Abstract
Urine tests for intestinal permeability typically detect the secretion of administered saccharides with relatively different absorptions over a designated time period to determine severity of disease. Traditionally, a disaccharide/monosaccharide ratio such as lactulose/mannitol is used. Due to the potential for contamination of mannitol from different foods and commercial products causing an elevated baseline measurement, 13C mannitol can be used instead. In this chapter, a method of detecting various administered saccharides in urine for the evaluation of intestinal permeability is described. Three monosaccharides and two disaccharides are included so researchers can choose which combinations best fit their needs. Here lactulose, mannitol, 13C mannitol, rhamnose, and sucralose levels are separated and detected in urine using HPLC separation and MS/MS analysis.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Camilleri M (2019) Leaky gut mechanisms, measurement and clinical implications in humans. Gut 68(8):1516–1526. https://doi.org/10.1136/gutjnl-2019-318427
Lostia AM, Lionetto L, Principessa L, Evangelisti M, Gamba A, Villa MP, Simmaco M (2008) A liquid chromatography/mass spectrometry method for the evaluation of intestinal permeability. Clin Biochem 41(10–11):887–892. https://doi.org/10.1016/j.clinbiochem.2008.03.016
Rao AS, Camilleri M, Eckert DJ, Busciglio I, Burton DD, Ryks M, Wong BS, Lamsam J, Singh R, Zinsmeister AR (2011) Urine sugars for in vivo gut permeability: validation and comparisons in irritable bowel syndrome-diarrhea and controls. Am J Physiol Gastrointest Liver Physiol 301(5):G919–G928. https://doi.org/10.1152/ajpgi.00168.2011
Miki K, Butler R, Moore D, Davidson G (1996) Rapid and simultaneous quantification of rhamnose mannitol, and lactulose in urine by HPLC for estimating intestinal permeability in pediatric practice. Clin Chem 42(1):71–75
Barboza MS Jr, Silva TMJ, Guerrant RL, Lima AAM (1999) Measurement of intestinal permeability using mannitol and lactulose in children with diarrheal diseases. Braz J Med Biol Res 32:1499–1504. https://doi.org/10.1590/s0100-879x1999001200008
Vilela EG, Torres HO, Ferrari ML, Lima AS, Cunha AS (2008) Gut permeability to lactulose and mannitol differs in treated Crohn’s disease and celiac disease patients and healthy subjects. Braz J Med Biol Res 41(12):1105–1109. https://doi.org/10.1590/s0100-879x2008001200010
Grover M, Camilleri M, Hines J, Burton D, Ryks M, Wadhwa A, Sundt W, Dyer R, Singh RJ (2016) 13C-mannitol as a novel biomarker for measurement of intestinal permeability. Neurogastroenterol Motil 28:1114–1119
Van Nieuwenhoven MA, Geerling BJ, Deutz NEP, Brouns F, Brummer R-JM (1999) The sensitivity of the lactulose/rhamnose gut permeability test. Eur J Clin Investig 29:160–165. https://doi.org/10.1046/j.1365-2362.1999.00421.x
Fujii T, Seki T, Maruoka M, Tanaka J, Kawashima Y, Watanabe T, Sawamura T, Inoue K (2001) Lactulose-L-rhamnose intestinal permeability test in patients with liver cirrhosis. Hepatol Res 19(2):158–169. https://doi.org/10.1016/S1386-6346(00)00099-1
Sanderson IR, Boulton P, Menzies I, Walker-Smith JA (1987) Improvement of abnormal lactulose/rhamnose permeability in active Crohn’s disease of the small bowel by an elemental diet. Gut 28(9):1073–1076. https://doi.org/10.1136/gut.28.9.1073
Faubion WA, Camilleri M, Murray JA, Kelly P, Amadi B, Kosek MN, Enders F, Larson J, Boe G, Dyer R, Singh R (2016) Improving the detection of environmental enteric dysfunction: a lactulose, rhamnose assay of intestinal permeability in children aged under 5 years exposed to poor sanitation and hygiene. BMJ Glob Health 1:e000066
Khoshbin K, Khanna L, Maselli D, Atieh J, Breen-Lyles M, Arndt K, Rhoten D, Dyer RB, Singh RJ, Nayar S, Bjerkness S, Harmsen WS, Busciglio I, Camilleri M (2021) Development and validation of test for "Leaky Gut" small intestinal and colonic permeability using sugars in healthy adults. Gastroenterology S0016-5085(21):00642–00649. https://doi.org/10.1053/j.gastro.2021.04.020. Epub ahead of print
CLSI (ed) (2009) Urinalysis, CLSI guideline GP16-A3, 3rd edn. Clinical and Laboratory Standards Institute, Wayne
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 The Author(s), under exclusive license to Springer Science+Business Media, LLC, part of Springer Nature
About this protocol
Cite this protocol
Larkey, N.E., Fatica, E.M., Singh, R.J. (2022). Detection of 13C-Mannitol and Other Saccharides Using Tandem Mass Spectrometry for Evaluation of Intestinal Permeability or Leaky Gut. In: Garg, U. (eds) Clinical Applications of Mass Spectrometry in Biomolecular Analysis. Methods in Molecular Biology, vol 2546. Humana, New York, NY. https://doi.org/10.1007/978-1-0716-2565-1_26
Download citation
DOI: https://doi.org/10.1007/978-1-0716-2565-1_26
Published:
Publisher Name: Humana, New York, NY
Print ISBN: 978-1-0716-2564-4
Online ISBN: 978-1-0716-2565-1
eBook Packages: Springer Protocols