Quantitative Measure of Intestinal Permeability Using Blue Food Coloring

Abstract

Background: Loss of intestinal barrier integrity plays a fundamental role in the pathogenesis of various gastrointestinal diseases and is implicated in the onset of sepsis and multiple organ failure. An array of methods to assess different aspects of intestinal barrier function suffers from lack of sensitivity, prolonged periods of specimen collection, or high expense. We have developed a technique to measure the concentration of the food dye FD&C Blue #1 from blood and sought to assess its utility in measuring intestinal barrier function in humans.

Materials and methods: Four healthy volunteers and 10 critically ill subjects in the intensive care unit were recruited in accordance with an institutional review board approved protocol. Subjects were given 0.5 mg/kg Blue #1 enterally as an aqueous solution of diluted food coloring. Five blood specimens were drawn per subject: 0 h (before dose), 1, 2, 4, and 8 h. After plasma isolation, organic extracts were analyzed by high-performance liquid chromatography/mass spectrometry detecting the presence of unmodified dye.

Results: We found no baseline detectable absorption in healthy volunteers. After including the subjects in the intensive care unit, we compared dye absorption in the six subjects who met criteria for septic shock with the eight who did not. Septic patients demonstrated significantly greater absorption of Blue #1 after 2 h.

Conclusions: We have developed a novel, easy-to-use method to measure intestinal barrier integrity using a food grade dye detectable by mass spectrometry analysis of patient blood following oral administration.

Keywords: Critical illness; FD&C Blue #1; Gut permeability; High performance liquid chromatography/mass spectrometry; Intestinal barrier; Sepsis.

Fig. 1

Peak height of Blue #1 detected in plasma of nonseptic versus septic subjects at 2 h and 8 h after dye administration. (Color version of figure is available online.)

Fig. 2

Peak height of Blue #1 detected in plasma of subjects without vasopressor support and those on vasopressor support at 2 h and 8 h after dye administration. (Color version of figure is available online.)