title: Mucosal changes induced by ischemia-reperfusion injury in a jejunal loop transplanted in oropharynx.
abstract: Tissues exposed to ischemia and reperfusion develop an inflammatory response. We investigate the morphological and immunological changes occurring in the mucosa of a jejunal loop transplanted in the oropharynx of a man undergoing circular pharyngolaryngectomy. Jejunal biopsies were collected during the transplantation procedures (cold and warm ischemia, reperfusion), during the 7 post-operative days through an exteriorized jejunal segment for flap monitoring, and 45 days after transplantation through an upper endoscopy. Matrix metalloproteinase (MMP)-3 and MMP-12 increase was accompanied by a parallel rise in apoptotic enterocytes, and by a concomitant reduction of surface area to volume ratio and enterocyte height. Goblet cell hyperplasia is coupled with Paneth cell disappearance at the crypt base. CD8-positive intraepithelial lymphocytes initially decrease, then they increase in accordance with the peak of enterocyte apoptosis. We identified alterations in lymphocyte infiltration, mucosal architecture and epithelial cell turnover, which may give a window to mechanisms of small bowel ischemia-reperfusion in humans.
authors.affiliation: First Department of Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Piazzale Golgi 19, 27100, Pavia, Italy. a.disabatino@smatteo.pv.it
authors.forename: Antonio
authors.initials: A
authors.lastname: Di Sabatino
authors.forename: Laura
authors.initials: L
authors.lastname: Brunetti
authors.forename: Paolo
authors.initials: P
authors.lastname: Biancheri
authors.forename: Rachele
authors.initials: R
authors.lastname: Ciccocioppo
authors.forename: Marco
authors.initials: M
authors.lastname: Guerci
authors.forename: Claudia
authors.initials: C
authors.lastname: Casella
authors.forename: Francesca
authors.initials: F
authors.lastname: Vidali
authors.forename: Thomas T
authors.initials: TT
authors.lastname: MacDonald
authors.forename: Marco
authors.initials: M
authors.lastname: Benazzo
authors.forename: Gino R
authors.initials: GR
authors.lastname: Corazza
mesh_terms: D000714:Anastomosis, Surgical; D017209:Apoptosis; D015153:Blotting, Western; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D049109:Cell Proliferation; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007413:Intestinal Mucosa / Q000098:blood supply / Q000473:pathology; D007583:Jejunum / Q000098:blood supply / Q000637:transplantation*; D007825:Laryngectomy; D008875:Middle Aged; D010610:Pharyngeal Neoplasms / Q000601:surgery*; D010611:Pharyngectomy; D056144:Pyriform Sinus / Q000601:surgery*; D019651:Plastic Surgery Procedures; D015427:Reperfusion Injury / Q000473:pathology*; D013524:Surgical Flaps / Q000098:blood supply; D013536:Suture Techniques