# Polyethylene glycol (PEG) as a marker for gastrointestinal permeability:



## SpAsMaN* (May 11, 2002)

http://www.nvge.nl/upload/algemeen/Abstrac...jaar%202005.pdf*Polyethylene glycol (PEG) as a marker for gastrointestinal permeability`;a novel assay, excretion kinetics, and sensitivity*A.P.M. Kerckhoffs1, M.B.M. de Smet2, M.G.H. Besselink2, W. Renooij2,L.M.A. Akkermans2. Dept of Gastroenterology1 and Surgery2, UniversityMedical Center Utrecht, The NetherlandsIntestinal permeability is a key factor in small bowel bacterial overgrowthleading to bacterial translocation and sepsis. PEGs of various molecularmass have been used as markers for intestinal permeability: PEG 400 canfreely pass the intestinal mucosal barrier, larger PEG molecules only ifintestinal permeability is compromised. We developed an HPLC-basedassay of PEGs using evaporative light-scattering detection allowing simultaneousquantitation of PEGs. We aimed to test the physiologic sensitivityof the assay by challenging the intestinal mucosal barrier with NSAIDs.Ten healthy volunteers drank a 100 mL solution of 5 g PEG 400, 1.5 gPEG 1500, 5 g PEG 4000 and 10 g PEG 10 000 in water before and after2 days naproxen (750 mg/day). Urine was collected at 2-hour intervals for24 hours. A standard lactulose-mannitol test was performed for comparison.Mucosal damage was evaluated from release of intestinal fattyacid binding protein (I-FABP). Changes in intestinal permeability wereevaluated from areas under the PEG-excretion time-curves (AUC) andfrom the intestinal permeability index (IPI: % of initial dose of PEGs 1500,4000, and 10 000 recovered in 24-hour urine relative to PEG 400).Excretion of PEGs 400 and 1500 peaked within 2 hours after ingestion;PEG 4000 peaked at 4 hours; PEG 10 000 was not identified in urine.Naproxen did not influence peak excretion times of PEGs and had noeffect on extent of excretion of PEGs 400 and 1500. Naproxen significantlyincreased excretion of PEG 4000 (AUCâ€™s: p < 0.05; IPI: p <0.05). Naproxen increased lactulose-mannitol ratioâ€™s significantly (p <0.01) but mostly still to values within the normal range (ratio < 0.03).Naproxen did not cause release of I-FABP indicating no extensivemucosal damage.*Conclusion: 2-days ingestion of naproxen compromised intestinal permeability**to the extent of allowing passage of PEG molecules up to the size of 4000,**while the intestine is still impermeable for PEGs the size of 10 000.*


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## SpAsMaN* (May 11, 2002)

NAPROXEN was my IBS maker!


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