Short- and long-term effects of small bowel resection: a unique histological study in a piglet model of short bowel syndrome.
If we are to develop successful interventions to improve clinical outcomes for short bowel syndrome patients we require (1) knowledge of changes within the epithelial population following small bowel resection (SBR) and (2) an idea of when these changes occur to inform on the timing of potential interventions aimed at enhancing the adaptive response. The aim of this study was to produce a temporal map of epithelial changes within the crypt and villus at early and late adaptation phases. Four-week-old piglets underwent a 75% SBR or sham operation and were studied at 2, 4 and 6 weeks post-operation to allow analysis of early and late adaptation responses. Piglets received polymeric infant formula (PIF). Immunohistochemistry with specific cell markers was used to quantitate intestinal cell types and the total cell numbers. Changes within the crypt were temporally dependent on an early significant increase in enterocytes and proliferative cells not sustained at 6 weeks. Goblet cell numbers were increased at all time points. Despite a significant increase in total villus cell numbers at 6 weeks there was no change in specific cell types. We observed two distinct phases of cellular change following SBR. An early increase in enterocytes and proliferative cells was not reflected in increased weight gain indicating the early increase represents immature enterocytes. Interventions aimed at increasing differentiation of the rapidly changing crypt population would allow for an earlier increase in absorption.
Intestinal Failure and Clinical Nutrition Group, Murdoch Children's Research Institute, 1st Floor, Gantry Building, Flemington Rd, Parkville, VIC 3052, Australia. prue.pereira@mcri.edu.au
Prue M
PM
Pereira-Fantini
Sarah L
SL
Thomas
Guineva
G
Wilson
Russell G
RG
Taylor
Magdy
M
Sourial
Julie E
JE
Bines
D000222:Adaptation, Physiological / Q000502:physiology; D000818:Animals; D004195:Disease Models, Animal; D020895:Enterocytes / Q000378:metabolism; D007413:Intestinal Mucosa / Q000378:metabolism*; D007421:Intestine, Small / Q000187:drug effects / Q000378:metabolism*; D012778:Short Bowel Syndrome / Q000473:pathology*; D013552:Swine; D013997:Time Factors
J Gastroenterol Hepatol. 2002 Nov;17(11):1170-9
12453276
Am J Clin Nutr. 2008 Dec;88(6):1552-9
19064515
Scand J Gastroenterol. 2000 Jul;35(7):719-25
10972175
Am J Physiol Gastrointest Liver Physiol. 2009 Mar;296(3):G490-8
19109406
Gastroenterology. 2009 Dec;137(6):2052-62
19737569
Am J Physiol Gastrointest Liver Physiol. 2000 Nov;279(5):G1003-10
11052998
Am J Physiol. 1996 Jan;270(1 Pt 1):G143-52
8772512
Pediatr Surg Int. 2002 May;18(4):258-63
12021975
Dig Dis Sci. 2004 Oct;49(10):1688-95
15573929
J Surg Res. 1996 Feb 1;60(2):370-4
8598671
Am J Physiol Gastrointest Liver Physiol. 2007 Jan;292(1):G215-22
16920699
J Pediatr Gastroenterol Nutr. 1997 Sep;25(3):327-31
9285386
J Pediatr Gastroenterol Nutr. 2004 Nov;39(5):487-92
15572887
Gastroenterology. 2007 Jun;132(7):2478-88
17570220
Biopharm Drug Dispos. 1995 Jul;16(5):351-80
8527686
JPEN J Parenter Enteral Nutr. 2008 May-Jun;32(3):266-75
18443138
BMC Nurs. 2005 Feb 01;4(1):2
15686591
J Pediatr Gastroenterol Nutr. 2008 Jan;46(1):20-8
18162829
Am J Physiol Gastrointest Liver Physiol. 2009 Jul;297(1):G124-34
19389805