Department of Internal Medicine IV, University Clinics of Heidelberg, Heidelberg, Germany.
Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Mainz, Germany.
J Crohns Colitis. 2017 Oct 1;11(10):1247-1257. doi: 10.1093/ecco-jcc/jjx075.
A key pathogenetic feature of ulcerative colitis [UC] is an intrinsic low mucus phosphatidylcholine[PC] content. Recently, a paracellular transport for PC across tight junctions[TJs] was described, suggesting TJ disturbance as a cause of diminished luminal PC transport. Therefore, we aimed to generate mutant mice with TJ deletion to evaluate whether a UC phenotype developed.
CL57BL/6 control wild-type mice were compared to mutant mice with tamoxifen-induced villin-Cre-dependent intestinal deletion of kindlin 1 and 2.
Electron microscopy of mucosal biopsies obtained from both mutants before overt inflammation following only 2 days of tamoxifen exposure revealed a defective TJ morphology with extended paracellular space and, by light microscopy, expanded mucosal crypt lumina. PC secretion into mucus was reduced by >65% and the mucus PC content dropped by >50%, causing a >50 % decrease of mucus hydrophobicity in both mutants. Consequently, the microbiota was able to penetrate the submucosa. After 3 days of tamoxifen exposure, intestinal inflammation was present in both mutants, with loose bloody stools as well as macroscopic and histological features of colitis. Oral PC supplementation was able to suppress inflammation. By analogy, colonic biopsies obtained from patients with UC in remission also showed a defective epithelium with widened intercellular clefts, and enlarged crypt luminal diameters with functionally impaired luminal PC secretion.
Genetic mouse models with intestinal deletion of kindlin 1 and 2 resulted in TJ deletion and revealed pathophysiological features of impaired PC secretion to the mucus leading to mucosal inflammation compatible with human UC.
溃疡性结肠炎[UC]的一个关键发病特征是固有低黏液磷脂酰胆碱[PC]含量。最近,描述了 PC 通过紧密连接[TJs]的旁细胞转运,表明 TJ 紊乱是导致管腔 PC 转运减少的原因。因此,我们旨在生成具有 TJ 缺失的突变小鼠,以评估是否会出现 UC 表型。
将 CL57BL/6 对照野生型小鼠与经他莫昔芬诱导的绒毛蛋白-Cre 依赖性肠道缺失 1 和 2 的突变小鼠进行比较。
在仅接受他莫昔芬暴露 2 天后出现明显炎症之前,从两种突变体的黏膜活检中获得的电子显微镜显示 TJ 形态缺陷,细胞旁空间扩展,并且通过光镜观察,黏膜隐窝腔扩张。PC 分泌到黏液中的减少超过 65%,黏液 PC 含量下降超过 50%,导致两种突变体的黏液疏水性下降超过 50%。因此,微生物群能够穿透黏膜下。在他莫昔芬暴露 3 天后,两种突变体均出现肠道炎症,表现为松散的血性粪便以及结肠炎的宏观和组织学特征。口服 PC 补充能够抑制炎症。类似地,从处于缓解期的 UC 患者获得的结肠活检也显示出具有细胞间裂隙加宽的功能障碍上皮,并且隐窝腔的直径增大,管腔 PC 分泌功能受损。
具有肠道缺失 1 和 2 的基因小鼠模型导致 TJ 缺失,并揭示了 PC 分泌到黏液中受损导致与人类 UC 相兼容的黏膜炎症的病理生理特征。