title: Small intestinal permeability in patients with eosinophilic oesophagitis during active phase and remission.
abstract: BACKGROUND
  Eosinophilic oesophagitis (EoE) is presumed to be an isolated oesophageal disease; yet other allergic diseases associated with eosinophilic infiltration of target tissues, such as asthma and eczema, show perturbed functions of other sites that may be involved in the diathesis of allergy modulation.
  
  
  OBJECTIVE
  To analyse small intestinal permeability in patients with active EoE and in a separate group of patients in remission.
  
  
  METHODS
  Small bowel permeability was determined using a dual sugar method by calculating lactulose:mannitol (L:M) ratio in 17 patients who met consensus criteria for active EoE (>15 eos/HPF) and 8 patients in remission (<5 eos/HPF). Data from 28 healthy controls was used for comparison.
  
  
  RESULTS
  Patients with active EoE had significantly higher L:M ratios when compared to controls (0.045 vs. 0.033, p<0.001) and to EoE in remission (0.041 vs. 0.027, p<.001). There was no significant difference in L:M between the group with EoEin remission and healthy controls. The current data show that L:M ratio of 0.033 also provides a reasonable cut-off that defined the active EoE group compared to patients in remission. The main component explaining the change in L:M ratio was increased absorption (and excretion) of lactulose ((1601 ± 106 ug) when compared to the EoE remission (969 ± 91 ug) and control (1043 ± 92 ug, p<.001) groups.
  
  
  CONCLUSIONS
  Small bowel permeability is overall increased in patients with active EoE, and is normal in patients with EoE in remission when compared to healthy controls. The role of the small bowel in active EoE deserves further investigation.
authors: Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, Minnesota, United States.
authors: David A
authors: DA
authors: Katzka
authors: Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, Minnesota, United States.
authors: Debra M
authors: DM
authors: Geno
authors: Immunochemistry Core Laboratory, Mayo Clinic Rochester, Minnesota, United States.
authors: Hilary E
authors: HE
authors: Blair
authors: Immunochemistry Core Laboratory, Mayo Clinic Rochester, Minnesota, United States.
authors: Jesse L
authors: JL
authors: Lamsam
authors: Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, Minnesota, United States.
authors: Jeffrey A
authors: JA
authors: Alexander
authors: Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, Minnesota, United States.
authors: Michael
authors: M
authors: Camilleri
mesh_terms: D000328:Adult; D000368:Aged; D057765:Eosinophilic Esophagitis / Q000378:metabolism*; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010539:Permeability; D012074:Remission Induction; D055815:Young Adult
keywords: OESOPHAGEAL DISORDERS; OESOPHAGITIS; SMALL INTESTINE