BACKGROUND: Combination of platinum derivatives with paclitaxel is currently the standard front line regimen for patients with epithelial ovarian carcinoma, and represents also an active regimen in patients with metastatic breast or unknown primary carcinomas. Measurement of intestinal permeability represents one of the potential methods of noninvasive laboratory assessment of gastrointestinal mucositis induced by chemotherapy, but little is known about intestinal permeability in patients treated with paclitaxel or platinum. METHODS: Intestinal permeability was assessed in 36 breast and ovarian cancer patients treated with paclitaxel/platinum combination by measuring, using capillary gas chromatography, urinary sucrose, lactulose, xylose and mannitol after oral challenge. The significance of differences during the therapy compared to pre-treatment values was studied by Wilcoxon paired test. The differences between groups of patient were studied by Mann-Whitney U test. Fisher exact test was used to compare the frequency in different subgroups. RESULTS: After administration of the first dose, a significant (p < 0.05) decrease in xylose absorption and increased lactulose/mannitol, sucrose/mannitol, lactulose/xylose and sucrose/xylose ratios were observed, but these parameters returned subsequently to pre-treatment levels. Patients who experienced serious (grade 3 or 4) toxicity had at baseline significantly lower percentages of xylose, mannitol and sucrose, and higher lactulose/mannitol ratio. Nine of 13 (69%) patients with baseline lactulose/mannitol ratio 0.070 or above experienced serious toxicity compared to 4 out of 23 patients (17%) with the ratio below 0.070 (p = 0.002). Post-treatment lactulose, lactulose/mannitol, sucrose/mannitol and lactulose/xylose ratios were significantly increased in patients with serious toxicity. CONCLUSION: A transient significant increase in lactulose/monosaccharide and sucrose/monosaccharide ratios was observed in ovarian and breast cancer patients treated with paclitaxel and platinum. Increased lactulose absorption, lactulose/mannitol, sucrose/mannitol and lactulose/xylose ratios were evident in patients with grade 3 or 4 toxicity, and increased baseline lactulose/mannitol ratio predicted serious toxicity.
- MeSH
- adenokarcinom farmakoterapie metabolismus patologie MeSH
- cisplatina aplikace a dávkování MeSH
- dospělí MeSH
- financování organizované MeSH
- gastrointestinální trakt metabolismus MeSH
- intestinální absorpce účinky léků MeSH
- karboplatina aplikace a dávkování MeSH
- laktulosa metabolismus MeSH
- lidé středního věku MeSH
- lidé MeSH
- mannitol metabolismus MeSH
- monoklonální protilátky aplikace a dávkování MeSH
- nádory glandulární a epitelové farmakoterapie metabolismus patologie MeSH
- nádory prsu farmakoterapie metabolismus patologie MeSH
- nádory vaječníků farmakoterapie metabolismus patologie MeSH
- paclitaxel aplikace a dávkování MeSH
- permeabilita buněčné membrány účinky léků MeSH
- protokoly protinádorové kombinované chemoterapie terapeutické užití MeSH
- sacharasa metabolismus MeSH
- senioři MeSH
- xylosa metabolismus MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
The increase in ammonia and ethanol in the exhaled breath stream following mouthwashes by aqueous solutions of urea and sugar (sucrose), respectively, has been investigated by analysing exhaled breath in real time using selected ion flow tube mass spectrometry, SIFT-MS. It is shown that the measured levels of these compounds in the stream of exhaled breath can be much greater than the endogenous levels originating at the alveolar boundary. Thus, it is concluded that without careful preparation, mouth production of these compounds, and other compounds as yet unidentified, can seriously compromise the quantification of truly endogenous trace compounds present in blood and in the alveolar breath, as required for clinical diagnosis, and can probably introduce additional compounds into the breath stream that could seriously mislead breath analysis. The concentrations of both the urea and sucrose solutions used to enhance the ammonia and ethanol levels were larger than normally present in food and drinks and so in most situations such severe enhancements will not occur.
- MeSH
- dialýza ledvin MeSH
- glukonáty aplikace a dávkování farmakologie MeSH
- lidé MeSH
- riziko MeSH
- sacharasa aplikace a dávkování farmakologie MeSH
- železo-dextranový komplex aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- železo aplikace a dávkování krev škodlivé účinky MeSH
- Check Tag
- lidé MeSH
- MeSH
- biopsie metody využití MeSH
- fosforylasy izolace a purifikace metabolismus MeSH
- glukosa-6-fosfatasa izolace a purifikace metabolismus MeSH
- glykogen izolace a purifikace metabolismus MeSH
- glykogenóza diagnóza etiologie MeSH
- histocytochemie * metody využití MeSH
- klinické enzymatické testy * využití MeSH
- laktasa izolace a purifikace metabolismus MeSH
- lidé MeSH
- metabolické nemoci * diagnóza MeSH
- mukopolysacharidózy diagnóza etiologie MeSH
- příznaky a symptomy MeSH
- sacharasa izolace a purifikace metabolismus MeSH
- střevní sekrety cytologie enzymologie chemie MeSH
- trehalasa izolace a purifikace metabolismus MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- aktivace enzymů * fyziologie MeSH
- alkalická fosfatasa izolace a purifikace metabolismus MeSH
- cirkadiánní hodiny fyziologie MeSH
- cirkadiánní rytmus * fyziologie MeSH
- disacharidy izolace a purifikace metabolismus MeSH
- duodenum enzymologie MeSH
- enterocyty enzymologie metabolismus MeSH
- experimenty na zvířatech MeSH
- histocytochemie metody využití MeSH
- ileum enzymologie MeSH
- jejunum enzymologie MeSH
- laktasa izolace a purifikace metabolismus MeSH
- oxidoreduktasy izolace a purifikace metabolismus MeSH
- potkani Wistar MeSH
- sacharasa izolace a purifikace metabolismus MeSH
- statistika jako téma MeSH
- tenké střevo * enzymologie fyziologie MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
- MeSH
- alkalická fosfatasa izolace a purifikace metabolismus MeSH
- aminohydrolasy izolace a purifikace metabolismus MeSH
- disacharidy izolace a purifikace metabolismus MeSH
- enterocyty * cytologie enzymologie MeSH
- experimenty na zvířatech MeSH
- histocytochemie metody využití MeSH
- klinické enzymatické testy * metody využití MeSH
- morčata MeSH
- plod enzymologie MeSH
- potkani Wistar MeSH
- sacharasa izolace a purifikace metabolismus MeSH
- statistika jako téma MeSH
- tenké střevo * cytologie enzymologie MeSH
- zvířata MeSH
- Check Tag
- morčata MeSH
- zvířata MeSH
- MeSH
- centrifugace - gradient hustoty MeSH
- centrifugace MeSH
- chemická precipitace MeSH
- chlazení MeSH
- chromatografie MeSH
- dialýza MeSH
- fosfáty MeSH
- glykoly MeSH
- halogenované uhlovodíky MeSH
- jedlé rostliny MeSH
- koncentrace vodíkových iontů MeSH
- merkaptoethanol MeSH
- metody MeSH
- nemoci rostlin MeSH
- pufry MeSH
- rostlinné extrakty MeSH
- rostlinné viry izolace a purifikace patogenita MeSH
- sacharasa MeSH