title: Systemic inflammation increases intestinal permeability during experimental human endotoxemia.
abstract: Although the gut is often considered the motor of sepsis, the relation between systemic inflammation and intestinal permeability in humans is not clear. We analyzed intestinal permeability during experimental endotoxemia in humans. Before and during experimental endotoxemia (Escherichia coli LPS, 2 ng/kg), using polyethylene glycol (PEG) as a permeability marker, intestinal permeability was analyzed in 14 healthy subjects. Enterocyte damage was determined by intestinal fatty acid binding protein. Endotoxemia induced an inflammatory response. Urinary PEGs 1,500 and 4,000 recovery increased from 38.8 +/- 6.3 to 63.1 +/- 12.5 and from 0.58 +/- 0.31 to 3.11 +/- 0.93 mg, respectively (P < 0.05). Intestinal fatty acid binding protein excretion was not affected by endotoxemia. The peak serum IL-10 concentrations correlated with the increase in PEG 1,500 recovery (r = 0.48, P = 0.027). Systemic inflammation results in an increased intestinal permeability. The increase in intestinal permeability is most likely caused by inflammation-induced paracellular permeability, rather than ischemia-mediated enterocyte damage.
authors.affiliation: Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. F.Hietbrink@umcutrecht.nl
authors.forename: Falco
authors.initials: F
authors.lastname: Hietbrink
authors.forename: Marc G H
authors.initials: MG
authors.lastname: Besselink
authors.forename: Willem
authors.initials: W
authors.lastname: Renooij
authors.forename: Martin B M
authors.initials: MB
authors.lastname: de Smet
authors.forename: Annelies
authors.initials: A
authors.lastname: Draisma
authors.forename: Hans
authors.initials: H
authors.lastname: van der Hoeven
authors.forename: Peter
authors.initials: P
authors.lastname: Pickkers
mesh_terms: D000328:Adult; D019446:Endotoxemia / Q000139:chemically induced / Q000378:metabolism* / Q000473:pathology*; D050556:Fatty Acid-Binding Proteins / Q000378:metabolism; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D007413:Intestinal Mucosa / Q000378:metabolism*; D007422:Intestines / Q000473:pathology*; D008070:Lipopolysaccharides / Q000633:toxicity; D011092:Polyethylene Glycols / Q000378:metabolism; D018746:Systemic Inflammatory Response Syndrome / Q000378:metabolism / Q000503:physiopathology*; D055815:Young Adult
chemical_list: C493404:FABP2 protein, human; D050556:Fatty Acid-Binding Proteins; D008070:Lipopolysaccharides; D016753:Interleukin-10; D011092:Polyethylene Glycols