Multi-antioxidant supplementation does not prevent an increase in gut permeability after lower torso ischemia and reperfusion in humans.
BACKGROUND
An increase in gut permeability can have serious consequences leading to sepsis and multiple organ failure. After lower torso ischemia an increase in gut permeability is seen in both animals and humans. There is proof that this can be modified by antioxidant supplementation.


METHODS
In this prospective, randomized study we have looked at the influence of a multiantioxidant supplementation regime, using allopurinol, vitamins E and C, mannitol and N-acetylcysteine, perioperatively. Twenty-two patients received standard treatment and 20 patients received supplementation. Gut permeability was determined using a double sugar test with lactulose and rhamnose.


RESULTS
A significant increase in gut permeability was found neither in the non-treatment group (p = 0.012) nor in the treatment group (p = 0.006) after 6 and 24 h. No difference was found between the group receiving antioxidants and the standard treatment group. p = 0.93 6 h post clamp; p = 0.97 24 h post clamp.


CONCLUSIONS
In this study we have not found an influence of multiantioxidant supplementation on gut permeability after lower torso ischemia. Possible explanations for this negative result are being discussed.
Wijnen
M H W A
MH
Department of Surgery, St. Joseph Hospital, Veldhoven, The Netherlands. mhwijnen@worldonline.nl
Vader
H L
HL
Roumen
R M H
RM
D000111:Acetylcysteine / Q000008:administration & dosage; D000368:Aged; D000493:Allopurinol / Q000008:administration & dosage; D000963:Antimetabolites / Q000008:administration & dosage; D000975:Antioxidants / Q000008:administration & dosage*; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001205:Ascorbic Acid / Q000008:administration & dosage; D004234:Diuretics, Osmotic / Q000008:administration & dosage; D005260:Female; D016166:Free Radical Scavengers / Q000008:administration & dosage; D006801:Humans; D007408:Intestinal Absorption / Q000187:drug effects*; D007792:Lactulose / Q000493:pharmacokinetics; D008297:Male; D008353:Mannitol / Q000008:administration & dosage; D008875:Middle Aged; D011446:Prospective Studies; D015427:Reperfusion Injury / Q000188:drug therapy*; D012210:Rhamnose / Q000493:pharmacokinetics; D014810:Vitamin E / Q000008:administration & dosage
D000963:Antimetabolites; D000975:Antioxidants; D004234:Diuretics, Osmotic; D016166:Free Radical Scavengers; D014810:Vitamin E; D008353:Mannitol; D007792:Lactulose; D000493:Allopurinol; D001205:Ascorbic Acid; D012210:Rhamnose; D000111:Acetylcysteine