Enteric protein loss and intestinal permeability changes in children during acute shigellosis and after recovery: effect of zinc supplementation

Gut. 1994 Dec;35(12):1707-11. doi: 10.1136/gut.35.12.1707.

Abstract

The effect of zinc supplementation on intestinal permeability changes and protein loss was studied in 32 children aged between 1 and 12 years during bouts of acute shigellosis and after recovery. An intestinal permeability test and then a 48 hour balance study were performed on all patients. They were then blindly assigned to receive vitamin B syrup either with or without zinc acetate (15 mg/kg per day) for a month. All patients received a five day course of nalidixic acid. The balance study was repeated during convalescence and follow up, but a permeability test was done only at follow up after one month. Intestinal permeability, expressed as a urinary lactulose:mannitol excretion ratio, improved significantly (p = 0.001) along with a significant increase (p = 0.005) in mannitol excretion in the zinc supplemented children, suggesting a resolution of small bowel mucosal damage. The latter was associated with a higher coefficient of nitrogen absorption (p = 0.03), suggesting a possible role of zinc in the treatment of shigellosis. Enteric protein loss, as assessed by faecal alpha 1 antitrypsin clearance, was not influenced by zinc supplementation.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Cell Membrane Permeability / drug effects
  • Child
  • Child, Preschool
  • Double-Blind Method
  • Dysentery, Bacillary / drug therapy
  • Dysentery, Bacillary / metabolism*
  • Female
  • Humans
  • Infant
  • Intestinal Mucosa / metabolism
  • Lactulose / urine
  • Male
  • Mannitol / urine
  • Nalidixic Acid / therapeutic use
  • Nitrogen / metabolism
  • Protein-Losing Enteropathies / drug therapy*
  • Vitamin B Complex / therapeutic use
  • Zinc / therapeutic use*

Substances

  • Vitamin B Complex
  • Nalidixic Acid
  • Mannitol
  • Lactulose
  • Zinc
  • Nitrogen