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Title: Investigation of gastrointestinal mucosal immunity and inflammation in children
Author: Croft, Nicholas Michael
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1996
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In this thesis I have introduced a new technique, whole gut lavage (WGL), for the study of gastrointestinal secretory immunity in children. Initially I arranged to collect specimens from control children, undergoing whole gut lavage prior to colonoscopy or surgery, at the Royal Hospital for Sick Children, Edinburgh. Whole gut lavage has been used to treat severe constipation and so I organised a study to look at the effectiveness of this, intending both these groups of children as immunologically normal controls. Analysis of specimens from the first five severely constipated children showed that the total IgA levels in all were very low. I went on to examine reasons for these low IgA levels including mucosal IgA deficiency, degradation and interference by other factors in the bowel lumen. Having collected specimens from control children I then arranged a study of intestinal secretory immunity in children with cystic fibrosis (CF). This was stimulated by a paper in the Lancet suggesting that CF children, taking high dose pancreatic enzyme supplements, had developed strictures of the ascending colon possibly due to direct toxic effects of these medications. As CF children have chronic lung infections I then studied the possible influence of respiratory secretions on assays of whole gut lavage fluid by measuring concentrations of immune factors in sputum. With the data from these patient groups I was able to analyse, in some detail, the clinical aspects of whole gut lavage in children. Although I had established that WGL could be an ethical and useful method for research in children it was clear, for clinical reasons, this could not be used for the study of acute diarrhoeal illness, one of the most common paediatric problems involving the gastrointestinal mucosal immune system. With the help of adult patients, I directly compared outputs of immune factors in faeces and whole gut lavage.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available