This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Sarah T. O'Dwyer, FRCS; Hamish R. Michie, FRCS; Thomas R. Ziegler, MD; Arthur Revhaug, MD; Robert J. Smith, MD; Douglas W. Wilmore, MD

Arch Surg. 1988;123(12):1459-1464.

Abstract
• To investigate the effects of endotoxin on gut barrier function, we performed paired studies of intestinal permeability in healthy humans (N=12) receiving intravenous Escherichia coli endotoxin (4 ng/kg) or 0.9% saline solution. Two nonmetabolizable sugars, lactulose and mannitol, which are standard permeability markers, were administered orally, 30 minutes before and 120 minutes after the test injection. The 12-hour urinary excretion of these substances after endotoxin/saline solution administration was used to quantitate intestinal permeability. After endotoxin administration systemic absorption and excretion of lactulose increased almost two-fold (mean±SEM, 263±36 µmol per 12 hours vs 145±19 µmol per 12 hours during saline studies). Similar but less marked alterations in mannitol absorption and excretion occurred after endotoxin injection (5.7 ± 0.3 mmol per 12 hours vs 4.9±0.3 mmol per 12 hours). When individual 12-hour lactulose excretion after endotoxin administration was related to the magnitude of systemic responses, a significant relationship occurred between lactulose excretion and elaboration of norepinephrine and between lactulose excretion and minimum white blood cell count. These data suggest that a brief exposure to circulating endotoxin increases the permeability of the normal gut. These observations are consistent with the hypothesis that during critical illness, prolonged or repeated exposure to systemic endotoxins or associated cytokines may significantly compromise the integrity of the gastrointestinal mucosal barrier.

(Arch Surg 1988;123:1459-1464)

Author Affiliations
From the Laboratory for Surgical Metabolism and Nutrition, Brigham and Women's Hospital and Harvard Medical School (Drs O'Dwyer, Michie, Ziegler, Revhaug, and Wilmore), and Joslin Diabetes Center, Harvard Medical School (Dr Smith), Boston.

Footnotes
Accepted for publication July 18, 1988.

Read before the Eighth Annual Meeting of the Surgical Infection Society, San Francisco, May 5, 1988.

Reprint requests to Surgical Metabolism Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115 (Dr Wilmore).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Retroperitoneal Repair of Abdominal Aortic Aneurysm Reduces Bowel Dysfunction
Arya et al.
VASC ENDOVASCULAR SURG 2009;43:262-270.
ABSTRACT  

Detectable serum flagellin and lipopolysaccharide and upregulated anti-flagellin and lipopolysaccharide immunoglobulins in human short bowel syndrome
Ziegler et al.
Am. J. Physiol. Regul. Integr. Comp. Physiol. 2008;294:R402-R410.
ABSTRACT | FULL TEXT  

Palifermin (recombinant keratinocyte growth factor-1): a pleiotropic growth factor with multiple biological activities in preventing chemotherapy- and radiotherapy-induced mucositis
Blijlevens and Sonis
Ann Oncol 2007;18:817-826.
ABSTRACT | FULL TEXT  

The {alpha}2-adrenergic receptor antagonist yohimbine improves endotoxin-induced inhibition of gastrointestinal motility in mice
Hamano et al.
Br J Anaesth 2007;98:484-490.
ABSTRACT | FULL TEXT  

Insulin-like growth factor I improves intestinal barrier function in cirrhotic rats
Lorenzo-Zuniga et al.
Gut 2006;55:1306-1312.
ABSTRACT | FULL TEXT  

Physiologically relevant increase in temperature causes an increase in intestinal epithelial tight junction permeability
Dokladny et al.
Am. J. Physiol. Gastrointest. Liver Physiol. 2006;290:G204-G212.
ABSTRACT | FULL TEXT  

Intraoperative oesophageal Doppler guided fluid management shortens postoperative hospital stay after major bowel surgery
Wakeling et al.
Br J Anaesth 2005;95:634-642.
ABSTRACT | FULL TEXT  

Myosin Light Chain Kinase Is Involved in Lipopolysaccharide-Induced Disruption of Colonic Epithelial Barrier and Bacterial Translocation in Rats
Moriez et al.
Am. J. Pathol. 2005;167:1071-1079.
ABSTRACT | FULL TEXT  

Serotonin stimulates endotoxin translocation via 5-HT3 receptors in the rat ileum
Yamada et al.
Am. J. Physiol. Gastrointest. Liver Physiol. 2003;284:G782-G788.
ABSTRACT | FULL TEXT  

Increased nitric oxide excretion in patients with severe acute pancreatitis: evidence of an endotoxin mediated inflammatory response?
Rahman et al.
Gut 2003;52:270-274.
ABSTRACT | FULL TEXT  

Detection of Aspiration in Enterally Fed Patients: A Requiem for Bedside Monitors of Aspiration
Maloney and Ryan
JPEN J Parenter Enteral Nutr 2002;26:S34-S42.
ABSTRACT  

Intestinal permeability is reduced and IL-10 levels are increased in septic IL-6 knockout mice
Wang et al.
Am. J. Physiol. Regul. Integr. Comp. Physiol. 2001;281:R1013-R1023.
ABSTRACT | FULL TEXT  

Enteral feeding decreases gut apoptosis, permeability, and lung inflammation during murine endotoxemia
Alscher et al.
Am. J. Physiol. Gastrointest. Liver Physiol. 2001;281:G569-G576.
ABSTRACT | FULL TEXT  

The Effects of Olprinone (a Phosphodiesterase III Inhibitor) on Hepatic Vascular Bed in a Porcine Model of Endotoxemia
Nagata et al.
Anesth. Analg. 2001;92:676-680.
ABSTRACT | FULL TEXT  

Hepatic glucose metabolism during intraduodenal glucose infusion: impact of infection
McGuinness et al.
Am. J. Physiol. Endocrinol. Metab. 2000;279:E108-E115.
ABSTRACT | FULL TEXT  

Adverse Host Responses to Bacterial Toxins in Human Infants
Shah and Walker
J. Nutr. 2000;130:420-420.
ABSTRACT | FULL TEXT  

Lipopolysaccharide-Induced Biliary Factors Enhance Invasion of Salmonella enteritidis in a Rat Model
Islam et al.
Infect. Immun. 2000;68:1-5.
ABSTRACT | FULL TEXT  

Increased lactulose/rhamnose ratio during fluid load is caused by increased urinary lactulose excretion
Hallemeesch et al.
Am. J. Physiol. Gastrointest. Liver Physiol. 2000;278:G83-G88.
ABSTRACT | FULL TEXT  

Glutamine Reduces Phorbol-12,13-Dibutyrate-Induced Macromolecular Hyperpermeability in HT-29Cl.19A Intestinal Cells
Kouznetsova et al.
JPEN J Parenter Enteral Nutr 1999;23:136-139.
ABSTRACT  

DOES STEROID PRETREATMENT INCREASE ENDOTOXIN RELEASE DURING CLINICAL CARDIOPULMONARY BYPASS?
Wan et al.
J. Thorac. Cardiovasc. Surg. 1999;117:1004-1008.
ABSTRACT | FULL TEXT  

Does the Route of Feeding Modify Gut Barrier Function and Clinical Outcome in Patients After Major Upper Gastrointestinal Surgery?
Reynolds et al.
JPEN J Parenter Enteral Nutr 1997;21:196-201.
ABSTRACT  

Systemic inflammatory response and the splanchnic bed in cardiopulmonary bypass
Ohri
Perfusion 1996;11:200-212.
 

Randomised trial of safety and efficacy of immediate postoperative enteral feeding in patients undergoing gastrointestinal resection
Carr et al.
BMJ 1996;312:869-871.
ABSTRACT | FULL TEXT  

The Effects of Glutamine-Supplemented Parenteral Nutrition in Premature Infants
Lacey et al.
JPEN J Parenter Enteral Nutr 1996;20:74-80.
ABSTRACT  

Review: Bacterial Translocation and Enteral Nutrition in Humans: An Outsider Looks In
Lipman
JPEN J Parenter Enteral Nutr 1995;19:156-165.
ABSTRACT  

A.S.P.E.N.: Respecting the Past, Managing the Present, Preparing for the Future--Growth Factors in the Media Soup
Wesley
JPEN J Parenter Enteral Nutr 1994;18:291-296.
 

Additive Effects of Thermal Injury and Infection on Gut Permeability
Ryan et al.
Arch Surg 1994;129:325-328.
ABSTRACT  

The Role of the Imino Transporter Protein in Sepsis-Impaired Intestinal Proline Absorption
Gardiner and Barbul
JPEN J Parenter Enteral Nutr 1993;17:507-512.
ABSTRACT  

Review: Intestinal Amino Acid Absorption During Sepsis
Gardiner and Barbul
JPEN J Parenter Enteral Nutr 1993;17:277-283.
ABSTRACT  

Intestinal Permeability After Severe Trauma and Hemorrhagic Shock Is Increased Without Relation to Septic Complications
Roumen et al.
Arch Surg 1993;128:453-457.
ABSTRACT  

Insulinlike Growth Factor 1 (IGF-1) Reduces Gut Atrophy and Bacterial Translocation After Severe Burn Injury
Huang et al.
Arch Surg 1993;128:47-54.
ABSTRACT  

Alterations in Intestinal Permeability After Thermal Injury
LeVoyer et al.
Arch Surg 1992;127:26-30.
ABSTRACT  

Ibuprofen Improves Survival but Does Not Ameliorate Increased Gut Mucosal Permeability in Endotoxic Pigs
Fink et al.
Arch Surg 1992;127:49-54.
ABSTRACT  

Enteric Bacteria and Ingested Inert Particles Translocate to Intraperitoneal Prosthetic Materials
Mora et al.
Arch Surg 1991;126:157-163.
ABSTRACT  

Increased Gut Permeability Following Burn Trauma
Epstein et al.
Arch Surg 1991;126:198-200.
ABSTRACT  

Increased Intestinal Permeability in Endotoxic Pigs: Mesenteric Hypoperfusion as an Etiologic Factor
Fink et al.
Arch Surg 1991;126:211-218.
ABSTRACT  

MCP-1 causes leukocyte recruitment and subsequently endotoxemic ileus in rat
Turler et al.
Am. J. Physiol. Gastrointest. Liver Physiol. 2002;282:G145-G155.
ABSTRACT | FULL TEXT