Ultrastructural characteristics of distal duodenum mucosa in patients with cirrhosis.
OBJECTIVE
Morphological abnormalities observed by light microscopy, such as oedema or vasodilatation, have been described in intestinal mucosa of patients with cirrhosis, but no information is available regarding the ultrastructural characteristics of the intestinal epithelial layer. The aim of this observational study was to investigate the ultrastructural characteristics of the intestinal epithelial layer of duodenum mucosa in patients with cirrhosis.


METHODS
Six patients with advanced cirrhosis and six control patients without liver disease were included in the study. Biopsies were obtained from the distal duodenum during upper diagnostic endoscopy, and ultrastructural characteristics were studied by means of electron microscopy.


RESULTS
A distended interenterocyte space with intestinal epithelial cells closely attached by morphologically intact tight junctions has been observed in cirrhotic patients, together with shorter and wider microvilli than in the control subjects.


CONCLUSIONS
The epithelial layers from cirrhotic patients show ultrastructural abnormalities. However, it is not known if the observed alterations are related to the presence of increased intestinal permeability or to bacterial translocation, which are frequently found in these patients.
Such
José
J
Liver Unit, University General Hospital of Alicante, Miguel Hernández University, 03010 Alicante, Spain. such_jos@gva.es
Guardiola
José V
JV
de Juan
Joaquín
J
Casellas
Juan A
JA
Pascual
Sonia
S
Aparicio
José R
JR
Solá-Vera
Javier
J
Pérez-Mateo
Miguel
M
D000328:Adult; D000368:Aged; D004386:Duodenum / Q000648:ultrastructure*; D020895:Enterocytes / Q000648:ultrastructure; D004848:Epithelium / Q000648:ultrastructure; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000648:ultrastructure*; D008103:Liver Cirrhosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D019108:Tight Junctions / Q000648:ultrastructure