INCREASED INTESTINAL PERMEABILITY TO POLYSUCROSE IN NSAID-TREATED PATIENTS

Objective: To examine intestinal permeability to synthetic polysucrose in healthy humans and in rheumatoid arthritis patients with and witho ut non-steroidal anti-inflammatory drug (NSAID) treatment. Design: Rhe umatoid arthritis patients on NSAID treatment (n = 27) and age-matched healthy volunteers (n = 22) were given an oral dose of polysucrose wi th mean molecular weight of about 15 000, administered together with a tube feeding standard formula to mimick a meal. Urine was collected f or 0-4, 4-8 and 8-12h. Seven of the rheumatoid arthritis patients also underwent the test before starting NSAID treatment. Methods: Intestin al permeability to polysucrose 15 000 was estimated as urinary excreti on of the compound, measured by immunoassay. Results: In healthy volun teers urinary excretion of polysucrose 15 000 was about 0.02% of dose over 12 h. Intestinal permeability was significantly higher in the NSA ID patients than in the non-NSAID patients or in the healthy volunteer s. Intestinal permeability increased in all of the rheumatoid arthriti s patients starting NSAID treatment during the study. Conclusions: Pol ysucrose 15 000 is suggested as a marker of intestinal paracellular pe rmeability, especially to macromolecules, being neutral, water-soluble , non-lipid-soluble, non-toxic, non-immunogenic, of speherical molecul ar shape, and possible to produce over a wide range of molecular weigh ts including those of several food proteins.