Gastroenterology Center, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou 213000, Jiangsu Province, China.
Medical Statistics Center, Changzhou University, Changzhou 213000, Jiangsu Province, China.
World J Gastroenterol. 2022 Apr 21;28(15):1536-1547. doi: 10.3748/wjg.v28.i15.1536.
Crohn's disease (CD) is a chronic nonspecific intestinal inflammatory disease. The aetiology and pathogenesis of CD are still unclear. Anal fistula is the main complication of CD and is a difficult problem to solve at present. The main limitation of developing new therapies is bound up with the short of preclinical security and effectiveness data. Therefore, an ideal animal model is needed to establish persistent anal fistula and an inflamed rectal mucosa.
To improve the induction method of colitis and establish a reliable and reproducible perianal fistulizing Crohn's disease animal model to evaluate new treatment strategies.
Twenty male New Zealand rabbits underwent rectal enema with different doses of 2,4,6-trinitrobenzene sulfonic acid to induce proctitis. Group A was treated with an improved equal interval small dose increasing method. The dosage of group B was constant. Seven days later, the rabbits underwent surgical creation of a transsphincteric fistula. Then, three rabbits were randomly selected from each group every 7 d to remove the seton from the fistula. The rabbits were examined by endoscopy every 7 days, and biopsy forceps were used to obtain tissue samples from the obvious colon lesions for histological analysis. The disease activity index (DAI), colonoscopy and histological scores were recorded. Perianal endoscopic ultrasonography (EUS) was used to evaluate the healing of fistulas.
Except for the DAI score, the colonoscopy and histological scores in group A were significantly higher than those in group B ( < 0.05). In the ideal model rabbit group, on the 7 day after the removal of the seton, all animals had persistent lumens on EUS imaging, showing continuous full-thickness high signals. Histological inspection of the fistula showed acute and chronic inflammation, fibrosis, epithelialization and peripheral proctitis of the adjoining rectum.
The improved method of CD colitis induction successfully established a rabbit perianal fistula CD preclinical model, which was confirmed by endoscopy and pathology.
克罗恩病(CD)是一种慢性非特异性肠道炎症性疾病。CD 的病因和发病机制尚不清楚。肛瘘是 CD 的主要并发症,是目前亟待解决的难题。开发新疗法的主要限制在于缺乏临床前安全性和有效性数据。因此,需要建立一种理想的动物模型,以建立持续性肛瘘和发炎的直肠黏膜。
改进结肠炎诱导方法,建立可靠且可重复的肛周瘘型克罗恩病动物模型,以评估新的治疗策略。
20 只雄性新西兰兔接受不同剂量(2、4、6-三硝基苯磺酸)直肠灌肠以诱导直肠炎。A 组采用改良的等间隔小剂量递增法。B 组剂量不变。7 天后,所有兔子均接受经括约肌瘘管手术。然后,每组随机选择 3 只兔子,每 7 天从瘘管中取出缝线。每 7 天对兔子进行内镜检查,使用活检夹从明显的结肠病变处获取组织样本进行组织学分析。记录疾病活动指数(DAI)、结肠镜检查和组织学评分。经肛门内镜超声(EUS)用于评估瘘管的愈合情况。
除 DAI 评分外,A 组的结肠镜检查和组织学评分均显著高于 B 组(<0.05)。在理想模型兔组中,缝线取出后第 7 天,所有动物的 EUS 影像均显示瘘管持续存在完整的腔隙,表现为连续的全层高信号。瘘管的组织学检查显示急性和慢性炎症、纤维化、上皮化和邻近直肠的周围直肠炎。
改良的 CD 结肠炎诱导方法成功建立了一种兔肛周瘘 CD 临床前模型,该模型通过内镜和病理学得到了证实。