Intestinal permeability in the ileal pouch.

BACKGROUND: Villous atrophy, mucin changes ('colonic metaplasia'), and chronic inflammation occur to varying degrees in all patients with ileal pouchanal anastomosis whereas acute inflammation (pouchitis) affects a subgroup of patients with prior ulcerative colitis. AIM: To measure epithel...

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Main Authors: Merrett, M, Soper, N, Mortensen, N, Jewell, D
Format: Journal article
Language:English
Published: 1996
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author Merrett, M
Soper, N
Mortensen, N
Jewell, D
author_facet Merrett, M
Soper, N
Mortensen, N
Jewell, D
author_sort Merrett, M
collection OXFORD
description BACKGROUND: Villous atrophy, mucin changes ('colonic metaplasia'), and chronic inflammation occur to varying degrees in all patients with ileal pouchanal anastomosis whereas acute inflammation (pouchitis) affects a subgroup of patients with prior ulcerative colitis. AIM: To measure epithelial barrier function looking for possible functional adaptation in ileal 'pouch' mucosa. PATIENTS: Patients with an ileal pouch prior to ileostomy closure (n = 12), functioning pouch (n = 14), pouchitis (n = 8), and ulcerative colitis (n = 12) were assessed. METHODS: 51Cr-EDTA was administered into the 'pouch' or rectum and urinary recovery over 24 hours was taken as an indication of permeability (barrier function). Histological analysis of 'pouch' biopsy specimens was undertaken. RESULTS: Mucosal permeability is decreased from median 9.4% (range 5.4% to 39.1%) to 1.4% (range 0.38% to 2.2%) after ileostomy closure (p < 0.002) with levels being negatively correlated with two histological parameters of colonic metaplasia-mucin changes (p = 0.03) and villous atrophy (p = 0.05). Pouchitis was associated with increased permeability 5.9% (1.9% to 19.5%) compared with healthy 'pouch' 1.4% (0.35 to 2.2%) (p < 0.006). CONCLUSION: Despite the presence of chronic inflammation in the mature 'pouch' functional adaptation with reduced permeability occurs in conjunction with colonic metaplasia.
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spelling oxford-uuid:763a5a9b-9846-4cfe-b9e4-614c0ed73cf52022-03-26T20:14:16ZIntestinal permeability in the ileal pouch.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:763a5a9b-9846-4cfe-b9e4-614c0ed73cf5EnglishSymplectic Elements at Oxford1996Merrett, MSoper, NMortensen, NJewell, DBACKGROUND: Villous atrophy, mucin changes ('colonic metaplasia'), and chronic inflammation occur to varying degrees in all patients with ileal pouchanal anastomosis whereas acute inflammation (pouchitis) affects a subgroup of patients with prior ulcerative colitis. AIM: To measure epithelial barrier function looking for possible functional adaptation in ileal 'pouch' mucosa. PATIENTS: Patients with an ileal pouch prior to ileostomy closure (n = 12), functioning pouch (n = 14), pouchitis (n = 8), and ulcerative colitis (n = 12) were assessed. METHODS: 51Cr-EDTA was administered into the 'pouch' or rectum and urinary recovery over 24 hours was taken as an indication of permeability (barrier function). Histological analysis of 'pouch' biopsy specimens was undertaken. RESULTS: Mucosal permeability is decreased from median 9.4% (range 5.4% to 39.1%) to 1.4% (range 0.38% to 2.2%) after ileostomy closure (p < 0.002) with levels being negatively correlated with two histological parameters of colonic metaplasia-mucin changes (p = 0.03) and villous atrophy (p = 0.05). Pouchitis was associated with increased permeability 5.9% (1.9% to 19.5%) compared with healthy 'pouch' 1.4% (0.35 to 2.2%) (p < 0.006). CONCLUSION: Despite the presence of chronic inflammation in the mature 'pouch' functional adaptation with reduced permeability occurs in conjunction with colonic metaplasia.
spellingShingle Merrett, M
Soper, N
Mortensen, N
Jewell, D
Intestinal permeability in the ileal pouch.
title Intestinal permeability in the ileal pouch.
title_full Intestinal permeability in the ileal pouch.
title_fullStr Intestinal permeability in the ileal pouch.
title_full_unstemmed Intestinal permeability in the ileal pouch.
title_short Intestinal permeability in the ileal pouch.
title_sort intestinal permeability in the ileal pouch
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AT sopern intestinalpermeabilityintheilealpouch
AT mortensenn intestinalpermeabilityintheilealpouch
AT jewelld intestinalpermeabilityintheilealpouch