Systemic inflammation increases intestinal permeability during experimental human endotoxemia

Systemic inflammation increases intestinal permeability during experimental human endotoxemia,10.1097/SHK.0b013e3181a2bcd6,Shock,Falco Hietbrink,Marc

Systemic inflammation increases intestinal permeability during experimental human endotoxemia   (Citations: 6)
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Although the gut is often considered the motor of sepsis, the relation between systemic inflammation and intestinal permeability in humans is not clear. We analyzed intestinal permeability during experimental endotoxemia in humans. Before and during experimental endotoxemia (Escherichia coli LPS, 2 ng/kg), using polyethylene glycol (PEG) as a permeability marker, intestinal permeability was analyzed in 14 healthy subjects. Enterocyte damage was determined by intestinal fatty acid binding protein. Endotoxemia induced an inflammatory response. Urinary PEGs 1,500 and 4,000 recovery increased from 38.8 +/- 6.3 to 63.1 +/- 12.5 and from 0.58 +/- 0.31 to 3.11 +/- 0.93 mg, respectively (P < 0.05). Intestinal fatty acid binding protein excretion was not affected by endotoxemia. The peak serum IL-10 concentrations correlated with the increase in PEG 1,500 recovery (r = 0.48, P = 0.027). Systemic inflammation results in an increased intestinal permeability. The increase in intestinal permeability is most likely caused by inflammation-induced paracellular permeability, rather than ischemia-mediated enterocyte damage.
Journal: Shock , vol. 32, no. 4, pp. 374-378, 2009
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    • ...Hietbrink et al. [45] showed that during experimental human endotoxemia, SIRS increases intestinal permeability, but does not affect I-FABP levels...
    • ... recent literature reinforces such a model: critically ill patients with shock have an epithelial lifting of villi [16, 17], enterocyte necrosis explaining the increased I-FABP concentration observed in this context [21], acute reduction of enterocyte mass explaining the lower gut citrulline synthesis and therefore the rapid decrease of plasma citrulline concentration [46, 48, 49]; acute dysfunction of enterocytes associated with SIRS [45], ...

    Gaël Pitonet al. Acute intestinal failure in critically ill patients: is plasma citrull...

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