Intestinal permeability before and after albendazole treatment in low and high socioeconomic status schoolchildren in Makassar, Indonesia

highly infected with parasitic helminths because of poor sanitation and limited access to clean water facilities3 . Untreated, STH infection can cause malnutrition, impaired growth and physical development2,4 . Elevated intestinal permeability, and therefore impaired barrier function, along with gut infammation and dysbiosis have been observed in various pathological conditions such as in stunting, obesity, and metabolic diseases5–8 . Te human intestine, which essentially allows absorptions of dietary products while maintaining a barrier function with selective permeability, prevents intrusion of pathogens or translocation of harmful products9 . Te intestinal lining is at the interface of interaction between helminths and protozoa that reside in the gastrointestinal tract and their human host and if damaged by parasites, could lead to poor barrier function and poor health outcomes. To quantify the intestinal permeability in vivo, assays can be used that utilise the absorptive properties of diferently sized carbohydrate probes5 . Te lactulose/mannitol ratio (LMR) is the most commonly used probe combination. As a result of increased intestinal permeability, bacterial products may be able to cross the barrier more easily and end up in the systemic circulation. Terefore, another way to characterize the intestinal perme ability is by looking at markers for bacterial translocation. Examples of these include lipopolysaccharide binding protein (LBP)6 . Compromised intestinal epithelial integrity and epithelial cell damage can also be assessed by measuring markers of intestinal injury such as intestinal-fatty acid binding protein (I-FABP)10. Previous studies in low to middle income countries, have shown a diference in gut permeability of children of high and low SES11. Although an association between helminth infections and increased intestinal permeability12 was found in another study, there was no confrmation of causality through treatment. In the current study, we assessed the association between socioeconomic status (SES), intestinal parasitic infections and markers of intes tinal barrier function. To this end, the presence of intestinal parasitic infections and the levels of LMR, I-FABP, and LBP were determined in schoolchildren of low- and high-SES, before and afer albendazole treatment. In addition, this population has been characterized for baseline gut microbiota to assess the efect of socioeconomic status13. Here, we assessed the alteration of the gut microbiota afer albendazole treatment to delineate any con tribution to intestinal permeability and barrier function.