Depressed jejunal secretion of water and ions in response to prostaglandin E1 in adult celiac disease

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Abstract
In order to test in man the concept that intestinal fluid secretion originates from the crypts of Lieberkühn, we assessed the jejunal secretory effect of intraluminal prostaglandin E 1 (PGE 1 ) (0.9 μg/kg/min) in untreated adult celiac disease (ACD, N=7), treated ACD (N=4) and normal subjects using the intestinal perfusion technique. In untreated ACD (1) water and solutes were malabsorbed (or secreted) in the basal period; (2) fluid and ion secretion seen during PGE 1 infusion and net secretory effect of PGE 1 (difference in transport between basal and PGE 1 periods) were reduced (P 1 inhibition of sodium insorption, and stimulation of sodium exsorption, were decreased and abolished, respectively. In treated patients PGE 1 -induced secretion returned towards normal values. Our finding of a depressed secretory response to PGE 1 in the face of marked crypt hypertrophy do not support the concept that crypt cells are the major site of intestinal fluid secretion.