INCREASED ABSORPTION OF POLYSUCROSE, A MARKER OF INTESTINAL PARACELLULAR PERMEABILITY, IN CROHNS-DISEASE

Objective: To examine whether synthetic polysucrose behaves as a trans cellular or paracellular marker in patients with Crohn's disease and i n healthy subjects. Design: Patients with Crohn's disease (n = 23) and age- and sex-matched healthy controls (n = 22) were given an oral dos e of polysucrose with a mean molecular weight of about 15 kDa, adminis tered with a standard meal. Methods: Intestinal permeability to polysu crose was estimated as urinary excretion of the compound measured by i mmunoassay during 0-4, 4-8 and 8-12 h. Results: Urinary excretion valu es for polysucrose in the controls had a non-symmetrical frequency dis tribution and were not correlated to urinary volume. For the Crohn's d isease group, intestinal permeability to polysucrose was significantly increased for the intervals 4-8 h and 8-12 h (P < 0.05). Permeability was more increased in small intestinal disease than in colonic diseas e, and more increased in active than in quiescent disease; hence, in p atients with active Crohn's disease of the small intestine, intestinal permeability to polysucrose was significantly increased for all three time intervals (0-4, P < 0.05; 4-8 h, P < 0.001; 4-12 h, P < 0.01). P eak urinary excretion of polysucrose occurred later in the Crohn's dis ease patients than in the controls. Conclusions: Intestinal permeabili ty to polysucrose is increased in Crohn's disease. In Crohn's disease patients and in healthy controls, polysucrose behaves as earlier descr ibed for known markers of paracellular intestinal permeability such as Cr-51-ethylenediamine tetraacetic acid (Cr-51-EDTA) and lactulose. We conclude that polysucrose, which has the advantage of being both non- radioactive and resistant to bacterial degradation, may be used as suc h a marker.