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13C-mannitol is a stable isotope-labeled form of the monosaccharide mannitol, primarily utilized as a diagnostic probe in the assessment of intestinal permeability (IP). In clinical and research settings, it is often administered orally in conjunction with a larger molecule, such as lactulose, to determine the lactulose-to-mannitol ratio (LMR), a key indicator of mucosal barrier function or "leaky gut." The use of the 13C isotope is critical because it allows for precise quantification via high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS), thereby distinguishing the administered probe from 12C-mannitol naturally present in the diet or commercial products. This diagnostic tool is particularly valuable for monitoring disease activity and barrier integrity in patients with inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, where increased permeability often persists even during clinical remission.
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