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The hypothesis behind the LMR is that the smaller mannitol (6.7 Γ ) can pass via the pore pathway and can be considered as a marker for the total small intestinal surface, while the larger disaccharide lactulose (9.5 Γ ) will only pass the larger pores of the leak pathway in the crypt region and at sites where the barrier is damaged ( ex vivo in Ussing chambers, the difference is much less pronounced with a LMR of ~0.8 ex vivo vs
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