Measurement of oro-cecal transit time in young children using lactose [13C] ureide requires further validation

The duration of enzyme induction in orocaecal transit time measurements

OBJECTIVE

In this study, the duration of enzyme induction provoked by unlabelled lactose ureide (LU) in orocaecal transit time (OCTT) measurements with lactose-[(13)C]ureide ((13)C-LU) was evaluated.

DESIGN

Experimental study.

SETTING

University of Rostock, Children's Hospital, Research Laboratory.

SUBJECTS

Fifteen healthy adults aged 19-54 years.

INTERVENTION

One-half gram of (13)C-LU was administered together with a continental breakfast. After 1 week, the test was repeated after pre-dosing of 5 x 100 mg LU on the day before the study began. The (13)C-LU ingestion was repeated under identical conditions but without pre-dosing 1 and 3 weeks after pre-dosing. Expired air samples were taken over 14 h. (13)CO(2)-enrichment was measured by isotope ratio mass spectrometry (SerCon, Crewe, UK). The OCTT was calculated from the interval between (13)C-LU administration and the detection of a significant and sustained (13)C-rise of 2 delta over baseline in breath.

RESULTS

Without pre-dosing, an OCTT of 419+/-82 min was measured. The pre-dosing resulted in higher (13)C-enrichments and caused a significant OCTT shortening of 311+/-99 min (P=0.028). One and 3 weeks after pre-dosing, the measured OCTT again increased to 404+/-124 and 379+/-103 min, respectively.

CONCLUSIONS

Pre-dosing with LU before pulse labelling with (13)C-LU led to an induction of enzyme activity and resulted in a definitive estimation of the OCTT when using a threshold of 2 delta over baseline. After 1 and 3 weeks, respectively, the OCTT was no longer significantly different to those without pre-dosing, indicating the disappearance of enzyme induction. Therefore, a pre-dosing with LU on the day before (13)C-LU ingestion is essential for OCTT measurements.

The use of 13C-labelled glycosyl ureides for evaluation of orocaecal transit time

OBJECTIVE

In the present study, cellobiose-[13C]ureide and glucose-[13C]ureide were synthesized and tested as alternative substrates for noninvasive evaluation of the orocaecal transit time (OCTT).

DESIGN

Experimental study.

INTERVENTION

In total, 1 g cellobiose-[13C]ureide was administered together with a continental breakfast either without or after predosing of 5 x 1 g unlabelled cellobiose ureide on the day prior to study commencement. After 2 weeks, the same subjects ingested glucose-[13C]ureide (dosage: 0.57 g) either without or after predosing of the respective unlabelled ureide under identical conditions. Expired air samples were taken over 10 h. 13CO2-enrichment was measured by isotope ratio mass spectrometry (PDZ Europa, Sandbach, UK). The OCTT was calculated from the interval between 13C-ureide administration and the detection of a significant and sustained 13C-rise of 2 delta over baseline in breath.

SETTING

University of Rostock, Children's Hospital, Research Laboratory.

SUBJECTS

Eight healthy adults aged 22-55 y.

RESULTS

After application of cellobiose-[13C]ureide and glucose-[13C]ureide OCTTs of 401 and 415 min, respectively, were measured. The predosing resulted in higher and steeper 13C-enrichments and caused a significant shortening of OCTTs of 265 and 287 min, respectively (P=0.012 and 0.017).

CONCLUSIONS

The onset of 13CO2-enrichment reflected the degradation of glycosyl-[13C]ureides by glucose ureide hydrolase. The predosing with unlabelled ureides prior to pulse labelling with cellobiose-[13C]ureide and glucose-[13C]ureide (the latter is the key substance of the enzymatic sugar-ureide degradation) led to an induction of enzyme activity and resulted in a more precise and similar estimation of the OCTT when using both 13C-labelled ureides.