) Concentrations of immunoglobulin G, albumin and alpha-1 antitrypsin in whole gut lavage fluid: objective measures of disease activity in inflammatory bowel disease. Gastroenterology 104, 1064–1071.
Handy, L. M., Ghosh, S., and Ferguson, A. (1995) Investigation of neutrophil migration into the gut by cytology of whole gut lavage fluid. Eur. J. Gastroenterol. Hepatol. 7, 53–58.
Handy, L. M., Ghosh, S., and Ferguson, A. (1996) Investigation of neutrophils in the gut lumen by assay of granulocyte elastase in whole-gut lavage fluid. Scand. J. Gastroenterol. 31, 700–705.
Barclay, G. R. (1990) Antibodies to endotoxin in health and disease. Rev. Med. Microbiol. 1, 133–142.
Dieterich, W., Ehnis, T., Bauer, M., Donner, P., Volta, U., Riecken, E., and Schuppan, D. (1997) Identification of tissue transglutaminase as the autoantigen of celiac disease. Nat. Med. 3(7), 797–801.
Ichinose, A., Bottenus, R., and Davie, E. (1990) Structure of transglutaminases: minireview. J. Biol. Chem. 265(23), 13,411–13,414.
Folk, J. (1972) Structure and catalytic properties of hepatic transglutaminase. Ann. NY Acad. Sci. 202, 59–76.
Sblattero, D., Berti, I., Trevisiol, C., Marzari, R., Bradbury, A., Not, T., Fasano, A., and Ventura, A. (1999) Human tissue transglutaminase ELISA: a powerful mass screening diagnostic assay for coeliac disease. Abstract in Proceedings of the Eighth International Symposium on Coeliac Disease, Jean Gilder Congressi, Naples, Italy, p. 34.
Greenberg, C., Birckbichler, P., and Rice, R. (1991) Transglutaminases: multifunctional cross-linking enzymes that stabilize tissues. FASEB J. 5, 3071–3077.
Bruce, S., Bjarnason, I., and Peters, T. (1985) Human jejunal transglutaminase: demonstration of activity, enzyme kinetics and substrate specificity with special relation to gliadin and coeliac disease. Clin. Sci. 68, 573–579.
Molberg, O., McAdam, S., Korner, R., Quarsten, H., Kristiansen, C., Madsen, L., Fugger, L., Scott, H., Noren, O., Roepstorff, P., Lundin, K., Sjostrom, H., and Sollid, L. (1998) Tissue transglutaminase selectively modifies gliadin peptides that are recognised by gut-derived T cells in celiac disease. Nat. Med. 4(6), 713–717.
Sulkanen, S., Halttunen, T., Laurila, K., Kolho, K., Korponay-Szabo, R., Sarnesto, A., Savilahti, E., Collin, P., and Maki, M. (1998) Tissue transglutaminase autoantibody enzyme-linked immunosorbent assay in detecting celiac disease. Gastro-enterology 115, 1322–1328.
O’Mahoney, S., Arranz, E., Barton, J. R., and Ferguson, A. (1991) Dissociation between systemic and mucosal humoral immune responses in coeliac disease. Gut 32, 29–35.
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© 2000 Humana Press Inc., Totowa, NJ
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Ghosh, S., Dahele, A., Drummond, H.E., Hoque, S.S., Humphreys, K., Arnott, I.D.R. (2000). Whole Gut Lavage Fluid Analysis. In: Marsh, M.N. (eds) Celiac Disease. Methods in Molecular Medicine, vol 41. Humana Press. https://doi.org/10.1385/1-59259-082-9:257
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DOI: https://doi.org/10.1385/1-59259-082-9:257
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