Enteral feedback control of pancreatic hypertrophy: the role of pancreatic biliary secretions

Chronic diversion of pancreatic and biliary secretions away from the proximal small intestine resulted in rapid increases in pancreatic size and protein content in adult rats. The effect was detectable as early as 10 days postsurgery. Differential changes in pancreatic enzymes were evident after bypass. The concentration of trypsinogen remained stable while amylase concentrations showed a marked decrease. Total pancreatic trypsinogen content, however, was increased, while amylase content remained similar to controls. Feeding bypassed rats with chows containing various pancreatic and biliary supplements had no effect on the hyperplastic response of their pancreata. Trypsinogen and amylase levels in supplemented groups remained similar to the bypassed group fed nonsupplemented chow, with the exception of increases in trypsinogen concentration and content in the groups supplemented with bile and cotazyme plus bile acids. The adequacy of oral refeeding of pancreatic biliary components was supported by its effectiveness in restoring mucosal enterokinase activity and trypsin levels in segment 1. However, there was no correlation between tryptic activity in the contents of the bypassed segment and the eventual pancreatic weight. These results indicate that factors other than those supplemented in this study are required in maintaining the steady state of pancreatic growth in normal rats.     

Carbohydrate absorption in the rat small intestine following ligation of the bile duct

Active transport of free glucose, and glucose released from maltose and starch hydrolysis (F-, M-, and S-glucose, respectively) was investigated in vitro in the rat small intestine 7 and 14-17 days after the ligation of the common bile duct or after the laparotomy (control). The relative role of the ileum (its proximal portion in particular) in active transport of F- and M-glucose was enhanced following ligation of the common bile duct as compared with the control (laparotomy). The active transport of S-glucose was relatively low in the control and actually absent after the ligation of the common bile duct. The findings seem to reflect adaptive-compensatory responses of intestinal mucous membrane to insufficiency of the lumen digestion of carbohydrates due to exclusion of bile from the process.     

Effect of diversion of bile-pancreatic juice to the ileum on pancreatic secretion and adaptation in the rat

Cannulas were implanted to collect bile and pancreatic juice, and the collected secretions were pumped back into the intestine at the level of the duodenum or the proximal ileum. The effect of 6 days of such treatment on pancreatic secretion and on pancreatic growth was determined. The effect on pancreatic secretion was studied by measuring the pancreatic secretory response to a stimulus, provided by acute diversion of bile-pancreatic juice from the proximal intestine. Trophic effects were studied in a separate group of rats by measuring pancreatic weight, protein content, and chymotrypsin activity after an overnight fast. Stimulated pancreatic secretion was 2.1 times greater for protein output and 3.4 times greater for fluid output in rats with chronic diversion of bile-pancreatic juice to the ileum. Pancreatic weight, protein content, and chymotrypsin activity were increased 2.6, 2.9, and 4.8 times, respectively, by chronic diversion of bile-pancreatic juice to the ileum. These results indicate that pancreatic hypertrophy and hyperplasia reported in rats with bile-pancreatic duct transposition to the ileum are the result of loss of feed-back inhibition from bile-pancreatic juice in the proximal intestine.     

Endogenous cholecystokinin plays a role in down-regulation of pancreatic amylase independent of dietary carbohydrate in rats

The role of cholecystokinin (CCK) in the regulation of pancreatic amylase has not been fully clarified. We examined the effects of hyperCCKemia with chronic pancreatico-biliary diversion (PBD) and blockade of CCK(A)-receptor on rat pancreatic amylase activity and mRNA abundance. Also, we examined the relationship between diet and CCK in terms of regulation of pancreatic amylase. PBD was produced by transposition of the duodenal segment containing the ampulla of Vater to the upper ileum. A potent CCK(A)-receptor antagonist, devazepide, was injected (6 mg/kg body weight per day for 5 days) in the PBD rats fed with diets containing normal or low level of carbohydrate (695 or 345 g sucrose/kg diet). The specific activity and mRNA abundance of the pancreatic amylase were constantly lower 4, 10 and 28 days after PBD than those after the sham operation. Devazepide treatment completely restored the amylase activity lowered by PBD without any increases in amylase mRNA. Feeding a high-protein low-carbohydrate diet suppressed the pancreatic amylase activity and mRNA abundance in PBD rats to a similar degree in those treated, and those untreated, with devazepide. We conclude that endogenous CCK suppresses pancreatic amylase production, and we speculate that CCK reduced translational efficiency of amylase mRNA. The effect of CCK on amylase production is independent of regulation by dietary carbohydrate.     

Intestinal cholesterol esterase: intracellular enzyme or contamination of cytosol by pancreatic enzymes?

The location of cholesterol esterase in rabbit intestine was re-evaluated. In three different experiments that were designed to eliminate contaminating mucus and pancreatic enzymes from the lumen of the small intestine, it was observed that the activities of cholesterol esterase and amylase in intestinal cytosol and whole homogenate decreased in parallel fashion. After the mucus was carefully wiped from the intestinal mucosa prior to the preparation of cytosol, amylase and cholesterol esterase activities decreased sevenfold. The recovery of the total activity of both enzymes in the cytosol was approximately 15%. When the lumen of the small intestine was filled with phosphate buffer and incubated at 37 degrees C for 20 min, cholesterol esterase and amylase activities in the cytosol prepared from this segment were further decreased. Moreover, the activities of amylase and cholesterol esterase were completely recovered from the lumen. Amylase and cholesterol esterase activities in the cytosol were eliminated if dithiothreitol was used as a mucolytic agent to prepare intestinal mucosa for the isolation of intestinal cells. In whole homogenates prepared from these intestinal segments, approximately 10-15% of the total cholesterol esterase activity remained. This activity, which could not be accounted for by pancreatic contamination, was associated with intestinal nuclei and cellular debris. Progesterone, ethinyl estradiol, and 25-hydroxycholesterol regulated microsomal acyl CoA:cholesterol acyltransferase activity and caused similar directional changes in the rate of cholesteryl ester synthesis in isolated intestinal cells. These same sterols, however, failed to affect cytosolic cholesterol esterase activity in vitro.     

Ca2(+)-dependent glucose transport in chicken intestine

Transport of glucose was measured in the intestine of white leghorn layers in vivo using ligated upper small intestinal segment in the presence of Ca2+ and other ions either singly or in combination. Transport of glucose across the intestine was very significantly increased with Ca2+ than Na+, K+ and Po4(3-) individually, but when Ca2+ was combined with Na+, K+ and PO4(3-), the glucose absorption increased significantly over that achieved by Na+ ions alone. These data revealed that Ca2+ ions might be exerting the major influence on glucose transport processes of the chicken intestine.     

Glucose absorption by the interposed colon segment after intestinal resection.

One of the proposed surgical treatments of Short Bowel Syndrome is the interposition of a distal colon segment between two portions of the remnant small intestine. This method proved to reverse the nutritional disorders caused by this morbid entity. Surgical technique consisted in an 80% small bowel resection and the interposition of a 3 cm segment of distal colon between the remaining jejunum and ileum. After 70 days, the animals were reoperated and the interposed and the distal colon were isolated and tied. By using the method of rapid and successive absorptions of a glucose solution through the intestinal lumen, the relations between the absorption curves of the interposed and the normal colon could be drawn. Results show that the interposed colon segment absorbs more glucose (mean = 1.43 +/- 1.16 mg/dl) than the distal colon (mean = 0.37 +/- 0.29 mg/dl) and that its absorption pattern is similar to the small bowel rather than the colon. These results allow the use of this method for further studies in which the interposed colon adaptation is studied with other nutrients and/or under specific conditions.     

Luminal and systemic signals trigger intestinal adaptation in the juvenile python

Juvenile pythons undergo large rapid upregulation of intestinal mass and intestinal transporter activities upon feeding. Because it is also easy to do surgery on pythons and to maintain them in the laboratory, we used a python model to examine signals and agents for intestinal adaptation. We surgically isolated the middle third of the small intestine from enteric continuity, leaving its mesenteric nerve and vascular supply intact. Intestinal continuity was restored by an end-to-end anastomosis between the proximal and distal thirds. Within 24 h of the snake's feeding, the reanastomosed proximal and distal segments (receiving luminal nutrients) had upregulated amino acid and glucose uptakes by up to 15-fold, had doubled intestinal mass, and thereby soon achieved total nutrient uptake capacities equal to those of the normal fed full-length intestine. At this time, however, the isolated middle segment, receiving no luminal nutrients, experienced no changes from the fasted state in either nutrient uptakes or in morphology. By 3 days postfeeding, the isolated middle segment had upregulated nutrient uptakes to the same levels as the reanastomosed proximal and distal segments, but it still lacked any appreciable morphological response. These contrasting results for the reanastomosed intestine and for the isolated middle segment suggest that luminal nutrients and/or pancreatic biliary secretions are the agents triggering rapid upregulation of transporters and of intestinal mass and that systemic nerve or hormonal signals later trigger transporter regulation but no trophic response.     

Transmural Intestinal Wall Permeability in Severe Ischemia after Enteral Protease Inhibition

In intestinal ischemia, inflammatory mediators in the small intestine''s lumen such as food byproducts, bacteria, and digestive enzymes leak into the peritoneal space, lymph, and circulation, but the mechanisms by which the intestinal wall permeability initially increases are not well defined. We hypothesize that wall protease activity (independent of luminal proteases) and apoptosis contribute to the increased transmural permeability of the intestine''s wall in an acutely ischemic small intestine. To model intestinal ischemia, the proximal jejunum to the distal ileum in the rat was excised, the lumen was rapidly flushed with saline to remove luminal contents, sectioned into equal length segments, and filled with a tracer (fluorescein) in saline, glucose, or protease inhibitors. The transmural fluorescein transport was determined over 2 hours. Villi structure and epithelial junctional proteins were analyzed. After ischemia, there was increased transmural permeability, loss of villi structure, and destruction of epithelial proteins. Supplementation with luminal glucose preserved the epithelium and significantly attenuated permeability and villi damage. Matrix metalloproteinase (MMP) inhibitors (doxycycline, GM 6001), and serine protease inhibitor (tranexamic acid) in the lumen, significantly reduced the fluorescein transport compared to saline for 90 min of ischemia. Based on these results, we tested in an in-vivo model of hemorrhagic shock (90 min 30 mmHg, 3 hours observation) for intestinal lesion formation. Single enteral interventions (saline, glucose, tranexamic acid) did not prevent intestinal lesions, while the combination of enteral glucose and tranexamic acid prevented lesion formation after hemorrhagic shock. The results suggest that apoptotic and protease mediated breakdown cause increased permeability and damage to the intestinal wall. Metabolic support in the lumen of an ischemic intestine with glucose reduces the transport from the lumen across the wall and enteral proteolytic inhibition attenuates tissue breakdown. These combined interventions ameliorate lesion formation in the small intestine after hemorrhagic shock.     

Variations in enzyme activity in stomach and pancreatic tissue and digesta in piglets around weaning

A study was performed to investigate the effect of weaning at 4 weeks of age on the activity of digestive enzymes in the stomach and pancreatic tissue and in digesta from 3 days prior to weaning to 9 days postweaning in 64 piglets. In stomach tissue the activity of pepsin and gastric lipase was determined. Pepsin activity declined abruptly after weaning but 5 days postweaning the weaning level was regained and in the gastric contents no change in pepsin activity was observed. Weaning did not influence the activity of gastric lipase. The activity of eight enzymes and a cofactor was measured in pancreatic tissue. The effect of weaning on the enzyme activity was highly significant for all enzymes except elastase. The activity of all enzymes remained at the weaning level during day 1-2 postweaning followed by a reduction of the activity. The activity of trypsin, carboxypeptidase A, amylase and lipase exhibited minimum activity 5 days postweaning. Trypsin activity increased to the preweaning level on day 7-9 whereas the activity of the others increased but did not reach the preweaning level. The activity of chymotrypsin, carboxypeptidase B and carboxyl ester hydrolase decreased during the entire experimental period. In digesta no effect of weaning was observed on the activity of amylase and trypsin. The activity of chymotrypsin was reduced after weaning in the proximal third of the small intestine and lipase and carboxyl ester hydrolase activity was reduced in the middle and distal parts of the small intestine after weaning. The present study shows that the activities of the digestive enzymes in the pancreatic tissue are affected by weaning. Even though the pancreatic secretion cannot be judged from these results they show that the enzymes respond differently to weaning. In general the activity of the digestive enzymes in pancreatic tissue is low on day 5 postweaning which in interaction with other factors may increase the risk of developing postweaning diarrhoea.     

Variations in enzyme activity in stomach and pancreatic tissue and digesta in piglets around weaning

A study was performed to investigate the effect of weaning at 4 weeks of age on the activity of digestive enzymes in the stomach and pancreatic tissue and in digesta from 3 days prior to weaning to 9 days postweaning in 64 piglets. In stomach tissue the activity of pepsin and gastric lipase was determined. Pepsin activity declined abruptly after weaning but 5 days postweaning the weaning level was regained and in the gastric contents no change in pepsin activity was observed. Weaning did not influence the activity of gastric lipase. The activity of eight enzymes and a cofactor was measured in pancreatic tissue. The effect of weaning on the enzyme activity was highly significant for all enzymes except elastase. The activity of all enzymes remained at the weaning level during day 1–2 postweaning followed by a reduction of the activity. The activity of trypsin, carboxypeptidase A, amylase and lipase exhibited minimum activity 5 days postweaning. Trypsin activity increased to the preweaning level on day 7–9 whereas the activity of the others increased but did not reach the preweaning level. The activity of chymotrypsin, carboxypeptidase B and carboxyl ester hydrolase decreased during the entire experimental period. In digesta no effect of weaning was observed on the activity of amylase and trypsin. The activity of chymotrypsin was reduced after weaning in the proximal third of the small intestine and lipase and carboxyl ester hydrolase activity was reduced in the middle and distal parts of the small intestine after weaning. The present study shows that the activities of the digestive enzymes in the pancreatic tissue are affected by weaning. Even though the pancreatic secretion cannot be judged from these results they show that the enzymes respond differently to weaning. In general the activity of the digestive enzymes in pancreatic tissue is low on day 5 postweaning which in interaction with other factors may increase the risk of developing postweaning diarrhoea.     

A new model of chronic pancreatitis in rats

This study was designed to examine whether continuous pancreatic ductal hypertension (PDH) plays an important role in the onset and development of chronic pancreatitis (CP). Pancreatic, biliary, and duodenal cannulas were implanted in male Wistar rats. PDH was induced by vertically raising the free end of the pancreatic duct cannula to exert a hydrostatic pressure and maintained for 2 wk. PDH was gradually increased, but when the pancreatic juice (PJ) flow was interrupted, PDH was decreased to restore PJ flow. The induction of PDH resulted in a marked reduction of amylase activity in PJ and an increase in serum amylase activity. At 2 wk after persistent PDH, pancreatic exocrine function was markedly decreased in response to a bolus injection of secretin (100 pmol/kg) compared with the control group. Histological examination revealed interlobular as well as intralobular fibrosis in the form of nodular pancreatitis at 2 wk after the induction of PDH. Immunohistochemistry revealed the expression of fibronectin and collagen types I and III. Quantitative real-time RT-PCR showed an increase in transforming growth factor-beta(1) mRNA expression in the pancreas during PDH. The present results suggest that PDH plays an important role in the onset and development of CP. Furthermore, our animal model seems useful for investigating the mechanisms of CP in rats.     

急性冷胁迫对中华鳖幼鳖肠道黏膜组织的影响

为了探究急性冷胁迫对中华鳖(Pelodiscus sinensis)幼鳖肠道不同区段黏膜组织学特征的影响, 实验检测了急性冷胁迫前后血清二胺氧化酶(Diamine oxidase, DAO)的活性, 同时观察了急性冷胁迫前后中华鳖肠道黏膜的相关组织形态的差异。DAO活性显示: (1)在第一次急性冷胁迫实验中, 中华鳖血清DAO活性随急性冷胁迫时间的增加而呈现降低趋势, 并在冷胁迫到达48h降到了最低水平; (2)在急性冷胁迫及复温实验中, 中华鳖血清DAO的活性, 在冷胁迫3d后显著降低, 但随着温度的恢复, DAO活性又恢复到正常水平。组织病理结果显示: (1)急性冷胁迫对中华鳖肠道(回肠后段和大肠)黏膜上皮的形态没有明显影响; (2)急性冷胁迫对回肠后段的杯状细胞数目、肠绒毛长度和绒毛长度/隐窝深度的比值没有显著影响, 但会使回肠后段黏膜厚度显著降低; (3)急性冷胁迫会使大肠的杯状细胞数目降低。这表明急性冷胁迫会改变中华鳖肠道黏膜的结构, 但在不同的肠段, 这种改变是不同的。回肠后段和大肠在同样的冷胁迫方式下黏膜机械屏障的不同变化情况, 提示中华鳖肠道各段对急性冷胁迫具有特殊的应对方式。     

The effects of insulin on glucose and fluid transport in the isolated small intestine of normal rats

Chronically administered insulin returns enhanced maximal glucose transport capacity induced by diabetes to its normal state. In this study, the direct and acute effects of insulin on glucose transport in different parts of isolated small intestine were investigated. Mucosal Fluid Transport (MFT), Mucosal Glucose Transport (MGT) and Serosal Glucose Transport (SGT) were measured in the presence and absence of insulin in averted sacs, prepared from female Wistar rats. This study shows that the presence of insulin in vitro (40 and 80 microU/mL) can reduce MGT and SGT in different segments of the small intestine (duodenum, jejunum and ileum) after 30 min whereas it had no effect on MFT. Mucosal glucose transfer rates in the duodenum, jejunum and ileum of the controls were 6.07+/-0.4, 6.34+/-0.62 and 6.43+/-0.47 mg/g tissue respectively which were significantly reduced to 3.82+/-0.93, 3.60+/-0.50 and 1.17+/-0.45 in the presence of 80 microU/mL of insulin. Serosal glucose transfer too was decreased significantly from 0.3+/-0.05, 0.57+/-0.07 and 0.43+/-.07 in the duodenum, jejunum and ileum to 0.16+/-0.03, 0.16+/-0.04 and .07+/-.02 respectively. Mucosal fluid transfer was not affected by insulin. Insulin was as effective whether it was added on the mucosal or the serosal side. The results of this study show that insulin can directly affect glucose transport in the small intestine; its physiological role must be examined. Direct effect of insulin deficiency on glucose absorption in diabetic patients may play a role in the pathophysiology of the disease.     

Milk protein digestion and lysosomal proteinases of the ileal mucosa in young rats]

The proteolytic activity of lysosomal and pancreatic proteinases was studied in the chyme and tissue homogenates of the jejunum and ileum of 12- and 30-day rats in order to elucidate whether lysosomal proteinases of the mucous membrane of the ileum participate in cavitary digestion. During milk feeding the proteolytic activity of acid (lysosomal) proteinases in the ileum was 3 times greater than in the jejunum, which has been demonstrated both for the mucous membrane and the contents of these parts of the small intestine. In rats on definitive nutrition the activity of acid proteinases from the jejunum and ileum remained almost unchanged both in the mucous membrane and in the contents. The data obtained also indicate that pancreatic proteinase absorbed from the chyme of the small intestine may participate in parietal digestion.     

Pancreolauryl test, glucose tolerance test and endoscopic retrograde cholangiopancreatography in the diagnosis and monitoring of chronic pancreatitis

Fifteen patients with chronic pancreatitis were qualified for surgical treatment on the basis of the results of endoscopic retrograde cholangiopancreatography, pancreolauryl test and glucose tolerance test. Significant changes according to Cambridge scale correlated with exocrine-endocrine pancreatic failure. In patients with Wirsung duct of diameter above 6 mm Puestow operation was performed while in patients with narrow Wirsung duct resection procedures were carried out. Control examinations carried out one year after Puestow operation demonstrated in all 10 patients lack of improvement both in the exocrine and endocrine pancreatic function. In 70% of the patients after anastomotic operation and in 80% of the patients after resections, complete regression of preoperative pain was observed.     

Ontogeny of d-Mannose Transport and Metabolism in Rat Small Intestine

Oral mannose therapy is used to treat congenital disorders of glycosylation caused by a deficiency in phosphomannose isomerase. The segmental distribution and ontogenic regulation of d-mannose transport, phosphomannose isomerase, and phosphomannose mutase is investigated in the small intestine of fetuses, newborn, suckling, 1-month-old, and adult rats. The small intestine transports d-mannose by both Na⁺-dependent and Na⁺-independent transport mechanisms. The activities of both systems normalized to intestinal weight peak at birth and thereafter they decreased. In all the ages tested, the activity of the Na⁺-independent mechanism was higher than that of the Na⁺/mannose transport system. At birth, the Na⁺-independent d-mannose transport in the ileum was significantly higher than that in jejunum. Phosphomannose isomerase activity and mRNA levels increased at 1 month, and the values in the ileum were lower than in jejunum. Phosphomannose mutase activity in jejunum increased during the early stages of life, and it decreased at 1 month old, as does the amount of mannose incorporated into glycoproteins, whereas in the ileum, they were not affected by age. The phosphomannose isomerase/phosphomannose mutase activity ratio decreased at birth and during the suckling period, and increased at 1 month old. In conclusion, intestinal d-mannose transport activity and metabolism were affected by ontogeny and intestinal segment.     

Aboral changes in D-glucose transport by human intestinal brush-border membrane vesicles.

D-Glucose transport was investigated in isolated brush-border membrane vesicles from human small intestine. Characteristics of D-glucose transport from the jejunum were compared with that in the mid and terminal ileum. Jejunal and mid-ileal D-glucose transport was Na+-dependent and electrogenic. The transient overshoot of jejunal D-glucose transport was significantly greater than corresponding values in mid-ileum. The terminal ileum did not exhibit Na+-dependent D-glucose transport, but did exhibit Na+-dependent taurocholate transport. Na+-glucose co-transport activity as measured by tracer-exchange experiments was greatest in the jejunum, and diminished aborally. We conclude that D-glucose transport in man is Na+-dependent and electrogenic in the proximal intestine and directly related to the activity of D-glucose-Na+ transporters present in the brush-border membranes. D-Glucose transport in the terminal ileum resembles colonic transport of D-glucose.     

Nippostrongylus brasiliensis: malabsorption in experimentally infected rats

Glucose absorption and net small intestinal water movement were examined in rats infected with Nippostrongylus brasiliensis at Days 4, 6, 9, 13, and 19 after inoculation. Rats were infected with 4 X 10(3) N. brasiliensis third stage larvae. The entire small intestine was divided into three segments and each segment perfused simultaneously in vivo with Krebs-Ringer phosphate buffer containing 80 mM glucose, 6 X 10(5) dpm/ml [3H]glucose, and 6.2 X 10(3) dpm/ml [14C]polyethylene glycol. Rats perfused on Days 6, 9, 13, and 19 after inoculation showed a significant (P less than 0.05) decrease in glucose absorption rates from all three segments of the small intestine when compared to uninfected controls. In the three segments of uninfected rat small intestine and those perfused on Days 4, 13, and 19 after inoculation, net absorption of water occurred. However, in the proximal and distal segments perfused on Day 6 and the proximal segment perfused on Day 9, net water movement into the lumen occurred. This is the first report of depressed glucose absorption along the entire length of the small intestine during nippostrongylosis and contradicts previous reports of unaltered net glucose absorption in response to this parasite.     

Activity of "nonspecific pancreatic carboxylesterase" in rat serum in experimentally induced acute pancreatitis (preliminary results)

The aim of this study was to obtain more information on the serum level of "nonspecific pancreatic carboxylesterase" (PCE) in experimentally induced acute pancreatitis in rats. The effects of caerulein stimulation, hepatic duct ligation, bile-pancreatic duct ligation or the effect of retrograde injection of saline, 5% taurocholate and sunflower oil were investigated. The activity of PCE and amylase was measured in the serum, pancreatic tissue, pancreatic juice and ascitic fluid. The changes in PCE activity were greater (both in directions to increase or decrease) than that of amylase, produced by different experimental procedures. The results confirm the thesis that the serum activity of PCE is a more sensitive diagnostic method than that of amylase to detect the inflammatory process in the pancreas or the effect of obstruction of the pancreatic duct.