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Background and Aims: The dual sugar absorption test as a classic measure of human intestinal permeability has limited clinical utility due to lengthy and cumbersome urine collection, assay variability, and long turnaround. We aimed to determine if the orally administered fluorophore MB-102 (relmapirazin) (molecular weight [MW] = 372) compares to lactulose (L) (MW = 342) and rhamnose (R) (MW = 164)-based dual sugar absorption test as a measure of gut permeability in people with a spectrum of permeability including those with Crohn's disease (CD). Methods: We performed a single-center, randomized, open-label, crossover study comparing orally administered MB-102 (1.5 or 3.0 mg/kg) to L (1000 mg) and R (200 mg). Adults with active small bowel CD on magnetic resonance enterography (cases) and healthy adults (controls) were randomized to receive either MB-102 or L and R on study day 1, and the other tracer 3 to 7 days later. Urine was collected at baseline and 1, 2, 4, 6, 8, 10, and 12 hours after tracer ingestion to calculate the cumulative urinary percent excretion of MB-102 and L and R. Results: Nine cases and 10 controls completed the study without serious adverse events. Urinary recovery of administered MB-102 correlated with recovery of lactulose (r-squared = 0.83) for all participants. MB-102 urine recovery was also tracked with the L:R ratio urine recovery (r-squared = 0.57). In controls, the percentages of L and MB-102 recovered were similar within a narrow range, unlike in CD patients. Conclusion: This first-in-human study of an orally administered fluorophore to quantify gastrointestinal permeability in adults with CD demonstrates that MB-102 is well tolerated, and its recovery in urine mirrors that of percent L and the L:R ratio.
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INTRODUCTION: We describe videos posted to the YouTube video-sharing Web site by US state health departments (SHDs) and associated institutional factors. METHODS: YouTube channels from SHDs were identified, their data retrieved, and their videos saved to a playlist on January 10, 2016. Ten randomly sampled videos from each channel were manually coded for topics. The 2012 Association of State and Territorial Health Officials profile survey was used to obtain information on staff, expenditure, and top 5 priorities for each SHD. Descriptive statistics and univariable regression were conducted. RESULTS: Forty-three SHDs had YouTube channels. Together, all SHDs posted 3957 videos, accumulated 12,151,720 views, and gained 6302 subscribers. In total, 415 videos were manually coded. Information about the agency (17.6%), communicable diseases (12.5%), and mother/infant health (8.9%) comprised the largest share of topics. No statistically significant association was observed between the log-transformed number of videos posted on an SHD's YouTube channel and any of the explanatory variables of SHD staffing and expenditure in 2011. The number of full-time employees (r = 0.34, p = 0.03), number of epidemiologists and biostatisticians (r = 0.41, p = 0.01), and 2011 total year expenditure (r = 0.38, p = 0.02) were positively correlated with the log-transformed number of views per YouTube video posted by SHDs. No meaningful patterns of statistical association were observed between the percentage of expenditure on a specific program area and the topics of videos. CONCLUSION: Most SHDs are using YouTube, which provides a unique opportunity for SHDs to disseminate health messages.
