{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T05:08:12Z","timestamp":1785906492815,"version":"3.56.0"},"reference-count":30,"publisher":"Georg Thieme Verlag KG","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Gastroenterol"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n            Background Intestinal epithelial barrier dysfunction (\u201cleaky gut\n      syndrome\u201d, LGS) is thought to play a major role in the pathogenesis of disorders of the gut\n      brain axis. Endoscopic confocal laser endomicroscopy (eCLE) is an objective measure to test\n      duodenal permeability. We applied this technique in patients with functional gastrointestinal\n      symptoms and food intolerance to characterize the proportion of patients with LGS.<\/jats:p><jats:p>\n            Material and Methods In an observational study, we evaluated 85\n      patients with functional gastrointestinal symptoms and food intolerance. Gastrointestinal\n      symptoms were classified according to Rom IV into functional abdominal pain (FAP), irritable\n      bowel syndrome (IBS), irritable bowel syndrome diarrhea dominant (IBS-D), irritable bowel\n      syndrome constipation dominant (IBS-C), irritable bowel syndrome with mixed stool (IBS-M),\n      functional abdominal bloating (FAB), functional diarrhea (FD) and unclassified (NC). During\n      eCLE, spontaneous transfer of intravenously applied fluorescein into duodenal lumen (LGS) and\n      following duodenal food challenge (DFC) were analyzed. Blood analysis comprised parameters of mast cell\n      function, histology of duodenal mucosal biopsies analysis of mucosal inflammation,\n      intraepithelial lymphocytes (IELs) as well as number, distribution and morphology of mast\n      cells.<\/jats:p><jats:p>\n            Results 24 patients (9 IBS, 9 FAP, 3 FAB, 1 FD, 2 NC), showed\n      LGS, 50 patients (14 IBS-D, 4 IBS-C, 3 IBS-M, 23 FAP, 3 FAB, 3 NC) had no LGS but responded to\n      DFC and 11 patients (6 NC, 3 FAP, 1 FAB, 1 FD) had no LGS and no response to DFC. The\n      proportion of subgroups with\/or without spontaneous leakage of fluorescein (+LGS\/-LGS) were\n      IBS-LGS\/IBS+LGS 67%\/33%, FAP-LGS\/FAP+LGS 72%\/28%,FAB-LGS\/FAB+LGS 50%\/50%, NC-LGS\/NC+LGS\n      60%\/40%. Subgroup analysis revealed no significant differences for all parameters\n      tested.<\/jats:p><jats:p>\n            Conclusion As a proof of concept, the results of our study\n      indicate that eCLE is a clinical useful tool to evaluate patients with disorders of the gut\n      brain axis and those suspicious of LGS. However, the clinical significance of LGS remains\n      unclear. The study should be an incentive to perform a randomized study including healthy\n      controls.<\/jats:p>","DOI":"10.1055\/a-1959-3200","type":"journal-article","created":{"date-parts":[[2022,11,23]],"date-time":"2022-11-23T23:57:48Z","timestamp":1669247868000},"page":"1465-1471","source":"Crossref","is-referenced-by-count":7,"title":["Endoscopic laser endomicroscopy and \u201cleaky gut\u201d in patients with functional gastrointestinal symptoms and food intolerance"],"prefix":"10.1055","volume":"61","author":[{"given":"Thomas","family":"Frieling","sequence":"additional","affiliation":[{"name":"Medizinische Klinik II, HELIOS Klinikum Krefeld, Krefeld, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Besmir","family":"Gjini","sequence":"additional","affiliation":[{"name":"Medizinische Klinik II, HELIOS Klinikum Krefeld, Krefeld, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilka","family":"Melchior","sequence":"additional","affiliation":[{"name":"Medizinische Klinik II, HELIOS Klinikum Krefeld, Krefeld, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Euler","sequence":"additional","affiliation":[{"name":"Medizinische Klinik II, HELIOS Klinikum Krefeld, Krefeld, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Kreysel","sequence":"additional","affiliation":[{"name":"Medizinische Klinik II, HELIOS Klinikum Krefeld, Krefeld, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sigrid","family":"Kalde","sequence":"additional","affiliation":[{"name":"Medizinische Klinik II, HELIOS Klinikum Krefeld, Krefeld, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Britta","family":"Krummen","sequence":"additional","affiliation":[{"name":"Medizinische Klinik II, HELIOS Klinikum Krefeld, Krefeld, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Kiesslich","sequence":"additional","affiliation":[{"name":"Helios Dr. Horst Schmidt Kliniken Wiesbaden GmbH, Wiesbaden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Hemmerlein","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Pathologie, HELIOS Klinikum Krefeld, Krefeld, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,11,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1159\/000447252","article-title":"Increased intestinal permeability and decreased barrier function: does it really\n          influence the risk of inflammation?","volume":"1","author":"H Fukui","year":"2016","journal-title":"Inflamm Intest 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Functional dyspepsia-a \u201cleaky gut\u201d disorder?","volume":"116","author":"J Tack","year":"2020","journal-title":"Am J Gastroenterol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1891","DOI":"10.14309\/ajg.0000000000000827","article-title":"Evidence of duodenal epithelial barrier impairment and increased pyroptosis in\n          patients with functional dyspepsia on confocal laser endomicroscopy and \u201cex vivo\u201d mucosa\n          analysis","volume":"115","author":"B Nojkov","year":"2020","journal-title":"Am J Gastroenterol"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2022.851012","article-title":"The Role of Leaky Gut in Functional Dyspepsia.","author":"L Wauters","year":"2022","journal-title":"Front. 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