Safford S D, Freemerman A J, Safford K M, Bentley R, Skinner M A
Department of Surgery, Division of Pediatric Surgery, PO Box 31295, Duke University Medical Center, Durham, NC 27710, USA.
Gut. 2005 Aug;54(8):1085-90. doi: 10.1136/gut.2004.061481. Epub 2005 Apr 19.
The aim of our study was to apply longitudinal force to the small bowel to increase the length of intestine in juvenile rats.
Fifty juvenile rats had double barrelled, blind loop ostomies created using an isolated segment of bowel. Our intestinal lengthening device was inserted into one of the loops and the second loop served as a control. Once the device was deployed, the experimental, control, and in situ segments of bowel were evaluated for length, weight, histology, and disaccharidase enzyme activity.
Mechanical tension increased intestinal length by 149%. The lengthened bowel also exhibited a greater total weight (218%), greater mucosal weight (122%), and increased protein mass (164%) compared with the control limb of bowel. Histologically, there was a markedly increased thickness of the muscularis propria in the lengthened bowel (200% increase compared with the control limb). Functionally, we found increased total disaccharidase activity in the lengthened bowel (between 47% and 350%, depending on the particular enzyme tested; p<0.01).
Mechanical tension induces intestinal growth by increasing length, weight of the bowel and mucosa, and protein mass. Histological changes, such as increases in Paneth cells, suggest that increased proliferation and reorganisation of the mucosa and muscularis propria are a response to mechanical tension. Functionally, increased intestinal length corresponds with increased disaccharidase activity, thus implying potential increased absorptive capacity of the lengthened bowel.
我们研究的目的是对幼鼠的小肠施加纵向力,以增加肠道长度。
50只幼鼠采用一段孤立肠段制作双腔盲袢造口术。将我们的肠道延长装置插入其中一个肠袢,另一个肠袢作为对照。装置展开后,对肠道的实验段、对照段和原位段进行长度、重量、组织学和双糖酶活性评估。
机械张力使肠道长度增加了149%。与对照肠段相比,延长后的肠道总重量也更大(增加了218%)、黏膜重量更大(增加了122%)且蛋白质质量增加(增加了164%)。组织学上,延长后肠道的固有肌层厚度明显增加(与对照肠段相比增加了200%)。功能上,我们发现延长后肠道的双糖酶总活性增加(根据所测试的特定酶,增加幅度在47%至350%之间;p<0.01)。
机械张力通过增加肠道长度、肠道及黏膜重量和蛋白质质量来诱导肠道生长。组织学变化,如潘氏细胞增加,表明黏膜和固有肌层增殖及重组增加是对机械张力的一种反应。功能上,肠道长度增加与双糖酶活性增加相对应,因此意味着延长后肠道的吸收能力可能增加。