title: Simultaneous gas-chromatographic urinary measurement of sugar probes to assess intestinal permeability: use of time course analysis to optimize its use to assess regional gut permeability.
abstract: BACKGROUND
  Measurement of intestinal permeability is important in several diseases but currently several methods are employed. We sought to: (1) develop a new GC based method to measure urinary mannitol, lactulose and sucralose to assess regional and total gut permeability; (2) analyze the kinetics of these sugars in the urine to determine which ratio is useful to represent intestinal permeability; and (3) determine whether age, gender, race and BMI impact these values.
  
  
  METHODS
  Subjects drank a cocktail of sucrose, lactulose, mannitol and sucralose and these sugars were measured in the urine at 5, 12 and 24h with gas chromatography.
  
  
  RESULTS
  Urinary mannitol exhibited significantly different kinetics than lactulose and sucralose which were similar to each other and varied little over the 24h. No permeability differences were observed for renal function, age, race, sex, or BMI.
  
  
  CONCLUSIONS
  Our data do not support the use of the widely used L/M ratio as an accurate estimate of intestinal permeability. Our data support the use of: the sucralose/lactulose (S/M) ratio to measure: small intestine permeability (first 5h); small and large intestine (first 12h), and total gut permeability (24h). This was also found to be true in a Parkinson's disease model.
authors.affiliation: Department of Internal Medicine, Section of Gastroenterology, Rush University Medical Center, Chicago, IL, United States. Electronic address: Maliha_Shaikh@rush.edu.
authors.forename: Maliha
authors.initials: M
authors.lastname: Shaikh
authors.affiliation: Rush Institute for Healthy Aging, Chicago, IL, United States. Electronic address: Kumar_Rajan@rush.edu.
authors.forename: Kumar
authors.initials: K
authors.lastname: Rajan
authors.affiliation: Department of Internal Medicine, Section of Gastroenterology, Rush University Medical Center, Chicago, IL, United States; Department of Biochemistry, Rush University, Chicago, IL, United States. Electronic address: christopher_b_forsyth@rush.edu.
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Forsyth
authors.affiliation: Department of Internal Medicine, Section of Gastroenterology, Rush University Medical Center, Chicago, IL, United States. Electronic address: Robin_Voigt@rush.edu.
authors.forename: Robin M
authors.initials: RM
authors.lastname: Voigt
authors.affiliation: Department of Internal Medicine, Section of Gastroenterology, Rush University Medical Center, Chicago, IL, United States; Department of Pharmacology, Rush University, Chicago, IL, United States; Department of Molecular Biophysics and Physiology, Rush University, Chicago, IL, United States; F.C. Donders Chair, Faculty of Science, University of Utrecht, Utrecht, The Netherlands. Electronic address: ali_keshavarzian@rush.edu.
authors.forename: Ali
authors.initials: A
authors.lastname: Keshavarzian
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000378:metabolism; D015992:Body Mass Index; D050260:Carbohydrate Metabolism; D002241:Carbohydrates / Q000652:urine*; D002849:Chromatography, Gas; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D007408:Intestinal Absorption; D007413:Intestinal Mucosa / Q000378:metabolism*; D007677:Kidney Function Tests; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D010539:Permeability; D012727:Sex Characteristics; D012907:Smoking; D013997:Time Factors; D016482:Urinalysis / Q000379:methods*; D055815:Young Adult
chemical_list: D002241:Carbohydrates
keywords: Intestinal permeability; Lactulose; Leaky gut; Mannitol; Sucralose; Urine