Thompson J S, Barent B
Surgical Service, Omaha VA Medical Center, University of Nebraska Medical Center, Omaha, NE 68198-3280, USA.
J Gastrointest Surg. 1999 Nov-Dec;3(6):672-7. doi: 10.1016/s1091-255x(99)80092-4.
Intestinal resection results in increased numbers of villus and crypt enterocytes. This adaptive response occurs secondary to increased crypt cell proliferation early after resection. Apoptosis also increases in both crypt and villus compartments early after resection. Our aim was to evaluate change in proliferation and apoptosis later during the adaptive period. Eighteen rabbits undergoing 50% proximal intestinal resection were killed 7, 14, or 21 days after resection. Intestine at the resection margin was evaluated before and after resection for morphometry, crypt cell production rate (CCPR), and in situ end labeling of DNA fragmentation. Apoptotic cells were identified by morphologic evaluation. Villus height (382 +/- 51 microm vs. 505 +/- 131 microm) and crypt depth (121 +/- 10 microm vs. 163 +/- 21 microm; P <0.05) were significantly increased at 21 days. CCPR was also increased compared to preoperative values (5.8 +/- 1.2 cells/hr vs. 8.6 +/- 0. 3, 7.9 +/- 0.3, and 8.3 +/- 1.6 cells/hr at 7, 14, and 21 days; P <0. 05). Apoptotic index (apoptotic cells per 100 cells) was significantly increased in cells at the tip of the villus at 21 days (32 +/- 7% vs. 19 +/- 7%; P <0.05) but not in the lateral villus or total villus. Total cells per villus (83 +/- 6 vs. 65 +/- 3) and apoptotic cells per villus (9.2 +/- 1.6 vs. 4.5 +/- 2.5; P <0.05) were also greater at 21 days. Mean DNA fragmentation scores were similar before and after resection. The crypt apoptotic index was increased only in the lateral crypt at 14 days. Total cells per crypt increased after resection, and the number of apoptotic cells per crypt was increased at 7 and 14 days (2.5 +/- 1.7 and 2.3 +/- 1. 1 vs. 0.6 +/- 0.6 days; P <0.05). Thus the following conclusions were reached: (1) Apoptosis of villus tip cells remains elevated late in postresection adaptation; (2) crypt cell apoptosis returns to preoperative levels during the time interval when crypt cell proliferation is still stimulated; and (3) apoptosis in the crypt and villus compartments appears to be regulated independently.
肠道切除会导致绒毛和隐窝肠上皮细胞数量增加。这种适应性反应继发于切除术后早期隐窝细胞增殖的增加。切除术后早期，隐窝和绒毛区域的细胞凋亡也会增加。我们的目的是评估适应性阶段后期增殖和凋亡的变化。18只接受50%近端肠道切除的兔子在切除术后7、14或21天被处死。在切除前后对切除边缘的肠道进行形态学测量、隐窝细胞产生率（CCPR）以及DNA片段原位末端标记评估。通过形态学评估鉴定凋亡细胞。术后21天时，绒毛高度（382±51微米对505±131微米）和隐窝深度（121±10微米对163±21微米；P<0.05）显著增加。与术前值相比，CCPR也有所增加（术后7、14和21天时分别为5.8±1.2个细胞/小时对8.6±0.3、7.9±0.3和8.3±1.6个细胞/小时；P<0.05）。术后21天时，绒毛顶端细胞的凋亡指数（每100个细胞中的凋亡细胞数）显著增加（32±7%对19±7%；P<0.05），但绒毛侧面或整个绒毛的凋亡指数未增加。术后21天时，每个绒毛的总细胞数（83±6对65±3）和每个绒毛的凋亡细胞数（9.2±1.6对4.5±2.5；P<0.05）也更多。切除前后的平均DNA片段化评分相似。仅在术后14天时，隐窝侧面的隐窝凋亡指数增加。切除术后每个隐窝的总细胞数增加，术后7天和14天时每个隐窝的凋亡细胞数增加（分别为2.5±1.7和2.3±1.1对0.6±0.6；P<0.05）。因此得出以下结论：（1）切除术后适应性阶段后期，绒毛顶端细胞的凋亡仍维持在较高水平；（2）在隐窝细胞增殖仍受到刺激的时间段内，隐窝细胞凋亡恢复到术前水平；（3）隐窝和绒毛区域的凋亡似乎是独立调节的。
