Chen Jie, Qin Zhen, Shan Hongmei, Xiao Yongtao, Cai Wei
Department of Pediatric Surgery, Xin Hua Hospital, Shanghai Jiao Tong University, Shanghai, China.
Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai Institute of Pediatric Research, Shanghai Jiao Tong University, Shanghai, China.
Iran J Pediatr. 2015 Aug;25(4):e530. doi: 10.5812/ijp.530. Epub 2015 Aug 24.
It is important that the residual bowel adapts after massive resection. The necessary intestinal adaptation is a progressive recovery from intestinal failure through increase in absorptive surface area and functional capacity and includes both morphological and functional adaptations.
The aim of this study was to investigate intestinal morphological and functional adaptations of small bowel syndrome (SBS) model rats (SBS1W) 7 days after bowel resection.
Male sprague-dawley rats (n = 20/group) underwent either a 75% proximal small bowel resection (SBS1W group) or a control operation (control group). Markers of morphological adaptation were revealed by TEM analysis of H&E-stained tissue samples. The intestinal barrier condition was assessed by BT, and sIgA concentration in intestinal mucus was measured by ELISA. Contractility and the slow wave rhythm of the entire intestinal remnant were measured and recorded.
The SBS1W group experienced more weight loss than control group and had a clearly different intestinal morphology as revealed in TEM images. Compared with control rats, the SBS1W group had a lower sIgA concentration in intestinal mucus and higher BT to lymph nodes (70% vs 40%; level I), portal blood (40% vs 10%; level II), and peripheral blood (60% vs 30%; level III). Disorder of spontaneous rhythmic contraction, irregular amplitude, and slow frequency were detected in the SBS1W group by a muscle strips test. Similarly, the slow wave of the entire intestinal remnant in the SBS1W group was irregular and uncoordinated.
The finding of intestinal adaptation following massive SBR in SBS1W rats provides more understanding of the mechanisms of progressive recovery from the intestinal failure that underlies SBS. The mechanical, chemical, immunological, and biological barriers were all impaired at 7 days following bowel resection, indicating that the SBS model rats were still in the intestinal adaptation phase.
大面积肠切除术后残余肠管的适应至关重要。必要的肠道适应是从肠衰竭逐渐恢复，通过增加吸收表面积和功能能力实现，包括形态和功能两方面的适应。
本研究旨在探讨肠切除术后7天的短肠综合征（SBS）模型大鼠（SBS1W）的肠道形态和功能适应情况。
雄性Sprague-Dawley大鼠（每组n = 20）接受75%近端小肠切除（SBS1W组）或对照手术（对照组）。通过对苏木精-伊红染色组织样本进行透射电镜分析揭示形态适应的标志物。通过细菌易位（BT）评估肠道屏障状况，采用酶联免疫吸附测定法（ELISA）测量肠黏液中的分泌型免疫球蛋白A（sIgA）浓度。测量并记录整个残余肠管的收缩性和慢波节律。
SBS1W组比对照组体重减轻更多，透射电镜图像显示其肠道形态明显不同。与对照大鼠相比，SBS1W组肠黏液中的sIgA浓度较低，细菌易位至淋巴结（70%对40%；I级）、门静脉血（40%对10%；II级）和外周血（60%对30%；III级）的比例更高。通过肌条试验在SBS1W组检测到自发节律性收缩紊乱、幅度不规则和频率减慢。同样，SBS1W组整个残余肠管的慢波不规则且不协调。
SBS1W大鼠大面积小肠切除术后肠道适应的发现有助于更深入了解短肠综合征所基于的肠衰竭逐渐恢复的机制。肠切除术后7天，机械、化学、免疫和生物屏障均受损，表明SBS模型大鼠仍处于肠道适应阶段。
