Enteric protein loss and intestinal permeability changes in children during acute shigellosis and after recovery: effect of zinc supplementation.
The effect of zinc supplementation on intestinal permeability changes and protein loss was studied in 32 children aged between 1 and 12 years during bouts of acute shigellosis and after recovery. An intestinal permeability test and then a 48 hour balance study were performed on all patients. They were then blindly assigned to receive vitamin B syrup either with or without zinc acetate (15 mg/kg per day) for a month. All patients received a five day course of nalidixic acid. The balance study was repeated during convalescence and follow up, but a permeability test was done only at follow up after one month. Intestinal permeability, expressed as a urinary lactulose:mannitol excretion ratio, improved significantly (p = 0.001) along with a significant increase (p = 0.005) in mannitol excretion in the zinc supplemented children, suggesting a resolution of small bowel mucosal damage. The latter was associated with a higher coefficient of nitrogen absorption (p = 0.03), suggesting a possible role of zinc in the treatment of shigellosis. Enteric protein loss, as assessed by faecal alpha 1 antitrypsin clearance, was not influenced by zinc supplementation.
Alam
A N
AN
International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka.
Sarker
S A
SA
Wahed
M A
MA
Khatun
M
M
Rahaman
M M
MM
D002463:Cell Membrane Permeability / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D004405:Dysentery, Bacillary / Q000188:drug therapy / Q000378:metabolism*; D005260:Female; D006801:Humans; D007223:Infant; D007413:Intestinal Mucosa / Q000378:metabolism; D007792:Lactulose / Q000652:urine; D008297:Male; D008353:Mannitol / Q000652:urine; D009268:Nalidixic Acid / Q000627:therapeutic use; D009584:Nitrogen / Q000378:metabolism; D011504:Protein-Losing Enteropathies / Q000188:drug therapy*; D014803:Vitamin B Complex / Q000627:therapeutic use; D015032:Zinc / Q000627:therapeutic use*
D014803:Vitamin B Complex; D009268:Nalidixic Acid; D008353:Mannitol; D007792:Lactulose; D015032:Zinc; D009584:Nitrogen