Haem in the gut. Part II. Faecal excretion of haem and haem-derived porphyrins and their detection

Journal of Gastroenterology and Hepatology
G P YoungD Blake

Abstract

Only a fraction of haem (ferroprotoporphyrin) finding its way into the gut lumen is absorbed; the major portion enters the colon. There, unabsorbed haem, together with any haem of haemoproteins shed directly into the colonic lumen as haemoglobin or other haemoproteins, are converted by bacteria to a range of haem-derived porphyrins (HDP) lacking iron. This conversion is a slow and incomplete process and the amount converted in this way depends on colonic transit rate, site of bleeding and amount of luminal haem. As a consequence, faeces contain variable proportions of haem and HDP. The guaiac and tetramethylbenzidine tests give a qualitative index of faecal blood; they depend on the pseudoperoxidase activity of intact haem and cannot detect HDP. These tests perform better for large bowel bleeding than for more proximal bleeding. The fluorimetric HemoQuant assay quantitates both haem and HDP; it performs well for both proximal and distal bleeding. Neither type of test can allow for intestinal absorption of haem or HDP. Quantitation of gastrointestinal bleeding derived from measurement of faecally excreted haem and HDP is, therefore, likely to underestimate haem delivered into the gut lumen. In a given clinical situation, the cho...Continue Reading

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Citations

Oct 14, 2009·Journal of Gastroenterology and Hepatology·Graeme P Young
Feb 3, 2012·Biological Reviews of the Cambridge Philosophical Society·Annemarie Boleij, Harold Tjalsma
Feb 23, 2007·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·M ZappaG Castiglione
Dec 11, 2014·Digestive Diseases and Sciences·Graeme P YoungHelen E Seaman
Oct 1, 1996·Japanese Journal of Cancer Research : Gann·H Saito
Aug 19, 2007·Oncogene·M J BrookesC Tselepis
Feb 5, 2019·Journal of Digestive Diseases·Jing Nan Li, Si Yi Yuan
Nov 25, 2019·Analytical and Bioanalytical Chemistry·Triana Delfin-RielaGualberto González-Sapienza
Sep 21, 2018·Journal of Gastrointestinal Cancer·Barbara Kościelniak-MerakPrzemysław J Tomasik
Jul 30, 2020·Curēus·Gregory T Brennan, Andrew S Parsons
Mar 1, 1996·Cancer Control : Journal of the Moffitt Cancer Center·J S Mandel
Mar 7, 2021·International Journal of Molecular Sciences·Klaudia SiemińskaTeresa Olczak

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