Characterization of small bowel resection and intestinal adaptation in germ-free rats.
BACKGROUND
After massive small bowel resection (SBR), the remnant bowel adapts by increasing enterocyte proliferation and apoptosis. The purpose of this study was to investigate the relevance of luminal bacteria on postresection intestinal cell turnover.


METHODS
Male germ-free (GF) and normally colonized control rats underwent either a 75% mid-SBR or sham operation. In other experiments, normally colonized control rats were given antibiotics in the drinking water. After 7 days, the remnant ileum was harvested and adaptation verified by alterations in wet weight, crypt depth, and villus height. Proliferation and apoptosis were measured in crypts as the percent of crypt cells staining for Ki-67 or the number of apoptotic bodies per crypt.


RESULTS
Both GF and control rats demonstrated significant increases in all adaptive parameters. Proliferation was increased after SBR in both groups, but significantly greater in the GF animals over control. This response could not be recapitulated after antibiotic treatment. Apoptosis increased equally after SBR in all groups.


CONCLUSIONS
Resection-induced intestinal adaptation occurs normally in GF animals. Epithelial-microbial interactions are probably not involved in the activation of enterocyte apoptosis. The germ-free studies offer the possibility that luminal bacteria may attenuate the proliferative response of the enterocyte to massive small bowel resection.
Juno
Russell J
RJ
Division of Pediatric Surgery, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA.
Knott
Andrew W
AW
Jarboe
Marcus D
MD
Profitt
Sherri A
SA
Erwin
Christopher R
CR
Warner
Brad W
BW
D000222:Adaptation, Physiological; D000818:Animals; D000900:Anti-Bacterial Agents; D017209:Apoptosis; D002455:Cell Division; D004359:Drug Therapy, Combination / Q000494:pharmacology; D005856:Germ-Free Life; D007421:Intestine, Small / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*; D008297:Male; D051381:Rats; D017207:Rats, Sprague-Dawley; D013997:Time Factors
D000900:Anti-Bacterial Agents