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https://hdl.handle.net/2440/11787
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Type: | Journal article |
Title: | Improvement in intestinal permeability precedes morphometric recovery of the small intestine in coeliac disease |
Author: | Cummins, A. Thompson, F. Butler, R. Cassidy, J. Gillis, D. Lorenzetti, M. Southcott, E. Wilson, P. |
Citation: | Clinical Science, 2001; 100(4):379-386 |
Publisher: | Portland Press |
Issue Date: | 2001 |
ISSN: | 0143-5221 1470-8736 |
Abstract: | It is often difficult to assess small bowel recovery in adults with coeliac disease on a gluten-free diet (GFD). This prospective study compares changes in intestinal permeability with changes in intestinal biopsy at various intervals after commencing a GFD. Intestinal permeability was measured by lactulose/rhamnose absorption from 1 week to 24 months after commencing a GFD. Intestinal morphometry was measured by villus area, crypt length and mitotic count per crypt at diagnosis and after commencing a GFD. Median intestinal permeability values decreased from 0.47 (n = 35) at diagnosis to 0.25 (n = 17) after 1 week and to 0.16 (n = 18) after 2 months of a GFD. Rhamnose absorption improved significantly at an early stage, from 6.6% (untreated) to 15.4% at 3 months of a GFD, whereas the decrease in lactulose permeation took longer: from 3.4% (untreated) to 0.8% after 12 months of a GFD. Mean villus area (n = 29) was reduced to 16% of control values at diagnosis, and improved to a maximum of 48% after 6 months on a GFD, but did not change thereafter. Mean crypt length and mitotic count per crypt were increased by 222% and 356% respectively at diagnosis, and these parameters remained elevated at 172% and 216% above control values after 6 months of a GFD. We conclude that intestinal permeability improves within 2 months after starting a GFD, but that measurable intestinal biopsy improvement requires ingestion of a GFD for at least 3-6 months, and even then remains incomplete. |
Keywords: | Duodenum Humans Celiac Disease Rhamnose Lactulose Gliadin Autoantibodies Biopsy Treatment Outcome Follow-Up Studies Prospective Studies Intestinal Absorption Permeability Time Factors Adolescent Adult Aged Middle Aged Female Male Glutens |
DOI: | 10.1042/CS20000193 |
Published version: | http://dx.doi.org/10.1042/cs1000379 |
Appears in Collections: | Aurora harvest 2 Physiology publications |
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