Division of Pediatric Surgery, St Louis Children's Hospital, Department of Surgery, Washington University School of Medicine, St Louis, MO 63110, USA.
J Pediatr Surg. 2012 Sep;47(9):1748-53. doi: 10.1016/j.jpedsurg.2012.03.089.
Intestinal adaptation after massive small bowel resection (SBR) permits improved absorption of enteral nutrition despite significant loss of bowel length. Epidermal growth factor (EGF) and its receptor (EGFR) have previously been established to play major roles in the pathogenesis of adaptation. This study tested the hypothesis that EGFR signaling within the epithelial cell compartment (enterocytes) is required for intestinal adaptation.
We developed a tamoxifen-inducible Villin-Cre/LoxP recombinant system for enterocyte-directed EGFR deletion using EGFR-floxed mice. Epidermal growth factor receptor-null mice and wild-type littermates underwent either 50% proximal SBR or sham operation. Ileal tissue was harvested on postoperative day 7. To assess for adaptation, villus height and crypt depth as well as rates of crypt cell proliferation and apoptosis were measured.
Adaptation after SBR occurred normally, as demonstrated by significant increases in villus height, crypt depth, and crypt proliferative and apoptotic index in both the wild-type and EGFR-null mice.
Enterocyte EGFR expression is not required for the adaptation response to massive SBR. This novel finding suggests that enterocyte proliferation during adaptation is regulated by EGFR signaling in cells other than enterocytes, perhaps within the mesenchymal cell compartment of the bowel wall via factor(s) that are presently unknown.
尽管大量小肠切除(SBR)导致肠长度显著丢失,但小肠适应仍允许改善肠内营养的吸收。表皮生长因子(EGF)及其受体(EGFR)先前已被确定在适应发病机制中起主要作用。本研究检验了这样一个假设,即上皮细胞区室(肠细胞)中的 EGFR 信号对于肠适应是必需的。
我们使用 EGFR 基因敲除小鼠开发了一种可诱导的 Villin-Cre/LoxP 重组系统,用于肠细胞定向 EGFR 缺失。表皮生长因子受体缺失小鼠和野生型同窝仔鼠接受 50%近端 SBR 或假手术。术后第 7 天采集回肠组织。为了评估适应情况,测量了绒毛高度和隐窝深度以及隐窝细胞增殖和凋亡率。
SBR 后的适应正常发生,这表现在野生型和 EGFR 基因敲除小鼠的绒毛高度、隐窝深度以及隐窝增殖和凋亡指数均显著增加。
肠细胞 EGFR 表达对于大量 SBR 的适应反应不是必需的。这一新发现表明,适应过程中的肠细胞增殖受到肠壁间充质细胞区室中 EGFR 信号的调节,可能通过目前未知的因子。