Early signs of impaired gut function in patients with advanced cancer undergoing chemotherapy

Barbara S. van der Meij, Nicolaas E. Deutz, Steven Olde Damink, Ramon E. Rodriguez, Marielle P. Engelen

Research output: Contribution to journalMeeting AbstractResearchpeer-review


Aims: Chemotherapy can affect the lining of the gut and the digestion of nutrients and consequently cause muscle wasting and physical impairment. This study investigates gut function, by a battery of tests, in advanced cancer patients undergoing chemotherapy.

Methods: In 16 patients with advanced cancer undergoing chemotherapy (T) and 16 healthy controls (H), we performed gut permeability tests using the inert sugars rhamnose (R), lactulose (L), and 3‐O‐Methyl‐D‐glucose (3‐OMG) to measure L/R and 3‐OMG/R ratios. Mucosal function was assessed by pulse IV administration of L‐[5‐13C‐5,5‐2H2]‐CIT to calculate citrulline (CIT) concentration and production rate. Protein digestion capacity and splanchnic extraction of phenyalanine (PHE) were measured after combined intake of a high‐protein meal with enteral [1‐13C]PHE and 15N‐spirulina, and primed continuous infusion of [ring‐2H5]PHE. Blood/urine samples were obtained for inert sugars and amino concentrations/enrichments by LC‐MS/MS, and statistical analysis by unpaired t‐tests and Spearman correlation tests.

Results: Both T and H groups included 7 females (43.8%) and mean age was comparable (T: 60.1±16.6y, H: 59.3±16.0y, ns). L/R ratio and 3‐OMG/R ratios were not different, but 3‐OMG was higher in T (T: 48.4±19.7% vs H: 35.5±13.5%, P = 0.03). Protein digestion capacity tended to be lower in T (0.66±0.08 vs 0.75±0.15, P = 0.07), splanchnic extraction was comparable (T: 0.20 ± 0.1 vs H: 0.21 ± 0.1, ns). Plasma CIT (T: 20.5 ± 8.4 μmol/L vs. H: 29.9 ± 9.6 μmol/L, P = 0.009) and the production of CIT (T: 16.9 ± 7.7 μmol/kg FFM*h vs H: 11.0 ± 3.4 μmol/kg FFM*h, P = 0.02) were lower in T.

Conclusions: Patients with cancer undergoing chemotherapy show early signs of a leaky gut and impaired digestion and mucosal function
Original languageEnglish
Article number362
Pages (from-to)172-172
Number of pages1
JournalAsia-Pacific Journal of Clinical Oncology
Issue numberS7
Publication statusPublished - Nov 2018
EventCOSA's 45th Annual Scientific Meeting: Mesothelioma and Gastro‐Intestinal Cancers - Technology and Genomics - Perth Convention and Exhibition Centre, Perth, Australia
Duration: 13 Nov 201815 Nov 2018
Conference number: 45th


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