title: Acute experimental stress evokes a differential gender-determined increase in human intestinal macromolecular permeability.
abstract: BACKGROUND
  Intestinal epithelial dysfunction is a common pathophysiologic feature in irritable bowel syndrome (IBS) patients and might be the link to its clinical manifestations. We previously showed that chronic psychosocial stress induces jejunal epithelial barrier dysfunction; however, whether this epithelial response is gender-specific and might thus explain the enhanced female susceptibility to IBS remains unknown.
  
  
  METHODS
  Intestinal responses to acute stress were compared in age-matched groups of healthy women and men (n = 10 each) experiencing low background stress. A 20-cm jejunal segment, was perfused with an isosmotic solution, and intestinal effluents were collected under basal conditions, for 15 min during cold pain stress and for a 45-min recovery period. Epithelial function (net water flux and albumin output), changes in stress hormones, and cardiovascular and psychologic responses to cold stress were measured.
  
  
  RESULTS
  Heart rate and blood pressure significantly increased during cold pain stress with no differences between men and women. Adrenocorticotropic hormone and cortisol levels during cold pain stress were significantly higher in men. Basal net water flux and epithelial permeability were similar in men and women. Cold pain stress increased water flux in both groups (72 ± 23 and 107 ± 18 μL min(-1) cm(-1) , respectively; F(5, 90) = 5.5; P = 0.003 for Time) and, interestingly, this was associated with a marked increase of albumin permeability in women but not in men (0.8 ± 0.2 vs.-0.7 ± 0.2 mg/15 min; P < 0.0001).
  
  
  CONCLUSIONS
  Intestinal macromolecular permeability in response to acute experimental stress is increased in healthy women, a mechanism that may contribute to female oversusceptibility to IBS.
authors.affiliation: Laboratory of Neuro-Immuno-Gastroenterology, Digestive Diseases Research Unit, Institut de Recerca Vall d'Hebron, Hospital Universitari Vall d'Hebron; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Alonso
authors.forename: M
authors.initials: M
authors.lastname: Guilarte
authors.forename: M
authors.initials: M
authors.lastname: Vicario
authors.forename: L
authors.initials: L
authors.lastname: Ramos
authors.forename: S
authors.initials: S
authors.lastname: Rezzi
authors.forename: C
authors.initials: C
authors.lastname: Martínez
authors.forename: B
authors.initials: B
authors.lastname: Lobo
authors.forename: F-P
authors.initials: FP
authors.lastname: Martin
authors.forename: M
authors.initials: M
authors.lastname: Pigrau
authors.forename: A M
authors.initials: AM
authors.lastname: González-Castro
authors.forename: M
authors.initials: M
authors.lastname: Gallart
authors.forename: J R
authors.initials: JR
authors.lastname: Malagelada
authors.forename: F
authors.initials: F
authors.lastname: Azpiroz
authors.forename: S
authors.initials: S
authors.lastname: Kochhar
authors.forename: J
authors.initials: J
authors.lastname: Santos
mesh_terms: D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism*; D043183:Irritable Bowel Syndrome / Q000378:metabolism / Q000503:physiopathology; D008297:Male; D010539:Permeability; D012727:Sex Characteristics; D013315:Stress, Psychological / Q000378:metabolism* / Q000503:physiopathology; D055815:Young Adult