Monitoring gut permeability using a novel optical sensor
File(s)
Author(s)
Wei, Jonathan
Type
Thesis
Abstract
This thesis explores the concept of increased gut permeability, also known as ‘leaky gut’, which occurs when the integrity of the intestinal barrier is compromised, allowing certain intestinal products to pass into the bloodstream and lymphatic system. Leaky gut is observed in various gastrointestinal and non-gastrointestinal conditions. Despite the availability of multiple techniques to assess gut permeability, its clinical utility remains limited.
To address this, Alex Thompson and colleagues invented a novel fluorescence spectrometry device capable of real-time assessment of gut permeability. This device involves consuming a small amount of fluorescein after a 6-hour fast, and gut permeability is assessed using a clip sensor on the finger over a 180-minute period. Initial feasibility studies show promising results, although widespread clinical adoption is yet to be achieved.
The thesis aims to evaluate the feasibility of this device in measuring gut permeability in health and disease. A meta-analysis is conducted to assess the conventional gut permeability test (lactulose mannitol test), revealing higher permeability in conditions like Crohn’s disease and coeliac disease. The first clinical cohort study demonstrates the device's ability to differentiate between two states of gut permeability in healthy individuals, showcasing its potential for clinical use.
Subsequent case control studies compare gut permeability readings in healthy controls and Crohn’s disease patients, showing the device's capacity to distinguish between active and inactive disease. Correlation with the lactulose mannitol test is also explored. The third clinical cohort study investigates the device's utility in monitoring Crohn’s disease treatment, revealing improved gut permeability with Infliximab/Adalimumab treatment.
Public and patient involvement studies indicate cautious optimism about the device among patients and healthcare professionals. This thesis suggests the device's feasibility in health and disease, highlighting its potential for monitoring Crohn’s disease. However, further studies are needed for more validation and to achieve deeper understanding of gut permeability.
To address this, Alex Thompson and colleagues invented a novel fluorescence spectrometry device capable of real-time assessment of gut permeability. This device involves consuming a small amount of fluorescein after a 6-hour fast, and gut permeability is assessed using a clip sensor on the finger over a 180-minute period. Initial feasibility studies show promising results, although widespread clinical adoption is yet to be achieved.
The thesis aims to evaluate the feasibility of this device in measuring gut permeability in health and disease. A meta-analysis is conducted to assess the conventional gut permeability test (lactulose mannitol test), revealing higher permeability in conditions like Crohn’s disease and coeliac disease. The first clinical cohort study demonstrates the device's ability to differentiate between two states of gut permeability in healthy individuals, showcasing its potential for clinical use.
Subsequent case control studies compare gut permeability readings in healthy controls and Crohn’s disease patients, showing the device's capacity to distinguish between active and inactive disease. Correlation with the lactulose mannitol test is also explored. The third clinical cohort study investigates the device's utility in monitoring Crohn’s disease treatment, revealing improved gut permeability with Infliximab/Adalimumab treatment.
Public and patient involvement studies indicate cautious optimism about the device among patients and healthcare professionals. This thesis suggests the device's feasibility in health and disease, highlighting its potential for monitoring Crohn’s disease. However, further studies are needed for more validation and to achieve deeper understanding of gut permeability.
Version
Open Access
Date Issued
2024-01-16
Date Awarded
01/01/2025
License URL
Advisor
Thompson, Alex
Ashrafian, Hutan
Darzi, Ara
Sponsor
National Institute for Health Research (Great Britain)
Publisher Department
Department of Surgery & Cancer
Publisher Institution
Imperial College London
Qualification Level
Doctoral
Qualification Name
Doctor of Philosophy (PhD)