Effects of therapy with lansoprazole on intestinal permeability and inflammation in young cystic fibrosis patients

J Pediatr Gastroenterol Nutr. 2001 Sep;33(3):260-5. doi: 10.1097/00005176-200109000-00006.

Abstract

Background: Defective pancreatic bicarbonate secretion with low intestinal pH or intestinal inflammation of any origin increase intestinal permeability in cystic fibrosis (CF).

Methods: In this open study, the authors evaluated the effect of a proton-pump inhibitor on intestinal permeability and inflammation in 14 young, pancreatic-insufficient CF patients. Permeability was measured by a three-sugar permeability test before and after 1 year of lansoprazole use, and urinary nitric oxide (NO) oxidation products were assessed before and during that year as a marker of inflammation.

Results: After 1 year of lansoprazole use, median urinary recovery percentages changed from 2.5% to 1.7% (P = 0.064), from 24.9% to 24.5% (no significance), and from 10.5% to 11.1% (no significance) for lactulose, mannitol, and L-rhamnose, respectively. Despite the fact that the median urinary excretion ratios decreased from 0.108 to 0.083 (P = 0.03) and from 0.246 to 0.176 (P = 0.016) for lactulose and mannitol and for lactulose and rhamnose, respectively, they both remained increased. Median urinary NO products-to-creatinine ratios were 0.287 for CF patients before lansoprazole and 0.130 for healthy control participants (P = 0.002). Although there was a tendency toward a decrease in the NO products-to-creatinine ratio during treatment, this was not significant at the end point.

Conclusions: Intestinal permeability is considerably increased in CF patients and is partly corrected after the use of a proton-pump inhibitor for 1 year, which may point to a harmful effect of the acid luminal contents on the tight junctional related paracellular permeability pathway. The start and end values for the NO products-to-creatinine ratio in CF patients were not significantly different, but were considerably increased when compared with control participants (P = 0.002).

MeSH terms

  • 2-Pyridinylmethylsulfinylbenzimidazoles
  • Adolescent
  • Anti-Infective Agents / pharmacology*
  • Anti-Infective Agents / therapeutic use
  • Biomarkers
  • Child
  • Child, Preschool
  • Cystic Fibrosis / drug therapy*
  • Female
  • Humans
  • Inflammation / drug therapy
  • Intestinal Mucosa / metabolism*
  • Intestines / drug effects
  • Lactulose / metabolism
  • Lansoprazole
  • Longitudinal Studies
  • Male
  • Mannitol / metabolism
  • Nitric Oxide / metabolism
  • Nitric Oxide / urine
  • Omeprazole / analogs & derivatives*
  • Omeprazole / pharmacology*
  • Omeprazole / therapeutic use
  • Permeability / drug effects
  • Rhamnose / metabolism

Substances

  • 2-Pyridinylmethylsulfinylbenzimidazoles
  • Anti-Infective Agents
  • Biomarkers
  • Lansoprazole
  • Nitric Oxide
  • Mannitol
  • Lactulose
  • Omeprazole
  • Rhamnose