Time-dependent intestinal adaptation and GLP-2 alterations after small bowel resection in rats

Existing data on morphological adaptation after small bowel resection are obtained by potentially biased methods. Using stereological techniques, we examined segments of bowel on days 0, 4, 7, 14, and 28 after 80% jejunoileal resection or sham operation in rats and correlated intestinal growth with plasma levels of glucagon-like peptide-2 (GLP-2). In the jejunum and ileum of the resected rats, the mucosal weight increased by 120 and 115% during the first week, and the weight of muscular layer increased by 134 and 83%, compared with sham-operated controls. The luminal surface area increased by 190% in the jejunum and by 155% in the ileum after 28 days. The GLP-2 level was increased by 130% during the entire study period in the resected rats. Small bowel resection caused a pronounced and persistent transmural growth response in the remaining small bowel, with the most prominent growth occurring in the jejunal part. The significantly elevated GLP-2 level is consistent with an important role of GLP-2 in the adaptive response.     

Methane, a gas produced by enteric bacteria, slows intestinal transit and augments small intestinal contractile activity

The presence of methane on lactulose breath test among irritable bowel syndrome (IBS) subjects is highly associated with the constipation-predominant form. Therefore, we set out to determine whether methane gas can alter small intestinal motor function. In dogs, small intestinal fistulae were created to permit measurement of intestinal transit. Using a radiolabel, we evaluated transit during infusion of room air and subsequently methane. In this model, small intestinal infusion of methane produced a slowing of transit in all dogs by an average of 59%. In a second experiment, guinea pig ileum was pinned into an organ bath for the study of contractile activity in response to brush strokes applied to the mucosa. The force of contraction was measured both orad and aborad to the stimulus. The experiment was repeated while the bath was gassed with methane. Contractile activities orad and aborad to the stimulus were significantly augmented by methane compared with room air (P < 0.05). In a third experiment, humans with IBS who had undergone a small bowel motility study were compared such that subjects who produced methane on lactulose breath test were compared with those producing hydrogen. The motility index was significantly higher in methane-producing IBS patients (1,851 +/- 861) compared with hydrogen producers (1,199 +/- 301) (P < 0.05). Therefore, methane, a gaseous by-product of intestinal bacteria, slows small intestinal transit and appears to do so by augmenting small bowel contractile activity.     

PDGF-α stimulates intestinal epithelial cell turnover after massive small bowel resection in a rat

Numerous cytokines have been shown to affect epithelial cell differentiation and proliferation through epithelial-mesenchymal interaction. Growing evidence suggests that platelet-derived growth factor (PDGF) signaling is an important mediator of these interactions. The purpose of this study was to evaluate the effect of PDGF-α on enterocyte turnover in a rat model of short bowel syndrome (SBS). Male rats were divided into four groups: Sham rats underwent bowel transection, Sham-PDGF-α rats underwent bowel transection and were treated with PDGF-α, SBS rats underwent a 75% bowel resection, and SBS-PDGF-α rats underwent bowel resection and were treated with PDGF-α. Parameters of intestinal adaptation, enterocyte proliferation and apoptosis were determined at euthanasia. Illumina's Digital Gene Expression analysis was used to determine PDGF-related gene expression profiling. PDGF-α and PDGF-α receptor (PDGFR-α) expression was determined by real-time PCR. Western blotting was used to determine p-ERK, Akt1/2/3, bax, and bcl-2 protein levels. SBS rats demonstrated a significant increase in PDGF-α and PDGFR-α expression in jejunum and ileum compared with sham animals. SBS-PDGF-α rats demonstrated a significant increase in bowel and mucosal weight, villus height, and crypt depth in jejunum and ileum compared with SBS animals. PDGF-α receptor expression in crypts increased in SBS rats (vs. sham) and was accompanied by an increased cell proliferation following PDGF-α administration. A significant decrease in cell apoptosis in this group was correlated with lower bax protein levels. In conclusion, in a rat model of SBS, PDGF-α stimulates enterocyte turnover, which is correlated with upregulated PDGF-α receptor expression in the remaining small intestine.     

Growth and morphological changes in the small and the large intestine in piglets during the first three days after birth.

Growth and morphological changes in the small and the large intestine of piglets were examined during the first three days after birth. There was a 72% increase in small intestinal weight, virtually all of which occurred during the first day and was due primarily to a 115% increase in the weight of the mucosa. Associated with the tissue weight gain there was a 24% increase in small intestinal length, a 15% increase in small intestinal diameter, a 33-90% increase in villus height and a 14-51% increase in villus diameter, during the first day. The cellular population in the small intestinal mucosa, as indicated by its DNA content, increased progressively with age, and at three days had increased by 84-154%. The percentage increase in mucosal DNA content was highest in the duodenum, intermediate in the jejunum and lowest in the ileum. Histological features and tissue protein contents revealed a transient epithelial cellular swelling related to intracellular accumulation of protein on the first day. Protein accumulation was evident in the jejunum and ileum but not in the duodenum. The positions of the nuclei in the epithelial cells suggested that on the first day protein absorption was at a more advanced stage in the jejunum and the proximal ileum than in the distal ileum. Large intestinal weight increased by 33% during the first day and had doubled by the third day, and this weight gain was due to both mucosal and non-mucosal tissue growth. Villus-like structures were observed in the caecum and the proximal colon in piglets at birth and one day after birth but not in piglets three days after birth. It is speculated that such villus-like structures may have a functional significance during the transition to complete dependence on oral nutrition in newborns.     

3-Hydroxy-3-methylglutaryl coenzyme A reductase activity in the human gastrointestinal tract

Activity of 3-hydroxy-3-methylglutaryl coenzyme A reductase (EC 1.1.1.34) was measured in intestinal mucosa of the human gastrointestinal tract. Activity was highest in gastric mucosa (18.2 pmol per mg per min) and there was a constant low level in the small bowel and colon (approximately 10 pmol per mg per min). Phosphorylation/dephosphorylation modulation of intestinal reductase activity was demonstrated in normal mucosa. Expressed jejunal reductase activity was significantly higher in celiac sprue mucosa and mucosa from defunctionalized intestine of jejunoileal bypass patients. Enzyme activity also increased during 24-hr mucosal organ culture in the absence of exogenous cholesterol. Addition to the culture medium of pure cholesterol or 25-hydroxycholesterol dissolved in a small volume of ethanol suppressed the culture-induced increase to 86 +/- 3% and 69 +/- 5% of paired controls, respectively. This evidence suggests that a moderate degree of feedback regulation of intestinal cholesterol synthesis by luminal sterol occurs in man. Mucosal HMG-CoA reductase activity was also measured in patients with hyperlipoproteinemia. Patients with either predominant hypercholesterolemia or predominant hypertriglyceridemia lipid profiles had "normal" expressed reductase activity, but feedback regulation by free cholesterol could not be demonstrated in either group under these conditions.     

Intestinal adaptation to zinc absorption following massive small bowel resection and colon interposition in rhesus monkeys

The intestinal uptake of zinc was studied in Rhesus monkeys, after 80% small bowel resection and colon interposition in between the remnant jejunum and the ileum. The hair and serum zinc levels decreased in the early postoperative period and gradually attained normal values after three months postoperatively. A significant increase in the zinc uptake was observed in vitro, in the remnant jejunum, ileum and the grafted colon, both in six months and one year old operated monkeys, suggesting a compensatory intestinal adaptation for zinc absorption after massive small bowel resection and antiperistaltic colon interposition.     

The effect of jejunectomy on alkaline phosphatase activity in the ileum

The activity of alkaline phosphatase activity in the small intestinal wall was studied in dogs after jejunectomy. The observations were made 3, 6, 8 or 9 and 12 weeks after operation. The studies aimed to obtain some information about the functional adaptation processes of the remaining intestinal segments. The enzyme activity in homogenates of duodenal and ileal mucosa was determined. Parallel interferometric measurements in the brush border and on the surface of the absorptive cells were performed. The results obtained indicate that after temporary reduction (especially 6 weeks postoperatively) a gradual rise of the alkaline phosphatase activity both in homogenates and in the brush border of the intestinal remnants took place. Several times repeated biopsies confirmed the ability of the intestinal segments (duodenum and distal ileum) significant increase in enzyme activity over the normal (control) level was observed.     

Assessing the survival of transgenic plant DNA in the human gastrointestinal tract

The inclusion of genetically modified (GM) plants in the human diet has raised concerns about the possible transfer of transgenes from GM plants to intestinal microflora and enterocytes. The persistence in the human gut of DNA from dietary GM plants is unknown. Here we study the survival of the transgene epsps from GM soya in the small intestine of human ileostomists (i.e., individuals in which the terminal ileum is resected and digesta are diverted from the body via a stoma to a colostomy bag). The amount of transgene that survived passage through the small bowel varied among individuals, with a maximum of 3.7% recovered at the stoma of one individual. The transgene did not survive passage through the intact gastrointestinal tract of human subjects fed GM soya. Three of seven ileostomists showed evidence of low-frequency gene transfer from GM soya to the microflora of the small bowel before their involvement in these experiments. As this low level of epsps in the intestinal microflora did not increase after consumption of the meal containing GM soya, we conclude that gene transfer did not occur during the feeding experiment.     

Role of luminal nutrients and endogenous GLP-2 in intestinal adaptation to mid-small bowel resection

To elucidate the role of luminal nutrients and glucagon-like peptide-2 (GLP-2) in intestinal adaptation, rats were subjected to 70% midjejunoileal resection or ileal transection and were maintained with total parenteral nutrition (TPN) or oral feeding. TPN rats showed small bowel mucosal hyperplasia at 8 h through 7 days after resection, demonstrating that exogenous luminal nutrients are not essential for resection-induced adaptation when residual ileum and colon are present. Increased enterocyte proliferation was a stronger determinant of resection-induced mucosal growth in orally fed animals, whereas decreased apoptosis showed a greater effect in TPN animals. Resection induced significant transient increases in plasma bioactive GLP-2 during TPN, whereas resection induced sustained increases in plasma GLP-2 during oral feeding. Resection-induced adaptive growth in TPN and orally fed rats was associated with a significant positive correlation between increases in plasma bioactive GLP-2 and proglucagon mRNA expression in the colon of TPN rats and ileum of orally fed rats. These data support a significant role for endogenous GLP-2 in the adaptive response to mid-small bowel resection in both TPN and orally fed rats.     

Vagal afferents are essential for maximal resection-induced intestinal adaptive growth in orally fed rats

Small bowel resection stimulates intestinal adaptive growth by a neuroendocrine process thought to involve both sympathetic and parasympathetic innervation and enterotrophic hormones such as glucagon-like peptide-2 (GLP-2). We investigated whether capsaicin-sensitive vagal afferent neurons are essential for maximal resection-induced intestinal growth. Rats received systemic or perivagal capsaicin or ganglionectomy before 70% midjejunoileal resection or transection and were fed orally or by total parenteral nutrition (TPN) for 7 days after surgery. Growth of residual bowel was assessed by changes in mucosal mass, protein, DNA, and histology. Both systemic and perivagal capsaicin significantly attenuated by 48-100% resection-induced increases in ileal mucosal mass, protein, and DNA in rats fed orally. Villus height was significantly reduced in resected rats given capsaicin compared with vehicle. Sucrase specific activity in jejunal mucosa was not significantly different; ileal mucosal sucrase specific activity was significantly increased by resection in capsaicin-treated rats. Capsaicin did not alter the 57% increase in ileal proglucagon mRNA or the 150% increase in plasma concentration of bioactive GLP-2 resulting from resection in orally fed rats. Ablation of spinal/splanchnic innervation by ganglionectomy failed to attenuate resection-induced adaptive growth. In TPN rats, capsaicin did not attenuate resection-induced mucosal growth. We conclude that vagal afferents are not essential for GLP-2 secretion when the ileum has direct contact with luminal nutrients after resection. In summary, vagal afferent neurons are essential for maximal resection-induced intestinal adaptation through a mechanism that appears to involve stimulation by luminal nutrients.     

Potential role of the membrane in the development of intestinal cellular damage after whole-body gamma irradiation of the rat

Our study emphasizes the effect of gamma irradiation on intestinal cell membrane fluidity and addresses the potential relationships existing between radiation-induced lipoperoxidation, membrane fluidity, and changes in membrane protein activities. Male Wistar rats were exposed to an 8-Gy total body irradiation (60Co source) and studied 1, 4, and 7 days after irradiation (D1, D4, and D7). Membrane enzyme activities and fluorescence anisotropy were determined on small intestinal crude membrane preparations. The supernatants of membrane preparations as well as plasma were used for malonedialdehyde (MDA) quantification. The effect of carbamylcholine on electrical parameters was estimated on distal ileum placed in Ussing chambers. We observed a decrease in fluorescence anisotropy for at least 7 days, an increase in membrane production of MDA at D4, a decrease in membrane enzyme activities at D4, but an amplification of carbamylcholine-induced increase in short-circuit current at D4 and D7. Furthermore, correlations were observed between the 1,6-diphenyl-1,3,5-hexatriene anisotropy coefficient and sucrase activity and between MDA levels and leucine aminopeptidase activity. Thus, total body irradiation induces changes in intestinal membrane fluidity and an increase in lipoperoxidation. These modifications may have an impact on the activity of membrane proteins involved in intestinal function.     

Relationship between the spike activities of the small and large intestines

Experiments were performed using chronically implanted electrodes on the dog smooth muscle wall of the stomach and of the small and large intestines. Electrical activity of the muscle wall was recorded before and after feeding. When reaching the terminal ileum the active part of the migrating myoelectrical complex (MMC) continuously induced bursts of spike potentials superimposed on the slow waves. This electrical activity spread to the ascending colon. We also showed the existence of a spike activity on the terminal ileum independent of the MMC (appearing during the phase 1) and propagating to the colon. A relationship between the spike activities of the small and large intestines was also present after feeding. Beside the well-known gastro-colic reflex, we observed an increase in the spike activity of the terminal ileum and ascending colon between the 4th-5th hours after feeding. This probably corresponds to the arrival of the first portions of contents, evacuated from the arrival of the first portions of contents, evacuated from the stomach, and of the last portions of small intestinal contents. In conclusion, there is a relationship between the spike activities of the small and large intestines in starving animals and after feeding, and the terminal ileum plays a substantial role in this relationship.     

Effect of clofibrate on the small intestine of fetal mice

Pregnant Swiss ICR mice were injected with clofibrate at different dosages and time intervals, and embryos were removed either at 17 or 18 days of gestation. In embryos sacrificed at 17 days the level of intestinal catalase activity of the proximal and distal halves in the treated groups is identical in any case to that of the controls. In embryos sacrificed at 18 days, the rise in the level of catalase activity in the proximal half of the small intestine in treated groups is dose dependent up to a certain limit: with repeated injections the increase reaches a plateau. The distal halves of treated groups are much less responsive and an increase in catalase activity was noted only with repeated injections. In untreated embryos circular DAB-positive microperoxisomes (200 nm in diameter) and tubular structures (100 nm in thickness) are seen in the duodenum at 18 days of gestation. At the same stage, only circular microperoxisomes are identified in the ileum. After clofibrate treatment circular and tubular microperoxisomes are observed in the ileum also. It is concluded that clofibrate induces a rise in catalase activity in the embryo, only after 17 days of gestation. These observations are discussed in relation to the biogenesis of microperoxisome.     

Cytochemical and biochemical studies on the differentiation of microperoxisomes in the small intestine of the fetal mouse

The localization of catalase activity during the morphogenesis of duodenum and ileum has been studied in Swiss ICR mouse embryos from the 16th day of fetal life until birth. Catalase activity was also measured by a spectrophotometric method. Few diaminobenzidine-positive microperoxisomes are present at 15 days of gestation in undifferentiated cells of the stratified epithelium lining the lumen of duodenum and ileum. The number of microperoxisomes increases considerably in the duodenal enterocytes at 17 days; the highest concentration of microperoxisomes is attained at 18 days, after which time their number becomes stable until 4 weeks after birth. Biochemically, catalase activity is barely detected at 15 days in the first half of the small intestine, but afterwards it increases steadily up to 1 day after birth. In the ileum, the increase in microperoxisome number is far less important than in the duodenal enterocytes and reaches a maximum at 19 days of gestation, that is, immediately at birth. The level of catalase activity in the second half of the small intestine is also much lower than that measured in the first half. These results are discussed in relation to the biogenesis of microperoxisimes in the small intestine before birth.     

Portal hypertension produces an evolutive hepato-intestinal pro- and anti-inflammatory response in the rat

An inflammatory etiopathogeny can be suggested in portal hypertensive enteropathy since infiltration of the intestinal wall by mononuclear cells has been described in this condition. This work was carried out with the intention of shedding light on this matter. Male Wistar rats were divided into 4 control groups and 4 groups with partial portal vein ligation at 1, 2, 3 and 15 months. TNF-alpha, IL-1beta and IL-10 were quantified in liver and ileum by ELISA. CO and NO were measured in splanchnic and systemic vein by spectrophotometry and Griess reaction, respectively. Expression of constitutive and inducible isoforms of NO and HO were assayed by Western blot in liver and ileum. An increased hepatic release of proinflammatory mediators (TNF-alpha, IL-1beta and NO) associated with intestinal release of anti-inflammatory mediators (IL-10, CO) occurs in an early evolutive phase (1 month) of experimental portal hypertension. On the contrary, in the long-term (15 months), the increase in the intestinal release of proinflammatory mediators (TNF-alpha, IL-1beta) is associated with an increase in the hepatic release of anti-inflammatory mediators (IL-10, CO). These results suggest that experimental prehepatic portal hypertension presents changes in the serum and tissular (liver and small bowel) concentrations of mediators which are considered as pro- and anti-inflammatory.     

Permeability of polyethylene glycol in remnant small bowel after massive intestinal resection

Studies were designed to determine if permeability of adapted (remnant) small bowel mucosa to polyethylene glycol (PEG) was altered after major intestinal resection. Rats underwent 50% small bowel resection with preservation of duodenum and terminal ileum. Sham-operated animals served as controls. Two and four weeks later we cannulated the portal vein and measured mucosal permeability to luminal [3H]PEG and [14C]PEG in isotonic Ringer solution in remnant proximal or distal in situ closed intestinal loops. A lumen-to-portal blood gradient of at least 1000/1 persisted throughout the one-hour experimental period in both resected and sham-operated animals. Thus the adapted remnant intestinal mucosa was highly impermeable to luminal radiotracer PEG. In separate experiments 2 and 4 weeks after 70% small bowel resection or sham operation, in vivo segments of proximal and distal small intestinal were perfused through the lumen for one hour with hypertonic (800 mOsm) mannitol or NaCl solution containing [3H]PEG. There was equal and almost total recovery of [3H]PEG at the end of the experimental period in resected and control animals. The combined data of all experiments indicate that radiotracer PEG may be confidently used as a luminal water phase marker in transport studies of remnant bowel following intestinal resection.     

In vivo changes in the intestinal reflexes and the response to CCK in the inflamed small intestine of the rat

Functional motor changes and morphological alterations have been associated with intestinal inflammation. The aim of our study was to evaluate functional alterations of intestinal reflexes and of the responses to CCK in the Trichinella spiralis model of intestinal inflammation. Rats were prepared with strain gauges and electrodes in the small intestine to evaluate spontaneous motor activity, the ascending contraction of the peristaltic reflex, and the motor responses to CCK-8 infusion. Infected animals showed increased motor activity at the duodenum and jejunum but not at the ileum. Ascending contraction was increased in both duodenum and ileum. Ascending excitation after N(omega)-nitro-L-arginine was still increased as well as the residual response after atropine. Response to CCK-8 during intestinal inflammation was changed in the jejunum, in which it turned from the inhibition shown in healthy animals to excitation. NADPH-diaphorase staining did not show any changes between distribution and density of positive neurons in either healthy or infected animals. In conclusion, intestinal inflammation induces functional changes in the motor activity that could explain the abnormal motor responses observed in inflammatory disorders.     

Localized colonic inflammation increases cytokine levels in distant small intestinal segments in the rat

Local inflammation in the colon has been associated with nutrient malabsorption and altered motility in the small bowel. These remote effects suggest the release of mediators which can act (or alter) the function of intestinal segments located far from the primary area of inflammation. This study describes the changes in the expression of pro-inflammatory cytokines in the colon and in various segments of the small intestine in two rat models of experimental colitis. Colitis was induced by the intracolonic administration of 100 microL of 6% iodoacetamide or 250 microL of 2, 4, 6-trinitrobenzene sulfonic acid. Levels of interleukin one beta, interleukin 6, and tumor necrosis factor alpha were measured by ELISA in tissue homogenate sampled from duodenum, jejunum, ileum and colon at different time intervals. In homogenates of strips isolated from duodenum, jejunum and ileum, tumor necrosis alpha and interleukin-6, increased significantly 3-6 h after iodoacetamide or TNBS administration and remained elevated until the colonic inflammation subsided. Interleukin one beta showed comparable but delayed increase. Similar, but more pronounced increase of the three cytokines was noticed in areas of the colon adjacent to the ulcer. Histologic examinations revealed important inflammatory changes in the colon; however, examination of sections from the small intestines did not reveal significant differences between controls and rats with colitis. In conclusion, expression of pro-inflammatory cytokines is increased in remote segments of the small intestines during colitis. The findings may provide a partial explanation or a molecular substrate for the associated small bowel dysfunction.     

Starvation alters the activity and mRNA level of glutaminase and glutamine synthetase in the rat intestine

The metabolism of glutamine, the main respiratory fuel of enterocytes, is governed by the activity of glutaminase and glutamine synthetase. Because starvation induces intestinal atrophy, it might alter the rate of intestinal glutamine utilization. This study examined the effect of starvation on the activity, level of mRNA, and distribution of mRNA of glutaminase and glutamine synthetase in the rat intestine. Rats were randomized into groups and were either: (1) fed for 2 days with rat food ad libitum or (2) starved for 2 days. Standardized segments of jejunum and ileum were removed for the estimation of enzyme activity, level of mRNA, and in situ hybridization analysis. The jejunum of the fed rats had a greater activity of both enzymes per centimeter of intestine (P < 0.01), a greater glutaminase specific activity (1.97 +/- 0.45 vs. 1.09 +/- 0.34 micromol/hr/mg protein, P < 0.01), and a lower level of glutaminase and glutamine synthetase mRNA. The ileum of the fed rats had a greater activity of glutamine synthetase per centimeter of intestine (162.9 +/- 50.6 vs. 91.0 +/- 23.1 nmol/hr/cm bowel, P < 0.01), a lower level of glutaminase mRNA, and a greater level of glutamine synthetase mRNA. In situ hybridization analysis showed that starvation does not alter the distribution of glutaminase and glutamine synthetase mRNA in the intestinal mucosa. This study confirms that starvation decreases the total intestinal activity per centimeter of both glutaminase and glutamine synthetase. More importantly, the results indicate that the intestine adapts to starvation by accumulating glutaminase mRNA. This process prepares the intestine for a restoration of intake.     

Serum lipid concentrations and blood pressure in obese women.

In 70 obese women no correlation was found between body weight and serum cholesterol or triglyceride concentrations, but there was a significant correlation between weight and blood pressure. Weight reduction by diet or jejunoileal shunt was not accompanied by any significant change in serum lipid concentrations other than the decrease in serum cholesterol expected after intestinal bypass. Twelve months after bypass surgery was carried out on 14 patients, however, both systolic and diastolic blood pressures were significantly reduced and at levels appropriate to the patients'' new weights. These results suggest that obesity in women cannot be taken to indicate the presence of hyperlipidaemia and that sustained weight loss may lower blood pressure.