Gut Lavage Fluid Proteins as Markers of Activity of Inflammatory Bowel Disease

Intestinal secretions may be obtained by gut lavage using a polyethyleneglycol-based electrolyte lavage solution; concentrations of immunoglobulins and other proteins are readily measured in processed gut lavage fluid. As patients with inflammatory bowel disease (IBD) have greatly increased numbers of IgG-producing intestinal immunocytes, we measured gut lavage fluid IgG levels in 44 patients with IBD with various degrees of disease activity to determine whether total IgG in gut lavage fluid reflects disease activity. We also measured levels of albumin in gut lavage fluid, to determine the degree of plasma leakage. Both IgG and albumin levels in the patients with active IBD were significantly higher than those in controls and patients with inactive IBD (all p less than 0.00001). IgG is a more specific index of disease activity than albumin, with no overlap between levels in controls and patients with active IBD. There was a positive correlation (r = 0.68, p less than 0.0001) between IgG and albumin levels, suggesting that gut lavage fluid IgG is mainly plasma-derived.