一种新的小鼠回肠造口术模型：粪便再循环可预防回肠造口术远端的肠道萎缩。

A new murine ileostomy model: recycling stool prevents intestinal atrophy in the distal side of ileostomy.

作者信息

Uga Naoko, Nakatani Masashi, Yoshimura Aya, Kumamoto Kanako, Tsuchida Kunihiro, Nagao Shizuko, Tsuchiya Tomonori, Kondo Yasuhiro, Naoe Atsuki, Watanabe Shunsuke, Yasui Toshihiro, Hara Fujio, Suzuki Tatsuya

机构信息

Department of Pediatric Surgery, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan.

Division for Therapies against Intractable Diseases, Institute for Comprehensive Medical Science, Fujita Health University, Toyoake, Aichi, Japan.

出版信息

Fujita Med J. 2021;7(2):41-49. doi: 10.20407/fmj.2020-003. Epub 2020 Oct 10.

DOI:10.20407/fmj.2020-003

PMID:35111543

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8749537/

Abstract

OBJECTIVES

Proximal stoma creation in neonates results in growth failure and distal intestinal atrophy. "Recycling stool" consists of stool injection from the proximal limb to the distal limb of a stoma. Because this method may prevent distal bowel atrophy and increase body weight, we investigated the effects of recycling stool upon distal intestinal mucosa by generating an ileostomy model in rats.

METHODS

An ileostomy was created 5 cm proximal to the cecum in male Wistar/ST rats. Discharged stool or saline was injected into the distal limb, twice per day for 7 days. The intestinal adaptation was assessed by measuring the villus height and counting goblet cell number. Proliferation and apoptosis were analyzed by Ki67 and TUNEL immunostaining.

RESULTS

The ratios of the height of the distal villi (D) to the that of proximal villi (P) were 0.97 (median [range] of D and P length: 421 [240-729] μm and 436 [294-638] μm, <0.05) in the stool-injected group and 0.81 in the saline-injected group (442 [315-641] μm and 548 [236-776] μm, <0.05). Compared with the saline-injected group, the stool-injected group showed elevated numbers of goblet cells (3.6 [2.0-7.6] vs. 4.9 [2.4-7.5] cells/100-μm villus length) and Ki67-positive cells (26.8% [13.8%-35.4%] vs. 40.1% [31.2%-45.7%]), along with a reduced number of apoptotic cells (5.0 [2.0-14.0] vs. 4.0 [1.0-9.0] cells/100-μm villus length).

CONCLUSIONS

Recycling stool prevented distal intestinal atrophy; this experimental design may facilitate further studies concerning alternative methods to prevent intestinal atrophy and growth failure.

摘要

目的

新生儿近端造口会导致生长发育迟缓及远端肠道萎缩。“粪便回输”是指将粪便从造口近端肢体注入远端肢体。由于该方法可能预防远端肠萎缩并增加体重，我们通过在大鼠中建立回肠造口模型，研究了粪便回输对远端肠黏膜的影响。

方法

在雄性Wistar/ST大鼠盲肠近端5 cm处行回肠造口术。将排出的粪便或生理盐水注入远端肢体，每天2次，共7天。通过测量绒毛高度和计数杯状细胞数量评估肠道适应性。通过Ki67和TUNEL免疫染色分析增殖和凋亡情况。

结果

粪便注入组远端绒毛高度（D）与近端绒毛高度（P）的比值为0.97（D和P长度的中位数[范围]：421[240 - 729]μm和436[294 - 638]μm，P<0.05），生理盐水注入组为0.81（442[315 - 641]μm和548[236 - 776]μm，P<0.05）。与生理盐水注入组相比，粪便注入组杯状细胞数量增加（每100μm绒毛长度3.6[2.0 - 7.6]个对4.9[2.4 - 7.5]个）、Ki67阳性细胞数量增加（26.8%[13.8% - 35.4%]对40.1%[31.2% - 45.7%]），同时凋亡细胞数量减少（每100μm绒毛长度5.0[2.0 - 14.0]个对4.0[1.0 - 9.0]个）。