Intestinal permeability in patients with IgA nephropathy and other glomerular diseases: an observational study

Claudia Seikrit; Judith I Schimpf; Stephanie Wied; Eleni Stamellou; Ana Izcue; Oliver Pabst; Thomas Rauen; Kaatje Lenaerts; Jürgen Floege

doi:10.1007/s40620-022-01454-2

Intestinal permeability in patients with IgA nephropathy and other glomerular diseases: an observational study

Claudia Seikrit^*, Judith I Schimpf, Stephanie Wied, Eleni Stamellou, Ana Izcue, Oliver Pabst, Thomas Rauen, Kaatje Lenaerts, Jürgen Floege

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: A dysregulated 'gut-kidney axis' may contribute to immunoglobulin A nephropathy (IgAN). We studied whether IgAN patients have disturbed intestinal permeability.

METHODS: In a prospective, cross sectional, pilot study we assessed intestinal permeability in 35 IgAN patients, 18 patients with non-IgAN glomerulonephritides (GNs) and 19 healthy controls. After an overnight fast, trial participants ingested a multi-sugar solution and samples were obtained from 0 to 2, 2 to 5- and 5 to 24-h urine portions. Urinary sugar concentrations were quantified using isocratic ion-exchange high performance liquid chromatography. Indices of small intestinal permeability (0-2-h lactulose/L-rhamnose (L/R) ratio), distal small intestinal and proximal colonic permeability (2-5-h sucralose/erythritol (S/E) ratio) and colonic permeability (5-24-h sucralose/erythritol (S/E) ratio) were evaluated. Associations between groups and indices of intestinal permeability were investigated by a linear mixed model.

RESULTS: Small intestinal permeability (0-2 h L/R-ratio) was significantly increased in patients with glomerular diseases versus healthy controls. More precisely, increased small intestinal permeability was exclusively noted in non-IgAN GN patients, whereas IgAN patients exhibited a trend towards elevated small intestinal permeability. In total, 54% of patients with IgAN and 67% of non-IgAN GN patients had increased small intestinal permeability. Neither distal small intestinal and proximal colonic permeability nor colonic gut permeability indices (i.e., 2-5 h and 5-24 h S/E ratios) were significantly different between controls and any of the GN patient groups.

CONCLUSION: The present single center pilot study suggests that disturbed intestinal permeability is common in patients with glomerular diseases and is not specific for IgAN.

TRIAL REGISTRATION NUMBER: German Clinical Trials Register DRKS00021533, Date: 24.04.2020.

Original language	English
Pages (from-to)	463-474
Number of pages	12
Journal	Journal of Nephrology
Volume	36
Issue number	2
Early online date	15 Sept 2022
DOIs	https://doi.org/10.1007/s40620-022-01454-2
Publication status	Published - Mar 2023

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Cite this

@article{f8da3bfb20df477aab8bd70c7aee9a39,

title = "Intestinal permeability in patients with IgA nephropathy and other glomerular diseases: an observational study",

abstract = "BACKGROUND: A dysregulated 'gut-kidney axis' may contribute to immunoglobulin A nephropathy (IgAN). We studied whether IgAN patients have disturbed intestinal permeability.METHODS: In a prospective, cross sectional, pilot study we assessed intestinal permeability in 35 IgAN patients, 18 patients with non-IgAN glomerulonephritides (GNs) and 19 healthy controls. After an overnight fast, trial participants ingested a multi-sugar solution and samples were obtained from 0 to 2, 2 to 5- and 5 to 24-h urine portions. Urinary sugar concentrations were quantified using isocratic ion-exchange high performance liquid chromatography. Indices of small intestinal permeability (0-2-h lactulose/L-rhamnose (L/R) ratio), distal small intestinal and proximal colonic permeability (2-5-h sucralose/erythritol (S/E) ratio) and colonic permeability (5-24-h sucralose/erythritol (S/E) ratio) were evaluated. Associations between groups and indices of intestinal permeability were investigated by a linear mixed model.RESULTS: Small intestinal permeability (0-2 h L/R-ratio) was significantly increased in patients with glomerular diseases versus healthy controls. More precisely, increased small intestinal permeability was exclusively noted in non-IgAN GN patients, whereas IgAN patients exhibited a trend towards elevated small intestinal permeability. In total, 54% of patients with IgAN and 67% of non-IgAN GN patients had increased small intestinal permeability. Neither distal small intestinal and proximal colonic permeability nor colonic gut permeability indices (i.e., 2-5 h and 5-24 h S/E ratios) were significantly different between controls and any of the GN patient groups.CONCLUSION: The present single center pilot study suggests that disturbed intestinal permeability is common in patients with glomerular diseases and is not specific for IgAN.TRIAL REGISTRATION NUMBER: German Clinical Trials Register DRKS00021533, Date: 24.04.2020.",

author = "Claudia Seikrit and Schimpf, {Judith I} and Stephanie Wied and Eleni Stamellou and Ana Izcue and Oliver Pabst and Thomas Rauen and Kaatje Lenaerts and J{\"u}rgen Floege",

note = "{\textcopyright} 2022. The Author(s).",

year = "2023",

month = mar,

doi = "10.1007/s40620-022-01454-2",

language = "English",

volume = "36",

pages = "463--474",

journal = "Journal of Nephrology",

issn = "1121-8428",

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number = "2",

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TY - JOUR

T1 - Intestinal permeability in patients with IgA nephropathy and other glomerular diseases

T2 - an observational study

AU - Seikrit, Claudia

AU - Schimpf, Judith I

AU - Wied, Stephanie

AU - Stamellou, Eleni

AU - Izcue, Ana

AU - Pabst, Oliver

AU - Rauen, Thomas

AU - Lenaerts, Kaatje

AU - Floege, Jürgen

PY - 2023/3

Y1 - 2023/3

N2 - BACKGROUND: A dysregulated 'gut-kidney axis' may contribute to immunoglobulin A nephropathy (IgAN). We studied whether IgAN patients have disturbed intestinal permeability.METHODS: In a prospective, cross sectional, pilot study we assessed intestinal permeability in 35 IgAN patients, 18 patients with non-IgAN glomerulonephritides (GNs) and 19 healthy controls. After an overnight fast, trial participants ingested a multi-sugar solution and samples were obtained from 0 to 2, 2 to 5- and 5 to 24-h urine portions. Urinary sugar concentrations were quantified using isocratic ion-exchange high performance liquid chromatography. Indices of small intestinal permeability (0-2-h lactulose/L-rhamnose (L/R) ratio), distal small intestinal and proximal colonic permeability (2-5-h sucralose/erythritol (S/E) ratio) and colonic permeability (5-24-h sucralose/erythritol (S/E) ratio) were evaluated. Associations between groups and indices of intestinal permeability were investigated by a linear mixed model.RESULTS: Small intestinal permeability (0-2 h L/R-ratio) was significantly increased in patients with glomerular diseases versus healthy controls. More precisely, increased small intestinal permeability was exclusively noted in non-IgAN GN patients, whereas IgAN patients exhibited a trend towards elevated small intestinal permeability. In total, 54% of patients with IgAN and 67% of non-IgAN GN patients had increased small intestinal permeability. Neither distal small intestinal and proximal colonic permeability nor colonic gut permeability indices (i.e., 2-5 h and 5-24 h S/E ratios) were significantly different between controls and any of the GN patient groups.CONCLUSION: The present single center pilot study suggests that disturbed intestinal permeability is common in patients with glomerular diseases and is not specific for IgAN.TRIAL REGISTRATION NUMBER: German Clinical Trials Register DRKS00021533, Date: 24.04.2020.

AB - BACKGROUND: A dysregulated 'gut-kidney axis' may contribute to immunoglobulin A nephropathy (IgAN). We studied whether IgAN patients have disturbed intestinal permeability.METHODS: In a prospective, cross sectional, pilot study we assessed intestinal permeability in 35 IgAN patients, 18 patients with non-IgAN glomerulonephritides (GNs) and 19 healthy controls. After an overnight fast, trial participants ingested a multi-sugar solution and samples were obtained from 0 to 2, 2 to 5- and 5 to 24-h urine portions. Urinary sugar concentrations were quantified using isocratic ion-exchange high performance liquid chromatography. Indices of small intestinal permeability (0-2-h lactulose/L-rhamnose (L/R) ratio), distal small intestinal and proximal colonic permeability (2-5-h sucralose/erythritol (S/E) ratio) and colonic permeability (5-24-h sucralose/erythritol (S/E) ratio) were evaluated. Associations between groups and indices of intestinal permeability were investigated by a linear mixed model.RESULTS: Small intestinal permeability (0-2 h L/R-ratio) was significantly increased in patients with glomerular diseases versus healthy controls. More precisely, increased small intestinal permeability was exclusively noted in non-IgAN GN patients, whereas IgAN patients exhibited a trend towards elevated small intestinal permeability. In total, 54% of patients with IgAN and 67% of non-IgAN GN patients had increased small intestinal permeability. Neither distal small intestinal and proximal colonic permeability nor colonic gut permeability indices (i.e., 2-5 h and 5-24 h S/E ratios) were significantly different between controls and any of the GN patient groups.CONCLUSION: The present single center pilot study suggests that disturbed intestinal permeability is common in patients with glomerular diseases and is not specific for IgAN.TRIAL REGISTRATION NUMBER: German Clinical Trials Register DRKS00021533, Date: 24.04.2020.

U2 - 10.1007/s40620-022-01454-2

DO - 10.1007/s40620-022-01454-2

M3 - Article

C2 - 36107369

SN - 1121-8428

VL - 36

SP - 463

EP - 474

JO - Journal of Nephrology

JF - Journal of Nephrology

IS - 2

ER -