Intestinal permeability changes in response to acetylsalicylic acid in relatives of patients with Crohn's disease.
OBJECTIVE
Presence of a familial intestinal permeability defect in Crohn's disease remains controversial despite numerous studies. The purpose of this study was to determine whether detection of a permeability defect in first-degree relatives of patients with Crohn's disease can be enhanced using an acetylsalicylic acid provocation test.


METHODS
Lactulose-mannitol ratio, a measure of intestinal permeability, and total sucrose excretion, a measure of gastroduodenal permeability, were determined before and after ingestion of acetylsalicylic acid in healthy controls, in patients with Crohn's disease, and in the first-degree relatives of patients with Crohn's disease. Subjects were classified as hyperresponders if their results were above the mean of + 2SD of the controls.


RESULTS
First-degree relatives had a 110% increase in intestinal permeability after acetylsalicylic acid compared with an increase of 57% in controls (P = 0.001). Thirty-five percent of relatives were classified as hyperresponders. There was no significant difference in the change in sucrose excretion between relatives and controls (259% vs 198%; P < 0.05).


CONCLUSIONS
First-degree relatives of patients with Crohn's disease have an exaggerated increase in intestinal but not gastroduodenal permeability in response to acetylsalicylic acid. This study supports a familial permeability defect in Crohn's disease, which may not be present in all families.
Hilsden
R J
RJ
Department of Community Health Sciences, University of Calgary, Alberta, Canada.
Meddings
J B
JB
Sutherland
L R
LR
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin; D003424:Crohn Disease / Q000235:genetics / Q000378:metabolism* / Q000652:urine; D004386:Duodenum / Q000187:drug effects / Q000378:metabolism; D005192:Family Health; D005260:Female; D005753:Gastric Mucosa / Q000378:metabolism; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism; D007422:Intestines / Q000187:drug effects*; D007792:Lactulose / Q000652:urine; D008297:Male; D008353:Mannitol / Q000652:urine; D010375:Pedigree; D010539:Permeability / Q000187:drug effects; D013270:Stomach / Q000187:drug effects; D013395:Sucrose / Q000652:urine
D000894:Anti-Inflammatory Agents, Non-Steroidal; D008353:Mannitol; D007792:Lactulose; D013395:Sucrose; D001241:Aspirin