Can laboratory tests predict severity of small bowel histopathology in celiac disease?

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  • April 1995 Intestinal Disorders A273


    R. Benamouzim S. Mah6, AM, Barlier, J. Rautureau, D. Torn6. Dpt of

    Gastroenterology. Avicenne Hospital, Bobigny & INRA, Laboratory of

    Human Nutrition and Intestinal Physiology, Paris. France.

    Exogenous and endogenous digestive polyamines are involved in

    cell differenciation and proliferation and may be involved in tumoral

    growth. Polyamine levels in human intestinal lumen remain unknown.

    Putrescine (Put), cadaverine (Cd), spermidine (Spd) and spermine (Spm)

    concentrations (C in Ixmol/g DM) and flows (F in ~tmol/20 min) were

    determined by HPLC in jejunal and ileal effluents of healthy volunteers

    collected after 12 hours fasting by the slow marker perfusion technique

    during respectively 4 and 8 hours (m~+s.e.m):

    Jejunum (n=39) Ileum (n=9)

    Put Cd Spd Spm Put Cd Spd Spm

    C 5.3-+0.9 2.3:L0.6 0.6-20.1 0.09:~0.02 1.4:t0.3 0.7L~0.4 0.4:t0.1 0.2:t0.1

    F 23+3.7 8.5:t:2.7 2.-H).3 0.35:0.1 1.6-3:0.4 0.6:~0.5 0.4L-0.20.3:H).2

    After 12 hours fasting, significant amounts of polyamines are present in the

    gut with higher levels in the jejunum than in the ileum (p 3 feces / day) ; 16 in group D and 25 in group SB (NS). Digestive disorders were significantly more frequent in group B : 17.5 % versus 30.3 %, p = 0,0003. Among these, 35 showed diarrhea : D = 13 (7.4 %) and SB = 22 (l 1%), NS and 97 transit acceleration (more than 3 stools / day) : D = 42 (23.9 %) and SB = 55 (27.5 %), NS. Conclusion : The occurrence of diarrhea seems to be significantly associated to third generation cephalosporin and antibiotics containing clavulanic acid as compared to others. According to the litterature data, the occurrence of diarrhea appears to be reduced by D and SB. These treatments appears equally effective in reducing the side effects of some antibiotics. (1) Gastroenterology. 1989 ; 96 : 981-8

    GLUCAGON INTERFERES WITH NON-RECEPTOR CALCIUM DEPENDENT VASOCONSTRICTION IN RAT MESENTERIC ARTERIOLES. J.N. Benoit, Z.Y. Wu and H. Gao. Dept. of Physiology & Biophysics, L.S.U. Medical Center, Shreveport, LA 71130.

    Studies from our laboratory have linked glucagon to receptor mediated vasoconstrictor dysfunction in chronic portal hypertension. The purpose of the present study was to determine whether non-receptor mediated vasoconstrictor responses were impaired by glucagon. Methods: The mesentery of normal rats was prepared for intravital microscopy and an arteriole selected for study. Two groups of experiments were conducted. Group 1 examined the effects o! glucagon (450 pg/ml) on contractile responses to calcium influx produced by BayK-8644 after depletion of sarcoplasmic reticulum (SR) calcium by ryanodine. Group 2 examined the effects of glucagon on contractile responses to SR calcium release in the presence of the calcium channel blocker nifedipine. Results: Arteriolar diameter was not altered by ryanodine (1 pM) induced SR calcium depletion (30.2 _+ 1.0 pm, before, and 29.14 _+ 1.3 pm after). Blockade of voltage dependent calcium channels by nifedipine (10 pM) did not alter arteriolar diameter (27.5 _+ 3.1 before vs. 27.8 + 3.2 after). The effects of glucagon on equipotent concentrations of BayK-8644 and caffeine are shown in the table. Glucagon attenuated both extracellular and intracellular calcium dependent vasoconstriction.


    GLUCAGON GLUCAGON BayK-8644 10pM -22.7 + 3.2% -4.0 +1.1%* Caffeine 100 pM -19.7 _+ 1.8% -7.1 _+ 1.2%* Conclusion: Antagonism of vasoconstrictor function by glucagon is independent of the mechanism of calcium mobilization. (Supported by HL-45559 and Am. Heart Assn.)

    CAN LABORATORY TESTS PREDICT SEVERITY OF SMALL BOWEL HISTOPATHOLOGY IN CELIAC DISEASE ? Y.Z.Ben-Zion,Z.Weizman,M.Binsztok, E.Maor,A.Porath. Departments of Pediatric Gastroenterology and Nutrition,Pathology and Epidemiology.Soroka Medical Center,Faculty of Health Sciences, Ben-Gurien University of the Negev, Beer-Sheva,Israel.

    We have shown previously that only selected clinical parameters may predict the severity of small bowel histopathology in celiac disease. The present study was designed to assess the value of various laboratory tests in predicting the severity of small bowel histopathology in celiac disease.

    Small bowel specimen of 62 children, aged 0.7- -15.2 years, With established celiac disease were examined blindly.Morphology was evaluated based on common histopathology severity score. The following blood tests were evaluated:hemoglobin, folio acid, vitamines BI2,D3 and E,prothrombin time, caroten, caleium'phsphr'albumin'cholesterl'triglycerides' alkaline phosphatase, and xylose.

    Multivariate regression analysis was performed to evaluate the relative importance of each test.

    A combination of three of the above tests revealed the best correlation with severity of the small bowel histopathology score: hemoglobin (P= 0.0092),caroten (P=0.0009)and albumin(P=0.0058).

    We conclude that among various laboratory blood tests a combination of low levels of hemoglobin, caroten and albumin are probably better predictors of the severity of small bowel histopathelogy in celiac disease. Further large-scale studies are necessary to. confirm these preliminary results.