title: Associations among gut permeability, inflammatory markers, and symptoms in patients with irritable bowel syndrome.
abstract: BACKGROUND
  Alterations in gastrointestinal (GI) permeability and immune measures are present in some patients with irritable bowel syndrome (IBS) but the relationship to symptoms is poorly defined. In adults with IBS, we compared permeability, unstimulated peripheral blood monocyte (PBMC) interleukin-10 (IL-10) levels, IBS life interference, and GI and psychological distress symptoms.
  
  
  METHODS
  In 88 women and 18 men with IBS, GI permeability was quantitated as percent recovery of urinary sucrose and the lactulose/mannitol (L/M) ratio. IL-10 was measured in supernatants from 72-h incubated, unstimulated PBMCs. Participants completed a 4-week daily diary recording IBS life interference on daily activities and work, IBS symptoms, and psychological distress symptoms. They also completed the Brief Symptom Inventory.
  
  
  RESULTS
  The L/M ratio but not percent sucrose recovery was significantly correlated with IBS interference with activities and work and retrospectively measured anxiety and depression. Unstimulated PBMC production of IL-10 correlated significantly with IBS interference with daily work, IBS symptom score, and abdominal pain. We identified a subgroup of IBS subjects with higher IL-10 and/or higher L/M ratio who had substantially higher IBS interference and IBS symptom scores.
  
  
  CONCLUSIONS
  Our findings suggest a distinct subgroup of IBS patients with alterations in gut barrier function. This subgroup is characterized by increased GI permeability and/or increased PBMC production of IL-10. These physiologic alterations reflect more severe IBS as measured by interference of IBS with daily activities and daily IBS symptoms.
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Children's Nutrition Research Center, and Texas Children's Hospital, 1100 Bates Ave Room 8072, Houston, TX, 77030, USA, rshulman@bcm.edu.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Shulman
authors.forename: Monica E
authors.initials: ME
authors.lastname: Jarrett
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Cain
authors.forename: Elizabeth K
authors.initials: EK
authors.lastname: Broussard
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Heitkemper
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000097:blood*; D007413:Intestinal Mucosa / Q000378:metabolism*; D043183:Irritable Bowel Syndrome / Q000276:immunology / Q000378:metabolism / Q000503:physiopathology* / Q000523:psychology; D007963:Leukocytes, Mononuclear / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010539:Permeability; D011446:Prospective Studies; D012189:Retrospective Studies; D057566:Self Report; D012720:Severity of Illness Index; D013315:Stress, Psychological; D055815:Young Adult
chemical_list: D015415:Biomarkers; C508609:IL10 protein, human; D016753:Interleukin-10