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Gut. 1993 April; 34(4): 509–513.
PMCID: PMC1374312

Increased absorption of polyethylene glycol 600 deposited in the colon in active ulcerative colitis.


A defect in the barrier function of the intestinal mucosa has been proposed as important in both the pathogenesis and systemic manifestations of inflammatory bowel disease. After colonoscopy, polymers of polyethylene glycol (PEG) with molecular weights of 414-810 (mean 600), were instilled in the descending colon of patients with ulcerative colitis (n = 17) and in controls without intestinal inflammation (n = 8). The patients with active ulcerative colitis (n = 6) had a significantly increased uptake of PEGs in the molecular weight range 458-810, measured as urinary excretion over the first 6 hours after instillation. The median values for their excretion were 2.85-3.80% of PEGs instilled compared with 0.32-0.94% for patients in remission (n = 11) (p < 0.05-0.01) and 0.17-0.60% for the controls (p < 0.05-0.01). The differences in absorption of PEG 414 did not reach the present level of statistical significance. There was a positive correlation between PEG absorption and the endoscopic and histological grading of inflammatory activity in the sigmoid colon (p < 0.01-0.001). These findings support a correlation between the presence of active inflammation and PEG absorption. There was little evidence to support the presence of a primary defect in the colonic barrier in patients with ulcerative colitis.

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  • Shorter RG, Huizenga KA, Spencer RJ. A working hypothesis for the etiology and pathogenesis of nonspecific inflammatory bowel disease. Am J Dig Dis. 1972 Nov;17(11):1024–1032. [PubMed]
  • Walker WA, Isselbacher KJ. Uptake and transport of macromolecules by the intestine. Possible role in clinical disorders. Gastroenterology. 1974 Sep;67(3):531–550. [PubMed]
  • Hodgson HJ, Potter BJ, Jewell DP. Immune complexes in ulcerative colitis and Crohn's disease. Clin Exp Immunol. 1977 Aug;29(2):187–196. [PubMed]
  • Ward M. The pathogenesis of Crohn's disease. Lancet. 1977 Oct 29;2(8044):903–905. [PubMed]
  • Mee AS, McLaughlin JE, Hodgson HJ, Jewell DP. Chronic immune colitis in rabbits. Gut. 1979 Jan;20(1):1–5. [PMC free article] [PubMed]
  • Gebbers JO, Otto HF. Alterations of the intestinal mucosal block in ulcerative colitis and Crohn's disease--immunological and ultrastructural findings, and considerations of the pathogenesis. Klin Padiatr. 1985 Jul-Aug;197(4):341–348. [PubMed]
  • Hollander D, Vadheim CM, Brettholz E, Petersen GM, Delahunty T, Rotter JI. Increased intestinal permeability in patients with Crohn's disease and their relatives. A possible etiologic factor. Ann Intern Med. 1986 Dec;105(6):883–885. [PubMed]
  • Hollander D. Crohn's disease--a permeability disorder of the tight junction? Gut. 1988 Dec;29(12):1621–1624. [PMC free article] [PubMed]
  • Olaison G, Leandersson P, Sjödahl R, Tagesson C. Increase in permeability and phospholipase A2 activity of colonic mucosa in Crohn's colitis. Digestion. 1989;43(4):228–233. [PubMed]
  • Olaison G, Sjödahl R, Tagesson C. Abnormal intestinal permeability in Crohn's disease. A possible pathogenic factor. Scand J Gastroenterol. 1990 Apr;25(4):321–328. [PubMed]
  • Cobden I, Rothwell J, Axon AT. Intestinal permeability and screening tests for coeliac disease. Gut. 1980 Jun;21(6):512–518. [PMC free article] [PubMed]
  • Bjarnason I, O'Morain C, Levi AJ, Peters TJ. Absorption of 51chromium-labeled ethylenediaminetetraacetate in inflammatory bowel disease. Gastroenterology. 1983 Aug;85(2):318–322. [PubMed]
  • Peled Y, Watz C, Gilat T. Measurement of intestinal permeability using 51Cr-EDTA. Am J Gastroenterol. 1985 Oct;80(10):770–773. [PubMed]
  • O'Morain CA, Abelow AC, Chervu LR, Fleischner GM, Das KM. Chromium 51-ethylenediaminetetraacetate test: a useful test in the assessment of inflammatory bowel disease. J Lab Clin Med. 1986 Nov;108(5):430–435. [PubMed]
  • Casellas F, Aguadé S, Soriano B, Accarino A, Molero J, Guarner L. Intestinal permeability to 99mTc-diethylenetriaminopentaacetic acid in inflammatory bowel disease. Am J Gastroenterol. 1986 Sep;81(9):767–770. [PubMed]
  • Jenkins RT, Goodacre RL, Rooney PJ, Bienenstock J, Sivakumaran T, Walker WH. Studies of intestinal permeability in inflammatory diseases using polyethylene glycol 400. Clin Biochem. 1986 Oct;19(5):298–302. [PubMed]
  • Jenkins RT, Jones DB, Goodacre RL, Collins SM, Coates G, Hunt RH, Bienenstock J. Reversibility of increased intestinal permeability to 51Cr-EDTA in patients with gastrointestinal inflammatory diseases. Am J Gastroenterol. 1987 Nov;82(11):1159–1164. [PubMed]
  • Resnick RH, Royal H, Marshall W, Barron R, Werth T. Intestinal permeability in gastrointestinal disorders. Use of oral [99mTc]DTPA. Dig Dis Sci. 1990 Feb;35(2):205–211. [PubMed]
  • Zellweger U, Freiburghaus AU, Münch R, Meyenberger C, Bühler H, Ammann R. Messung der Darmpermeabilität bei Morbus Crohn, Colitis ulcerosa, Sprue und idiopathischer Hyperamylasämie mit Polyethylenglykol-400. Schweiz Med Wochenschr. 1990 Apr 28;120(17):617–620. [PubMed]
  • Chadwick VS, Phillips SF, Hofmann AF. Measurements of intestinal permeability using low molecular weight polyethylene glycols (PEG 400). II. Application to normal and abnormal permeability states in man and animals. Gastroenterology. 1977 Aug;73(2):247–251. [PubMed]
  • Olaison G, Sjödahl R, Tagesson C. Decreased gastrointestinal absorption of peroral polyethyleneglycols (PEG 1000) in Crohn's disease. A sign of jejunal abnormality. Acta Chir Scand. 1987;153(5-6):373–377. [PubMed]
  • Jenkins AP, Trew DR, Crump BJ, Nukajam WS, Foley JA, Menzies IS, Creamer B. Do non-steroidal anti-inflammatory drugs increase colonic permeability? Gut. 1991 Jan;32(1):66–69. [PMC free article] [PubMed]
  • ISLEY JK, SANDERS AP, SHARPE KW, REEVES RJ, BAYLIN GJ. The use of radioactive isotopes in the study of colonic absorption. Am J Roentgenol Radium Ther Nucl Med. 1959 Jan;81(1):89–92. [PubMed]
  • von Ritter C, Sekizuka E, Grisham MB, Granger DN. The chemotactic peptide N-formyl methionyl-leucyl-phenylalanine increases mucosal permeability in the distal ileum of the rat. Gastroenterology. 1988 Sep;95(3):651–656. [PubMed]
  • Granger DN, Zimmerman BJ, Sekizuka E, Grisham MB. Intestinal microvascular exchange in the rat during luminal perfusion with formyl-methionyl-leucyl-phenylalanine. Gastroenterology. 1988 Mar;94(3):673–681. [PubMed]
  • Ginsberg AL, Beck LS, McIntosh TM, Nochomovitz LE. Treatment of left-sided ulcerative colitis with 4-aminosalicylic acid enemas. A double-blind, placebo-controlled trial. Ann Intern Med. 1988 Feb;108(2):195–199. [PubMed]
  • Watts JM, Thompson H, Goligher JC. Sigmoidoscopy and cytology in the detection of microscopic disease of the rectal mucosa in ulcerative colitis. Gut. 1966 Jun;7(3):288–294. [PMC free article] [PubMed]
  • Tagesson C, Andersson PA, Andersson T, Bolin T, Källberg M, Sjödahl R. Passage of molecules through the wall of the gastrointestinal tract. Measurement of intestinal permeability to polyethylene glycols in the 634-1338 dalton range (PEG 1000). Scand J Gastroenterol. 1983 May;18(4):481–486. [PubMed]
  • Saweirs WM, Andrews DJ, Low-Beer TS. The double sugar test of intestinal permeability in the elderly. Age Ageing. 1985 Sep;14(5):312–315. [PubMed]
  • Black DA. Intestinal permeability in the elderly. Dig Dis Sci. 1988 Mar;33(3):382–382. [PubMed]
  • Katz D, Hollander D, Said HM, Dadufalza V. Aging-associated increase in intestinal permeability to polyethylene glycol 900. Dig Dis Sci. 1987 Mar;32(3):285–288. [PubMed]
  • Pironi L, Miglioli M, Ruggeri E, Levorato M, Dallasta MA, Corbelli C, Nibali MG, Barbara L. Relationship between intestinal permeability to [51Cr]EDTA and inflammatory activity in asymptomatic patients with Crohn's disease. Dig Dis Sci. 1990 May;35(5):582–588. [PubMed]
  • Kingham JG, Loehry CA. Permeability of the small intestine after intra-arterial injection of histamine-type mediators and irradiation. Gut. 1976 Jul;17(7):517–526. [PMC free article] [PubMed]
  • Delpre G, Avidor I, Steinherz R, Kadish U, Ben-Bassat M. Ultrastructural abnormalities in endoscopically and histologically normal and involved colon in ulcerative colitis. Am J Gastroenterol. 1989 Sep;84(9):1038–1046. [PubMed]
  • Hollander D, Koyama S, Dadufalza V, Tran DQ, Krugliak P, Ma T, Ling KY. Polyethylene glycol 900 permeability of rat intestinal and colonic segments in vivo and brush border membrane vesicles in vitro. J Lab Clin Med. 1989 Apr;113(4):505–515. [PubMed]
  • Marin ML, Greenstein AJ, Geller SA, Gordon RE, Aufses AH., Jr A freeze fracture study of Crohn's disease of the terminal ileum: changes in epithelial tight junction organization. Am J Gastroenterol. 1983 Sep;78(9):537–547. [PubMed]
  • Podolsky DK, Isselbacher KJ. Glycoprotein composition of colonic mucosa. Specific alterations in ulcerative colitis. Gastroenterology. 1984 Nov;87(5):991–998. [PubMed]
  • McCormick DA, Horton LW, Mee AS. Mucin depletion in inflammatory bowel disease. J Clin Pathol. 1990 Feb;43(2):143–146. [PMC free article] [PubMed]
  • Gibson PR, van de Pol E, Barratt PJ, Doe WF. Ulcerative colitis--a disease characterised by the abnormal colonic epithelial cell? Gut. 1988 Apr;29(4):516–521. [PMC free article] [PubMed]
  • Ramage JK, Hunt RH, Perdue MH. Changes in intestinal permeability and epithelial differentiation during inflammation in the rat. Gut. 1988 Jan;29(1):57–61. [PMC free article] [PubMed]
  • Nash S, Stafford J, Madara JL. Effects of polymorphonuclear leukocyte transmigration on the barrier function of cultured intestinal epithelial monolayers. J Clin Invest. 1987 Oct;80(4):1104–1113. [PMC free article] [PubMed]
  • Grisham MB, Gaginella TS, von Ritter C, Tamai H, Be RM, Granger DN. Effects of neutrophil-derived oxidants on intestinal permeability, electrolyte transport, and epithelial cell viability. Inflammation. 1990 Oct;14(5):531–542. [PubMed]
  • Chadwick VS, Mellor DM, Myers DB, Selden AC, Keshavarzian A, Broom MF, Hobson CH. Production of peptides inducing chemotaxis and lysosomal enzyme release in human neutrophils by intestinal bacteria in vitro and in vivo. Scand J Gastroenterol. 1988 Jan;23(1):121–128. [PubMed]
  • Marasco WA, Phan SH, Krutzsch H, Showell HJ, Feltner DE, Nairn R, Becker EL, Ward PA. Purification and identification of formyl-methionyl-leucyl-phenylalanine as the major peptide neutrophil chemotactic factor produced by Escherichia coli. J Biol Chem. 1984 May 10;259(9):5430–5439. [PubMed]
  • Williams LT, Snyderman R, Pike MC, Lefkowitz RJ. Specific receptor sites for chemotactic peptides on human polymorphonuclear leukocytes. Proc Natl Acad Sci U S A. 1977 Mar;74(3):1204–1208. [PubMed]
  • Painter RG, Sklar LA, Jesaitis AJ, Schmitt M, Cochrane CG. Activation of neutrophils by N-formyl chemotactic peptides. Fed Proc. 1984 Sep;43(12):2737–2742. [PubMed]
  • Nast CC, LeDuc LE. Chemotactic peptides. Mechanisms, functions, and possible role in inflammatory bowel disease. Dig Dis Sci. 1988 Mar;33(3 Suppl):50S–57S. [PubMed]
  • LeDuc LE, Nast CC. Chemotactic peptide-induced acute colitis in rabbits. Gastroenterology. 1990 Apr;98(4):929–935. [PubMed]
  • Magnusson KE, Dahlgren C, Sjölander A. Effect of N-formylated methionyl-phenylalanine (FMP) and methionyl-leucyl-phenylalanine (FMLP) on gut permeability. A model of local inflammatory process. Inflammation. 1985 Dec;9(4):365–373. [PubMed]
  • Fantozzi R, Brunelleschi S, Rubino A, Tarli S, Masini E, Mannaioni PF. FMLP-activated neutrophils evoke histamine release from mast cells. Agents Actions. 1986 Apr;18(1-2):155–158. [PubMed]
  • Miller MJ, Zhang XJ, Barkemeyer B, Sadowska-Krowicka H, Eloby-Childress S, Gu X, Clark DA. Potential role of histamine monochloramine in a rabbit model of ileitis. Scand J Gastroenterol. 1991 Aug;26(8):852–858. [PubMed]
  • Rampton DS, Sladen GE. Relationship between rectal mucosal prostaglandin production and water and electrolyte transport in ulcerative colitis. Digestion. 1984;30(1):13–22. [PubMed]
  • Lauritsen K, Laursen LS, Bukhave K, Rask-Madsen J. In vivo profiles of eicosanoids in ulcerative colitis, Crohn's colitis, and Clostridium difficile colitis. Gastroenterology. 1988 Jul;95(1):11–17. [PubMed]
  • Krugliak P, Hollander D, Le K, Ma T, Dadufalza VD, Katz KD. Regulation of polyethylene glycol 400 intestinal permeability by endogenous and exogenous prostanoids. Influence of non-steroidal anti-inflammatory drugs. Gut. 1990 Apr;31(4):417–421. [PMC free article] [PubMed]

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