Evaluation Of The Intestinal Barrier Failure Of The Patients With Chronic Digestive Diseases And Its Relationship With The Intestinal Bacterial Flora

Background and Aims: Intestinal barrier failure (IBF), which is able to cause intestine-originated sepsis, is a common secondary syndrome induced by various surgical interventions and has been considered as both the cause and one target organ of the multiple-system organ failure (MSOF). It is believed to be associated with some medical abnormalities as well such as pancreatis, liver cirrhosis and cancers. However, seldom study has been reported. IBF is attributed to the imbalance of the intestine microflora and the subsequent translocation of these bacteria out of the intestine. Thus, IBF is accompanied by the increase of the permeability of the intestine wall. The purpose of this study was to evaluate the IBF of the patients with chronic digestive diseases and its relationship with the intestinal bacterial flora.Methods: To evaluate the occurrence of the increase of the intestinal permeability, Lactulose/Mannitol (L/M ratio) in urine of gastrointestinal cancer patients and healthy volunteers who took the same amount of Lactulose/Mannitol were measured by gas chromatography. The amount of urinal polyethylene glycolin 600 (PEG600) after taken by patients with chronic digestive diseases was detected by spectrophotometric assay. Intestinal microflora of some patients were analyzed after the bacterial culture of faces. The relationship between the intestinal permeability and intestinal bacterial flora were assessed as well. To try to simplify thedetection of the imblance of theintestinal microflora, digoxigenin-labeled 16s rRNA oligonucleotide probes of Bifidobacterum genus bacteria were designed and evaluated their sensitivity and specificity in the detection of bifidobacteria in probiotic preparatios and feces.Results: The measurement of L/M ratio revealed that the intestinal permeability of gastrointestinal cancer patients increased when compared to the control. The L/M ratio of the two group were 0.0205?.0037ug vs 0.0064?.0021g (p <0.05). The measurement of PEG600 indicated that urinal PEG600 of patients with liver cirrhosis, liver cancer and gastrointestinal cancer were 94.672?6.091 ug, 91.741?4.823ug and 81.936?.926ug, respectively. All of them were significantly higher than that of the control patients (67.55l?.599ug, p <0.05). The occurrence of intestinal microflora dysfunction of patients with liver cirrhosis, liver cancer and gastrointestinal cancers were as follows: Degrade I, 33.3%,33.3% and 16.7%;degrade II, 16.7%, 16.7% and 16.7%; degrade 111,0,16.7% and 16.7%. No intestinal microflora dysfunction was found in control patients. The amount of the urinal PEG600 in patients with intestinal microflora dysfunction was slightly higher than the patients with normal intestinal microflora (89.024?4.364ig vs 80.368?3.083g). However, no significant difference was found (p < 0.05). Dig-labeled 16s rRNA oligonucleotide probes of Bifidobacteria had quite high sensitivity and specificity when used to detect bifidobacteria in probiotics andfeces(strain,95%,75%;adolescentis,87.5%,90%;infantis,75%,95%;longum,75 %, 100%;breve,87.5%,92.5%; bifidum87.5%,87.5%).Conclusions: (1) The intestinal permeabilities of patients with some chronic digestive diseases were increased. These patients were susceptible to the occurrence of Intestinal Barrier Failure. However, the relationship between the intestinal permeability and intestinal bacterial flora remains to be determined in the future study with more samples. (2) Spectrophotometricmeasurement of urinal PEG600 is a simple and easy-to-handle assay in the evaluation of intestinal permeability. It is valuable to be suggested in the clinical application. (3) Molecular assays by analyzing 16sRNA gene of intestinal bacteria should be the promised assay in the evaluation of intestinal microflora dysfunction to replace the classical bacterial culture techniques.