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Prostaglandin E 2 in jejunal fluids and its potential diagnostic value for selecting patients with indomethacin‐sensitive diarrhoea
Author(s) -
BUKHAVE K.,
RASKMADSEN J.
Publication year - 1981
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/j.1365-2362.1981.tb01840.x
Subject(s) - gastroenterology , radioimmunoassay , confidence interval , prostaglandin e , medicine , diarrhea , prostaglandin , pathogenesis , prostaglandin e2 , irritable bowel syndrome , chemistry , endocrinology
. Since prostaglandins (PGs) appear to be important in the pathogenesis of secretory diarrhoea, a radioimmunoassay for determination of PGE 2 was applied to purified samples of jejunal fluids aspirated at the ligament of Treitz. Studies on validation of the assay system included quantification of PGE 2 following alkali‐treatment of the samples, variation of the sample volume, and fractionation of immunoreactive‐and tracer PGE 2 . In addition, the specificity of the assay system was confirmed by gas chromatography‐mass spectrometry. In healthy volunteers ( n = 22) the PGE 2 concentration range was 5–205 pg/ml (99% confidence limits). Alcohol addicts ( n = 27) with diarrhoea or steator‐rhoea had PGE 2 levels within the normal range. Values beyond the 99% upper confidence limit were observed in ten out of seventeen patients with chronic diarrhoea (205–340 pg/ml) and two out of fifteen patients with intermittent diarrhoea (265 and 275 pg/ml) classified as irritable bowel syndrome. In six patients with high PGE 2 concentrations indomethacin treatment (25 mg × 4 daily) halved the associated diarrhoea and reduced PGE 2 concentrations to normal levels. Subsequently, a double‐blind multiple randomized clinical trial was carried out in two single patients. Indomethacin proved to be effective in preventing diarrhoea only in the patient with a raised PGE 2 level ( P < 0.005).