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Z Gastroenterol 2021; 59(06): 531-539
DOI: 10.1055/a-1156-4386
Originalarbeit

Expression of the fructose transporter GLUT5 in patients with fructose malabsorption

Expression des Fruktose-Transporters GLUT5 bei Patienten mit einer Fruktosemalabsorption
Pia Staubach
3   Department of Pathology, Christian-Albrechts-University Kiel, Germany
,
Anna Katharina Koch
4   Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, University of Duisburg-Essen, Germany
,
Jost Langhorst
4   Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, University of Duisburg-Essen, Germany
,
Stefan Schreiber
2   Department of Internal Medicine, Christian-Albrechts-University Kiel, Germany
,
Christoph Röcken   *
3   Department of Pathology, Christian-Albrechts-University Kiel, Germany
,
Ulf Helwig   *
1   Specialist Practice for Internal Medicine, Oldenburg, Oldenburg Germany
2   Department of Internal Medicine, Christian-Albrechts-University Kiel, Germany
› Author AffiliationsSupported by: Registered Society for Science and Education in the Internal Medicine and the University of Kiel Department of Pathology
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Abstract

Background Patients with abdominal symptoms are frequently diagnosed with fructose malabsorption (FM). Fructose is absorbed by monosaccharide transporters located in the brush border of the human small intestine. The aim of this study was to investigate the histoanatomical distribution of the main fructose transporter GLUT5.

Materials and methods We studied 223 patients diagnosed with FM by a hydrogen breath test and grouped according to their response to a fructose-free diet. The control group were 42 healthy individuals and 29 patients with celiac disease (CD). The fructose breath test was done with 50 g fructose. The expression of Glut5 in duodenal biopsy specimens was studied by immunohistochemistry. The Kruskal-Wallis-test and Mann-Whitney U-test were used to carry out the statistical analysis.

Results The histoanatomical expression pattern of GLUT5 did not differ significantly between those patients with FM who responded completely to a fructose-free diet (n = 183) and healthy individuals (n = 42); nor did it correlate to H2 production measured in fructose breath testing. In patients with FM, the GLUT5 expression pattern did not differ between those individuals responding to a fructose-free diet and those who did not. However, GLUT5 expression pattern was significantly different in patients with CD (n = 29) compared to patients with FM and to healthy individuals (p = 0.009).

Conclusion GLUT5 expression patterns are not be related to adult patients with FM. However, in secondary malabsorption, a decreased GLUT5 expression was found. Further investigation is needed to understand the essential factors in FM and the influence on functional gastrointestinal disorders.

Zusammenfassung

Fruktose wird durch den GLUT5-Rezeptor resorbiert, die Frage der klinischen Bedeutung bei der Fruktosemalabsorption ist ungeklärt. Daher haben wir insgesamt 223 Patienten mit einer Fruktosemalabsorption mit Normalkontrollen und Zöliakiepatienten verglichen. Nach H2-Atemtestung wurde die Diagnose der Fruktosemalabsorption durch die Besserung der klinischen Beschwerden nach Fruktoserestriktion verifiziert. Die Expression des GLUT5-Rezeptors in der Dünndarmbiopsie wurde mit Zöliakiepatienten und Normalkontrollen verglichen. Es zeigt sich keine verminderte GLUT5-Expression bei Patienten mit einer Fruktosemalabsorption im Vergleich zu Normalkontrollen. Hingegen ist bei der Zöliakie eine entzündungsabhängige Konzentrationsänderung von GLUT5 zu verzeichnen. Diese Daten belegen, dass die klinische Bedeutung der Fruktosemalabsorption nicht von der Rezeptorverteilung von GLUT5 abhängig sind und daher die Bestimmung desselben nicht zur Diagnostik geeignet ist.

Key words

malabsorption - colon irritabile - fructose malabsorption

Schlüsselwörter

Malabsorption - Reizdarmsyndrom - Fruktosemalabsorption

* Shared senior authorship.




Publication History

Received: 15 September 2019

Accepted: 05 April 2020

Article published online:
15 June 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
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