EFFECTS OF LUMINAL ANTIGEN ON INTESTINAL ALBUMIN AND HYALURONAN PERMEABILITY AND ION-TRANSPORT IN ATOPIC PATIENTS

Background: Increased luminal transport of proteins and fluid is part of the inflammatory reaction in inflammatory disease of the bowel and of the airways in allergic diseases and asthma. The objective of this study was to determine intestinal appearance rates of albumin and hyal uronan in vivo in atopic patients allergic to birch, as well as change s in net jejunal transport of monovalent ions and water induced by the antigen. Methods: Secretion studies were performed with the use of a segmental jejunal perfusion system with a small two-balloon, six-chann el tube. The intestinal mucosa was challenged with birch allergen in p atients allergic to birch and in matched control subjects (n = 12 in b oth groups). Results: In patients, but not in control subjects, the lu minal antigen induced a net increase in albumin of 2689 +/- 567 mu g/c m/hr and in hyaluronan of 2609 +/- 737 ng/cm/hr (p < 0.01 vs control s ubjects in both cases). Furthermore, basel net absorption of Cl- ions, Na+ ions, and water was converted to a net secretion after antigen ch allenge. Conclusion: Exposure to antigen normally acting on the respir atory tract induced increased permeability of the gastrointestinal muc osa. This would suggest less organ specificity and more general allerg ic recognition shared by several immunocompetent tissues in the body, probably mediated by circulating IgE antibodies.