Intestinal permeability in patients with chemotherapy-induced stomatitis
Language English Country Germany Media print
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
11355146
PubMed Central
PMC12164931
DOI
10.1007/s004320000209
Knihovny.cz E-resources
- MeSH
- Cisplatin administration & dosage adverse effects MeSH
- Deoxycytidine administration & dosage adverse effects analogs & derivatives MeSH
- Doxorubicin administration & dosage adverse effects MeSH
- Granulocyte-Macrophage Colony-Stimulating Factor therapeutic use MeSH
- Fluorouracil administration & dosage adverse effects MeSH
- Tegafur administration & dosage adverse effects MeSH
- Gemcitabine MeSH
- Drug Evaluation MeSH
- Intestinal Absorption drug effects MeSH
- Lactulose pharmacokinetics urine MeSH
- Leucovorin administration & dosage MeSH
- Middle Aged MeSH
- Humans MeSH
- Mannitol pharmacokinetics urine MeSH
- Digestive System Neoplasms complications drug therapy MeSH
- Paclitaxel administration & dosage adverse effects MeSH
- Permeability drug effects MeSH
- Antineoplastic Combined Chemotherapy Protocols adverse effects therapeutic use MeSH
- Stomatitis chemically induced drug therapy MeSH
- Intestinal Mucosa drug effects physiopathology MeSH
- Treatment Outcome MeSH
- Xylose pharmacokinetics urine MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Cisplatin MeSH
- Deoxycytidine MeSH
- Doxorubicin MeSH
- Granulocyte-Macrophage Colony-Stimulating Factor MeSH
- Fluorouracil MeSH
- Tegafur MeSH
- Gemcitabine MeSH
- Lactulose MeSH
- Leucovorin MeSH
- Mannitol MeSH
- Paclitaxel MeSH
- Xylose MeSH
PURPOSE: Mucositis represents one of the most common side effects of chemotherapy, and may affect any part of the gastrointestinal tract, resulting in stomatitis, dysphagia, dyspepsia, or diarrhea. The aim of the present study was to evaluate intestinal permeability in patients with stomatitis during treatment with oral granulocyte-monocyte colony-stimulating factor (GM-CSF, Leucomax). METHODS: Ten patients with chemotherapy-induced stomatitis and 21 control cancer patients were included in the study. Intestinal permeability in patients with stomatitis was evaluated before and after the treatment with oral GM-CSF (200 micrograms for 4 consecutive days) by measuring urinary lactulose, D-xylose, and mannitol after oral challenge in collected urine using capillary gas chromatography. RESULTS: Mean grade of stomatitis (3, range 2-3) improved during treatment by a mean of 1 grade (range 0-2, sign test P < 0.05) with an improvement observed in eight of ten patients. Lactulose excretion, lactulose/mannitol, and lactulose/xylose ratios were markedly elevated in the patients with mucositis compared with 21 control cancer patients (1.60 +/- 1.04%, 0.2446 +/- 0.2937, and 0.3877 +/- 0.6808 vs 0.35 +/- 0.20%, 0.0332 +/- 0.0148, and 0.0255 +/- 0.0086, respectively, Mann Whitney U-test, P < 0.001). After treatment, lactulose excretion, lactulose/mannitol, and lactulose/xylose ratio decreased significantly (1.60 +/- 1.04 vs 0.63 +/- 0.42%; 0.2446 +/- 0.2937 vs 0.1303 +/- 0.1149; and 0.3877 +/- 0.6808 vs 0.1126 +/- 0.1146, respectively, P < 0.05). CONCLUSIONS: Lactulose excretion after oral challenge, lactulose/mannitol, or lactulose/xylose ratio may be useful markers for intestinal involvement in chemotherapy-induced mucositis. Improvement of oral mucositis was associated with a significant decrease of intestinal permeability to lactulose. Testing of intestinal permeability by the present method may be useful to evaluate the effect of therapeutic interventions in patients with chemotherapy-induced mucositis.
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