title: Effects of transection and extrinsic denervation and a model of autotransplantation of the porcine jejunoileum on cholesterol biodynamics.
abstract: OBJECTIVE
  Small bowel transplantation impairs enteric function, necessitating transection, extrinsic denervation, and ischemia-reperfusion of the small intestine. The authors investigated how each of these nonimmunologic insides of the transplantation procedure modulates biodynamics of cholesterol and absorption of lipids.
  
  
  METHODS
  Twenty-three pigs with similar food, cholesterol, and fat intake underwent sham laparotomy (group 1), transection (group 2), extrinsic jejunoileal denervation (group 3), or a model of autotransplantation, including extrinsic jejunoileal denervation with in situ ischemia-reperfusion (group 4). Serum lipids, absorption, and excretion of cholesterol, bile acids, and fat were determined after 8 weeks. Plasma cholesterol precursors and plant sterols, respective markers of cholesterol synthesis, and absorption, were measured after 2 and 8 weeks.
  
  
  RESULTS
  When compared with sham laparotomy and transection groups, denervation and autotransplantation significantly decreased weight gain and increased plasma cholesterol precursors and fecal excretion of bile acids. In relation to sham operated animals, transection alone modestly increased plasma plant sterols at 2 weeks and biliary secretion and mass absorption of cholesterol. The latter changes were not observed after denervation or autotransplantation, ie, fractional and total absorption of cholesterol were significantly decreased in autotransplanted pigs when compared with transected controls. As compared with all the other groups, autotransplantation significantly increased bacterial metabolites of neutral sterols in feces and net fecal elimination of cholesterol, mainly as bile acids.
  
  
  CONCLUSIONS
  Extrinsic autonomic denervation of the jejunoileum, with or without synchronous ischemia-reperfusion, results in increased cholesterol synthesis, bile acid malabsorption, and decreased weight gain. Cholesterol malabsorption may develop gradually after intestinal autotransplantation, and even a short period of ischemia further impairs absorptive function of the denervated jejunoileum, resulting in increased fecal elimination of cholesterol mainly as bile acids.
authors: Department of Pediatric Surgery, Children's Hospital, University of Helsinki, Helsinki, Finland.
authors: Mikko P
authors: MP
authors: Pakarinen
authors: Paula
authors: P
authors: Pirinen
authors: Jouni
authors: J
authors: Lauronen
authors: Peter
authors: P
authors: Raivio
authors: Pekka
authors: P
authors: Kuusanmäki
authors: Jorma
authors: J
authors: Halttunen
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D017763:Autonomic Denervation; D001647:Bile Acids and Salts / Q000378:metabolism; D002784:Cholesterol / Q000031:analogs & derivatives / Q000096:biosynthesis* / Q000097:blood; D002791:Cholesterol, Dietary / Q000493:pharmacokinetics*; D005243:Feces / Q000737:chemistry; D005260:Female; D007082:Ileum / Q000098:blood supply / Q000294:innervation / Q000378:metabolism / Q000637:transplantation*; D007408:Intestinal Absorption; D007511:Ischemia / Q000378:metabolism; D007583:Jejunum / Q000098:blood supply / Q000294:innervation / Q000378:metabolism / Q000637:transplantation*; D008286:Malabsorption Syndromes / Q000209:etiology* / Q000378:metabolism; D023421:Models, Animal; D010840:Phytosterols / Q000493:pharmacokinetics; D015427:Reperfusion Injury / Q000378:metabolism; D013552:Swine; D014182:Transplantation, Autologous / Q000009:adverse effects; D015430:Weight Gain
chemical_list: D001647:Bile Acids and Salts; D002791:Cholesterol, Dietary; D010840:Phytosterols; C001521:lathosterol; D002784:Cholesterol