Usefulness of rectally administering [1-(13)C]-butyrate for breath test in patients with active and quiescent ulcerative colitis.
OBJECTIVE
Impaired butyrate metabolism plays a part in ulcerative colitis (UC). To assess the usefulness of measuring butyrate metabolism as an indication of inflammatory activity, we investigated the rate of butyrate metabolism by breath test after administering [1-(13)C]-butyrate rectally to patients with UC.


METHODS
Thirty-eight UC patients (22 active, 16 quiescent) and 15 healthy controls were given [1-(13)C]-butyrate enemas. The (13)CO2 production rate was measured by breath test using an infrared spectrometric analyzer.


RESULTS
The quantity of expired (13)CO2 was significantly lower in the active than in the quiescent UC and control groups. Cumulative (13)CO2 production at 240 min showed significant negative correlations with the clinical activity index (r=-0.65, p<0.0001), endoscopic activity index (r=-0.63, p=0.0001) and histology (r=-0.71, p<0.0001) in the active UC group. The (13)CO2 production rate was significantly increased in the quiescent stage as compared with the active stage in six UC patients, in whom clinical remission was achieved, in accordance with improvements in the clinical activity index, the endoscopic activity index, histology and fecal butyrate concentrations. Significant inverse correlations between the cumulative (13)CO2 production rate and these three parameters were seen in these six UC patients assessed in both the active and quiescent stages.


CONCLUSIONS
Measurement of expired (13)CO2 after rectally administering [1-(13)C]-butyrate in active and quiescent UC appears to be a promising and reliable method for evaluating disease activity and metabolic changes associated with amelioration of inflammation.
Kato
Kimitoshi
K
Department of Gastroenterology and Hepatology, Nihon University School of Medicine, Tokyo, 173-8610, Japan.
Ishii
Yukimoto
Y
Mizuno
Shigeaki
S
Sugitani
Masahiko
M
Asai
Satoshi
S
Kohno
Tadashi
T
Takahashi
Katsuyuki
K
Komuro
Sachiko
S
Iwamoto
Maho
M
Miyamoto
Shunpachi
S
Takayama
Tadatoshi
T
Arakawa
Yasuyuki
Y
D000285:Administration, Rectal; D000328:Adult; D001944:Breath Tests / Q000379:methods; D002087:Butyrates / Q000008:administration & dosage* / Q000493:pharmacokinetics; D002245:Carbon Dioxide / Q000378:metabolism; D002247:Carbon Isotopes; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000378:metabolism; D003113:Colonoscopy; D005260:Female; D006801:Humans; D008297:Male; D012720:Severity of Illness Index
D002087:Butyrates; D002247:Carbon Isotopes; D002245:Carbon Dioxide