13C-sucrose breath test

novel use of a noninvasive biomarker of environmental gut health

Brett Ritchie, David Brewster, G DAVIDSON, C TRAN, Yvette McNeil, J HAWKES, R BUTLER

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    OBJECTIVE: Environmental enteropathy syndrome may compromise growth and predispose to infectious diseases in children in the developing world, including Australian Aboriginal children from remote communities of the Northern Territory. In this study, we described the use of a biomarker 13C-sucrose breath test (SBT) to measure enterocyte sucrase activity as a marker of small intestinal villus integrity and function. METHODS: This was a hospital-based prospective case-control study of Aboriginal and non-Aboriginal children with and without acute diarrheal disease. Using the SBT, we compared 36 Aboriginal case subjects admitted to a hospital (18 diarrheal and 18 nondiarrheal disease), with 7 healthy non-Aboriginal control subjects. Intestinal permeability using the lactulose/rhamnose (L/R) ratio on a timed 90-minute blood test was performed simultaneously with the SBT. The SBT results are expressed as a cumulative percentage of the dose recovered at 90 minutes. RESULTS: Aboriginal children with acute diarrheal disease have a significantly decreased absorptive capacity, as determined by the SBT, with a mean of 1.9% compared with either Aboriginal children without diarrhea (4.1%) or non-Aboriginal (6.1%) control subjects. The mean L/R ratio in the diarrhea group was 31.8 compared with 11.4 in Aboriginal children without diarrhea. There was a significant inverse correlation between the SBT and the L/R ratio. CONCLUSIONS: The SBT was able to discriminate among Aboriginal children with diarrhea, asymptomatic Aboriginal children with an underlying environmental enteropathy, and healthy non-Aboriginal controls. This test provides a noninvasive, easy-to-use, integrated marker of the absorptive capacity and integrity of the small intestine and could be a valuable tool in evaluating the efficacy of interventions aimed at improving gut health. Copyright � 2009 by the American Academy of Pediatrics.
    Original languageEnglish
    Pages (from-to)620-626
    Number of pages7
    JournalPediatrics
    Volume124
    Issue number2
    Publication statusPublished - 2009

    Fingerprint

    Breath Tests
    Environmental Health
    Sucrose
    Biomarkers
    Lactulose
    Rhamnose
    Diarrhea
    Acute Disease
    Northern Territory
    Sucrase
    Enterocytes
    Hematologic Tests
    Small Intestine
    Communicable Diseases
    Case-Control Studies
    Permeability
    Health
    Growth

    Cite this

    Ritchie, B., Brewster, D., DAVIDSON, G., TRAN, C., McNeil, Y., HAWKES, J., & BUTLER, R. (2009). 13C-sucrose breath test: novel use of a noninvasive biomarker of environmental gut health. Pediatrics, 124(2), 620-626.
    Ritchie, Brett ; Brewster, David ; DAVIDSON, G ; TRAN, C ; McNeil, Yvette ; HAWKES, J ; BUTLER, R. / 13C-sucrose breath test : novel use of a noninvasive biomarker of environmental gut health. In: Pediatrics. 2009 ; Vol. 124, No. 2. pp. 620-626.
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    abstract = "OBJECTIVE: Environmental enteropathy syndrome may compromise growth and predispose to infectious diseases in children in the developing world, including Australian Aboriginal children from remote communities of the Northern Territory. In this study, we described the use of a biomarker 13C-sucrose breath test (SBT) to measure enterocyte sucrase activity as a marker of small intestinal villus integrity and function. METHODS: This was a hospital-based prospective case-control study of Aboriginal and non-Aboriginal children with and without acute diarrheal disease. Using the SBT, we compared 36 Aboriginal case subjects admitted to a hospital (18 diarrheal and 18 nondiarrheal disease), with 7 healthy non-Aboriginal control subjects. Intestinal permeability using the lactulose/rhamnose (L/R) ratio on a timed 90-minute blood test was performed simultaneously with the SBT. The SBT results are expressed as a cumulative percentage of the dose recovered at 90 minutes. RESULTS: Aboriginal children with acute diarrheal disease have a significantly decreased absorptive capacity, as determined by the SBT, with a mean of 1.9{\%} compared with either Aboriginal children without diarrhea (4.1{\%}) or non-Aboriginal (6.1{\%}) control subjects. The mean L/R ratio in the diarrhea group was 31.8 compared with 11.4 in Aboriginal children without diarrhea. There was a significant inverse correlation between the SBT and the L/R ratio. CONCLUSIONS: The SBT was able to discriminate among Aboriginal children with diarrhea, asymptomatic Aboriginal children with an underlying environmental enteropathy, and healthy non-Aboriginal controls. This test provides a noninvasive, easy-to-use, integrated marker of the absorptive capacity and integrity of the small intestine and could be a valuable tool in evaluating the efficacy of interventions aimed at improving gut health. Copyright � 2009 by the American Academy of Pediatrics.",
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    Ritchie, B, Brewster, D, DAVIDSON, G, TRAN, C, McNeil, Y, HAWKES, J & BUTLER, R 2009, '13C-sucrose breath test: novel use of a noninvasive biomarker of environmental gut health', Pediatrics, vol. 124, no. 2, pp. 620-626.

    13C-sucrose breath test : novel use of a noninvasive biomarker of environmental gut health. / Ritchie, Brett; Brewster, David; DAVIDSON, G; TRAN, C; McNeil, Yvette; HAWKES, J; BUTLER, R.

    In: Pediatrics, Vol. 124, No. 2, 2009, p. 620-626.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - 13C-sucrose breath test

    T2 - novel use of a noninvasive biomarker of environmental gut health

    AU - Ritchie, Brett

    AU - Brewster, David

    AU - DAVIDSON, G

    AU - TRAN, C

    AU - McNeil, Yvette

    AU - HAWKES, J

    AU - BUTLER, R

    PY - 2009

    Y1 - 2009

    N2 - OBJECTIVE: Environmental enteropathy syndrome may compromise growth and predispose to infectious diseases in children in the developing world, including Australian Aboriginal children from remote communities of the Northern Territory. In this study, we described the use of a biomarker 13C-sucrose breath test (SBT) to measure enterocyte sucrase activity as a marker of small intestinal villus integrity and function. METHODS: This was a hospital-based prospective case-control study of Aboriginal and non-Aboriginal children with and without acute diarrheal disease. Using the SBT, we compared 36 Aboriginal case subjects admitted to a hospital (18 diarrheal and 18 nondiarrheal disease), with 7 healthy non-Aboriginal control subjects. Intestinal permeability using the lactulose/rhamnose (L/R) ratio on a timed 90-minute blood test was performed simultaneously with the SBT. The SBT results are expressed as a cumulative percentage of the dose recovered at 90 minutes. RESULTS: Aboriginal children with acute diarrheal disease have a significantly decreased absorptive capacity, as determined by the SBT, with a mean of 1.9% compared with either Aboriginal children without diarrhea (4.1%) or non-Aboriginal (6.1%) control subjects. The mean L/R ratio in the diarrhea group was 31.8 compared with 11.4 in Aboriginal children without diarrhea. There was a significant inverse correlation between the SBT and the L/R ratio. CONCLUSIONS: The SBT was able to discriminate among Aboriginal children with diarrhea, asymptomatic Aboriginal children with an underlying environmental enteropathy, and healthy non-Aboriginal controls. This test provides a noninvasive, easy-to-use, integrated marker of the absorptive capacity and integrity of the small intestine and could be a valuable tool in evaluating the efficacy of interventions aimed at improving gut health. Copyright � 2009 by the American Academy of Pediatrics.

    AB - OBJECTIVE: Environmental enteropathy syndrome may compromise growth and predispose to infectious diseases in children in the developing world, including Australian Aboriginal children from remote communities of the Northern Territory. In this study, we described the use of a biomarker 13C-sucrose breath test (SBT) to measure enterocyte sucrase activity as a marker of small intestinal villus integrity and function. METHODS: This was a hospital-based prospective case-control study of Aboriginal and non-Aboriginal children with and without acute diarrheal disease. Using the SBT, we compared 36 Aboriginal case subjects admitted to a hospital (18 diarrheal and 18 nondiarrheal disease), with 7 healthy non-Aboriginal control subjects. Intestinal permeability using the lactulose/rhamnose (L/R) ratio on a timed 90-minute blood test was performed simultaneously with the SBT. The SBT results are expressed as a cumulative percentage of the dose recovered at 90 minutes. RESULTS: Aboriginal children with acute diarrheal disease have a significantly decreased absorptive capacity, as determined by the SBT, with a mean of 1.9% compared with either Aboriginal children without diarrhea (4.1%) or non-Aboriginal (6.1%) control subjects. The mean L/R ratio in the diarrhea group was 31.8 compared with 11.4 in Aboriginal children without diarrhea. There was a significant inverse correlation between the SBT and the L/R ratio. CONCLUSIONS: The SBT was able to discriminate among Aboriginal children with diarrhea, asymptomatic Aboriginal children with an underlying environmental enteropathy, and healthy non-Aboriginal controls. This test provides a noninvasive, easy-to-use, integrated marker of the absorptive capacity and integrity of the small intestine and could be a valuable tool in evaluating the efficacy of interventions aimed at improving gut health. Copyright � 2009 by the American Academy of Pediatrics.

    KW - carbon 13

    KW - lactulose

    KW - rhamnose

    KW - sucrase

    KW - sucrose

    KW - carbon

    KW - diagnostic agent

    KW - Aborigine

    KW - acute diarrhea

    KW - article

    KW - blood examination

    KW - breath analysis

    KW - child

    KW - clinical article

    KW - controlled study

    KW - enzyme activity

    KW - female

    KW - hospital admission

    KW - human

    KW - intestine cell

    KW - intestine function

    KW - intestine mucosa permeability

    KW - intestine villus

    KW - male

    KW - preschool child

    KW - priority journal

    KW - small intestine mucosa

    KW - Australia

    KW - blood

    KW - cell membrane permeability

    KW - dehydration

    KW - differential diagnosis

    KW - environmental disease

    KW - infant

    KW - infantile diarrhea

    KW - intestine absorption

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    KW - methodology

    KW - pathophysiology

    KW - physiology

    KW - prediction and forecasting

    KW - reference value

    KW - small intestine

    KW - tropical sprue

    KW - Breath Tests

    KW - Carbon Radioisotopes

    KW - Cell Membrane Permeability

    KW - Child, Preschool

    KW - Dehydration

    KW - Diagnosis, Differential

    KW - Diarrhea, Infantile

    KW - Environmental Illness

    KW - Female

    KW - Humans

    KW - Infant

    KW - Intestinal Absorption

    KW - Intestinal Mucosa

    KW - Intestine, Small

    KW - Lactulose

    KW - Male

    KW - Northern Territory

    KW - Oceanic Ancestry Group

    KW - Predictive Value of Tests

    KW - Reference Values

    KW - Rhamnose

    KW - South Australia

    KW - Sprue, Tropical

    KW - Sucrose

    M3 - Article

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    JO - Pediatrics

    JF - Pediatrics

    SN - 0031-4005

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    ER -

    Ritchie B, Brewster D, DAVIDSON G, TRAN C, McNeil Y, HAWKES J et al. 13C-sucrose breath test: novel use of a noninvasive biomarker of environmental gut health. Pediatrics. 2009;124(2):620-626.