Background and Aim:
The maturation of the intestinal epithelial barrier play an important role during the postnatal period and few data are available on the exact timing of gut closure in neonates. The aim of our study was to assess the timing of maturation of the gut barrier by the measure of the intestinal permeability (IP) in full term infants.
Patients and methods:
Twenty-nine full term infants born by vaginal delivery and exclusively breast fed entered the study. Caesarian section, therapies with antibiotics or probiotics, partial formula feeding, febrile or chronic diseases and a positive family history for atopy were considered exclusion criteria. All underwent double sugar (lactulose and mannitol) intestinal permeability test according to Generoso et al. 1 using pulsed amperometric detection (DIONEX DX 600) at birth and at day 20, 40 and 70 of life. The lactulose-to-mannitol ratio (L/M) was determined as a marker of IP.
19 infants (65,5%) completed the study, 8 (27,5%) disattended one or more IP determination and two (7%) were excluded for antibiotic treatment. Mannitol excretion significantly increased (Day 0: 3,8%; D10: 5,9%; D20: 7,5%; D40: 8,1%; D70: 7,9%; p < 0.01) and lactulose decreased (Day 0: 0,6%; D10: 0,4%; D20: 0,3%; D40: 0,3%; D70: 0,1%; p < 0.01) respectively during the study period. L/M progressively decreased reaching the normal value at day 20 (Day 0: 0.16; D10: 0,07; D20: 0,04; D40: 0,03; D70: 0,02; p < 0.001). The test was well tolerated by all infants.
Summary and conclusion:
Our study show that the IP to sugar probes in healthy breast fed infants is high at birth and progressively decrease during the first two months of life: however yet at 20 days the maturation of the IP and the gut closure seems to be completed.