Article ; Online: Increased Intestinal Permeability and Decreased Resiliency of the Intestinal Barrier in Alcoholic Liver Disease.
Clinical and translational gastroenterology
2024 Volume 15, Issue 4, Page(s) e00689
Abstract: Introduction: Only 20%-30% of individuals with alcohol use disorder (AUD) develop alcoholic liver disease (ALD). While the development of gut-derived endotoxemia is understood to be a required cofactor, increased intestinal permeability in ALD is not ... ...
Abstract | Introduction: Only 20%-30% of individuals with alcohol use disorder (AUD) develop alcoholic liver disease (ALD). While the development of gut-derived endotoxemia is understood to be a required cofactor, increased intestinal permeability in ALD is not completely understood. Methods: We recruited 178 subjects-58 healthy controls (HCs), 32 with ALD, 53 with AUD but no liver disease (ALC), and 35 with metabolic dysfunction-associated steatotic liver disease (MASLD). Intestinal permeability was assessed by a sugar cocktail as a percentage of oral dose. The permeability test was repeated after an aspirin challenge in a subset. Results: Five-hour urinary lactulose/mannitol ratio (primarily representing small intestinal permeability) was not statistically different in HC, ALC, ALD, and MASLD groups ( P = 0.40). Twenty-four-hour urinary sucralose (representing whole gut permeability) was increased in ALD ( F = 5.3, P < 0.01) and distinguished ALD from ALC; 24-hour sucralose/lactulose ratio (primarily representing colon permeability) separated the ALD group ( F = 10.2, P < 0.01) from the MASLD group. After aspirin challenge, intestinal permeability increased in all groups and ALD had the largest increase. Discussion: In a group of patients, we confirmed that (i) the ALD group has increased intestinal permeability compared with the HC, ALC, or MASLD group. In addition, because small bowel permeability (lactulose/mannitol ratio) is normal, the disruption of intestinal barrier seems to be primarily in the large intestine; (ii) decreased resiliency of intestinal barrier to injurious agents (such as NSAID) might be the mechanism for gut leak in subset of AUD who develop ALD. |
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MeSH term(s) | Humans ; Male ; Liver Diseases, Alcoholic/metabolism ; Middle Aged ; Female ; Permeability ; Lactulose/urine ; Lactulose/administration & dosage ; Intestinal Mucosa/metabolism ; Intestinal Mucosa/pathology ; Adult ; Mannitol/urine ; Mannitol/administration & dosage ; Case-Control Studies ; Aspirin/administration & dosage ; Intestinal Absorption/drug effects ; Sucrose/administration & dosage ; Sucrose/analogs & derivatives ; Alcoholism/complications ; Alcoholism/metabolism ; Aged ; Intestinal Barrier Function |
Chemical Substances | Lactulose (4618-18-2) ; Mannitol (3OWL53L36A) ; Aspirin (R16CO5Y76E) ; Sucrose (57-50-1) ; trichlorosucrose (96K6UQ3ZD4) |
Language | English |
Publishing date | 2024-04-01 |
Publishing country | United States |
Document type | Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't |
ZDB-ID | 2581516-7 |
ISSN | 2155-384X ; 2155-384X |
ISSN (online) | 2155-384X |
ISSN | 2155-384X |
DOI | 10.14309/ctg.0000000000000689 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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