title: Intestinal permeability and the prediction of relapse in Crohn's disease.
abstract: To see whether intestinal permeability (IP) predicted relapse in Crohn's disease, we measured IP in 72 patients with quiescent Crohn's disease using the lactulose-mannitol test. The permeability index (lactulose/mannitol) was significantly higher in patients than in controls (0.046 [SEM 0.005] vs 0.018 [SEM 0.002], respectively). Patients were followed for 1 year after the test. 26 of the 37 patients with raised permeability, but only 6 of the 35 with normal permeability relapsed within 1 year after the test (p < 0.001). The sensitivity of the permeability test as a predictor for relapse was 81%. A significant correlation was found between the value of the permeability index and the probability of relapse (p < 0.01). These results show that increases in intestinal permeability precede clinical relapses in Crohn's disease and so are an indicator of subclinical disease. The measurement of intestinal permeability may lead to a better understanding of the pathogenesis of Crohn's disease.
authors.affiliation: Department of Gastroenterology and Hepatology, Währinger Gürtel, Vienna.
authors.forename: J
authors.initials: J
authors.lastname: Wyatt
authors.forename: H
authors.initials: H
authors.lastname: Vogelsang
authors.forename: W
authors.initials: W
authors.lastname: Hübl
authors.forename: T
authors.initials: T
authors.lastname: Waldhöer
authors.forename: H
authors.initials: H
authors.lastname: Lochs
mesh_terms: D000328:Adult; D003424:Crohn Disease / Q000378:metabolism*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism*; D007792:Lactulose; D008297:Male; D008353:Mannitol; D010539:Permeability; D011237:Predictive Value of Tests; D012008:Recurrence
chemical_list: D008353:Mannitol; D007792:Lactulose