The impairment of gastroduodenal mucosal barrier by coffee.

BACKGROUND: Even though coffee is not considered to be responsible for development of peptic ulcer, it may, however, prolong its healing by increasing acidity of gastric content. In our former work we observed a profound increase in sucrose permeability (above normal values) in healthy volunteers regularly drinking coffee for years. In literature, many factors affecting sucrose permeability have been described so far. None of them, however, studied the effect of coffee. SUBJECTS, MATERIALS AND METHODS: 10 young asymptomatic habitual coffee drinkers were included in the study. The probands underwent SaLM test twice--first time without coffee restriction and second time after 48-hour coffee abstinence. The ingested SaLM solution comprised sucrose (25.0 g), lactulose (10.0 g), mannitol (2.0 g), xylose (2.0 g) and water (up to 100 ml). Urine was collected for five hours and the samples were analysed using gas chromatography. Results were compared with those of 8 young healthy volunteers not drinking coffee. Permeability for sucrose was significantly higher in the group of habitual coffee drinkers in comparison with non-coffee drinkers (p < 0.01). After 48-hour coffee abstinence sucrose excretion decreased significantly (p < 0.05) to a level not differing from that of non-coffee drinkers (p = 0.54). CONCLUSIONS: Our results indicate that coffee may damage gastroduodenal mucosa in habitual coffee drinkers. In a time period of 48 hours the gastroduodenal mucosa is capable of a significant regeneration.

[Use of sucrose permeability test (SaLM) for detection of lesions of upper gastrointestinal tract mucosa in upper dyspepsia patients--a pilot study]. / Vyuzití testu propustnosti pro sacharózu (SaLM) v detekci postizení sliznic horní cásti trávicí trubice u pacientu s horním dyspeptickým syndromem--pilotní studie.

INTRODUCTION: Endoscopy, a golden standard with its high diagnostic value, is an invasive and unpleasant method as far as patients are concerned. So far there has been no available non-invasive test in the Czech Republic capable of distinguishing between heavy (i.e. peptic ulcer) and light (i.e. portal gastropathy) lesions of upper gastrointestinal mucosa. AIMS: In this pilot study we decided to test our modification of sucrose permeability test (SaLM test) on upper dyspepsia patients in our conditions. We first needed to compare the results of intestinal permeability obtained from the studied test (containing sucrose, a so called SaLM test) with a formerly established intestinal permeability test (containing glucose, a so called LaMa test) to know, if the new test could replace the old one. Then we wanted to find normal values of sucrose permeability, find a relationship between sucrose permeability and endoscopically verified damage to upper gastrointestinal mucosa and calculate sensitivity and specificity of SaLM test using results of gastroduodenoscopy. After that we tried to suggest possible future benefits of the test for clinical praxis. MATERIALS AND METHODS: A group of 10 young healthy volunteers underwent both SaLM and LaMa tests, which were made methodically indentical to compare the tests as to the results of intestinal permeability. The probands ingested SaLM solution with the following composition: sucrose (25.0 g), lactulose (10.0 g), mannitol (2.0 g), xylose (2.0 g) and water (up to 100 ml). Urine was collected for five hours and the samples were analysed using gas chromatography. From the results normal value of sucrose permeability was calculated, too. After that, 28 patients with upper dyspepsia were included in the study. They were divided into two groups (a group of light lesions with 9 patients and a group of heavy lesions counting 19 patients) according to gastroscopical findings. We compared the results among the three groups. RESULTS: In our volunteers, the intestinal permeability values using LaMa and SaLM tests showed normal distributions. No statistically significant difference (p < 0.05) was found between the tests in regard to the intestinal permeability. The normal value of sucrose permeability was found to be up to 0.10% of the amount taken orally. The permeability for sucrose was significantly higher (p < 0.01) in patients with heavy lesions (0.527 +/- 0.414) versus those with light ones (0.178 +/- 0.090). Moreover, the latter had their sucrose permeability values significantly higher than healthy volunteers (0.088 +/- 0.067), (p < 0.05). Sensitivity and specificity of the test for heavy upper gastrointestinal mucosal damage was 0.95 and 0.33, respectively. CONCLUSION: SaLM test could replace LaMa test without having a significant effect on the intestinal permeability results. It is feasible to study SaLM test on bigger sets of patients and specify it in more detail, since the results of our pilot study (in accordance with many other studies) make it promising for various clinical applications (i.e. in upper dyspepsia patients it might help in deciding about urgency and reasonability of gastroduodenoscopy).

Fluorimetric determination of the levels of urinary neopterin and serum thiobarbituric acid reactive substances in the nonagenarians.

Twelve self-sustaining nonagenarians, 10 women and two men, aged 94+/-3 years, and eight institutionalised nonagenarians, eight women, aged 91+/-1 year as well as 11 control subjects, seven women and four men, aged 84+/-5 years entered the study. Urinary neopterin, an indicator of systemic immune activation, and serum thiobarbituric acid reactive substances (TBARS), a marker of lipoperoxidation, were determined initially, and collection of the blood and urine samples was repeated at 3-month interval. Neopterin was measured in the urine specimens by reversed-phase high performance liquid chromatography. A C(18) reversed-phase column 3.3x150 mm, 5 mum-diameter packing Separon SGX was used. Potassium phosphate buffer (15 mmol l(-1), pH 6.4) at flow rate of 0.8 ml min(-1) was used as mobile phase. After centrifugation (5 min, 1300xg) and diluting 100 mul of urine specimens with 1.0 ml of mobile phase containing 2 g of disodium-EDTA per litre, a 20 mul sample was injected on a column. Neopterin was identified by its native fluorescence (353 nm excitation, 438 nm emission). Creatinine was determined by Jaffé kinetic reaction after dilution of sample 1:50 (v/v). The concentration of neopterin in urine was expressed as neopterin/creatinine ratio (mumol mol(-1) creatinine). TBARS were determined spectrofluorometrically using LS-5 spectrofluorimeter (excitation wavelength 528 nm, emission wavelength 558 nm) after extraction with n-butanol treatment with thiobarbituric acid. The significance of differences between nonagenarians and control group was examined by ANOVA-Kruskal-Wallis tests, using statistical software NCSS 6.0.21 (Kaysville, UT, 1996). The decision on significance was based on P=0.05. Urinary neopterin was significantly higher in institutionalised compared to self-sustaining subjects and controls (625+/-565 vs. 203+/-63 mumol mol(-1) creatinine, and 198+/-128 mumol mol(-1) creatinine, respectively, P=0.006). The serum TBARS were higher in both groups of nonagenarians (3.23+/-1.16 mumol l(-1) and 2.69+/-0.39 vs. 2.12+/-0.83 mumol l(-1) for the self-sustaining, institutionalised and controls, respectively, P=0.023). We conclude that the fluorimetric determinations of urinary neopterin and serum TBARS can be useful for the monitoring health status in the elderly patients.