BACKGROUND: Small intestinal mucositis is a common side-effect following high-dose chemotherapy, causing patients to experience pain and abdominal complications often leading to extended stays in hospital. A biomarker to detect these small intestinal changes does not exist in clinical practice. This study aimed to assess the noninvasive 13C-Sucrose breath test (SBT) to detect small intestinal damage associated with mucositis in pediatric cancer patients having chemotherapy. PATIENTS AND METHODS: Small intestinal function was assessed in 15 pediatric cancer patients and 26 healthy children. Subjects were studied for small intestinal permeability (SIP; lactulose/rhamnose), digestive and absorptive capacity (SBT; sucrose), and oro-cecal transit time (OCTT; lactulose), by ingesting two sugar drinks containing the respective sugars. Combined tests were carried out at baseline, day 1, day 3-5 and day 6-9, and in healthy individuals on two separate occasions. A total of 25 cycles of chemotherapy were assessed. Breath samples for the SBT were collected every 15 min for 3 h (expressed as % cumulative dose at 90 min (CD)), a 5 h urine collection for SIP and breath hydrogen determined every 30 min for three hours for OCTT. RESULTS: Clinical mucositis occurred in seven of the 25 cycles of chemotherapy (28%). No significant difference was observed for SIP and OCTT. The SBT %CD at 90 min was significantly lower in the mucositis group compared to the unaffected group and controls at baseline (p<0.05). Patients who developed mucositis maintained a significantly lower %CD, for all test points (p<0.05) compared to the unaffected patients. In patients who developed mucositis the SBT was below the reference range of the controls at all time points. CONCLUSION: The findings show for the first time that it is possible to noninvasively detect and monitor gut damage associated with chemotherapy-induced mucositis in pediatric cancer patients.
BACKGROUND: Small intestinal mucositis is a common side-effect following high-dose chemotherapy, causing patients to experience pain and abdominal complications often leading to extended stays in hospital. A biomarker to detect these small intestinal changes does not exist in clinical practice. This study aimed to assess the noninvasive 13C-Sucrose breath test (SBT) to detect small intestinal damage associated with mucositis in pediatric cancerpatients having chemotherapy. PATIENTS AND METHODS: Small intestinal function was assessed in 15 pediatric cancerpatients and 26 healthy children. Subjects were studied for small intestinal permeability (SIP; lactulose/rhamnose), digestive and absorptive capacity (SBT; sucrose), and oro-cecal transit time (OCTT; lactulose), by ingesting two sugar drinks containing the respective sugars. Combined tests were carried out at baseline, day 1, day 3-5 and day 6-9, and in healthy individuals on two separate occasions. A total of 25 cycles of chemotherapy were assessed. Breath samples for the SBT were collected every 15 min for 3 h (expressed as % cumulative dose at 90 min (CD)), a 5 h urine collection for SIP and breath hydrogen determined every 30 min for three hours for OCTT. RESULTS: Clinical mucositis occurred in seven of the 25 cycles of chemotherapy (28%). No significant difference was observed for SIP and OCTT. The SBT %CD at 90 min was significantly lower in the mucositis group compared to the unaffected group and controls at baseline (p<0.05). Patients who developed mucositis maintained a significantly lower %CD, for all test points (p<0.05) compared to the unaffected patients. In patients who developed mucositis the SBT was below the reference range of the controls at all time points. CONCLUSION: The findings show for the first time that it is possible to noninvasively detect and monitor gut damage associated with chemotherapy-induced mucositis in pediatric cancerpatients.
Authors: Deborah Tomlinson; Peter Judd; Eleanor Hendershot; Anne-Marie Maloney; Lillian Sung Journal: Support Care Cancer Date: 2007-08-28 Impact factor: 3.603
Authors: Ross N Butler; Margaret Kosek; Nancy F Krebs; Cornelia U Loechl; Alexander Loy; Victor O Owino; Michael B Zimmermann; Douglas J Morrison Journal: J Pediatr Gastroenterol Nutr Date: 2017-01 Impact factor: 2.839
Authors: Jamee Martin; Scott C Howard; Asha Pillai; Peter Vogel; Anjaparavanda P Naren; Steven Davis; Karen Ringwald-Smith; Karyl Buddington; Randal K Buddington Journal: Chemotherapy Date: 2014-10-21 Impact factor: 2.544
Authors: Ker Y Cheah; Susan E P Bastian; Thomas M V Acott; Suzanne M Abimosleh; Kerry A Lymn; Gordon S Howarth Journal: Dig Dis Sci Date: 2012-11-10 Impact factor: 3.199
Authors: Darren S Miller; Anne Michelle Parsons; John Bresland; Paul Herde; Duc Minh Pham; Angel Tan; Hung-yao Hsu; Clive A Prestidge; Tim Kuchel; Rezaul Begg; Syed Mahfuzul Aziz; Ross N Butler Journal: J Zhejiang Univ Sci B Date: 2015-07 Impact factor: 3.066
Authors: Robyn Terry; William H E J van Wettere; Alexandra L Whittaker; Paul J Herde; Gordon S Howarth Journal: Comp Med Date: 2012-12 Impact factor: 0.982
Authors: Gwenyth O Lee; Robert Schillinger; Nirupama Shivakumar; Sherine Whyte; Sayeeda Huq; Silvenus Ochieng Konyole; Justin Chileshe; Maribel Paredes-Olortegui; Victor Owino; Roger Yazbeck; Margaret N Kosek; Paul Kelly; Douglas Morrison Journal: BMJ Open Date: 2020-11-17 Impact factor: 2.692