Division of Pediatric Surgery, Washington University in St. Louis School of Medicine, One Children's Place, Suite 6110, St. Louis, MO, 63110, USA.
Division of Pediatric Surgery, Washington University in St. Louis School of Medicine, One Children's Place, Suite 6110, St. Louis, MO, 63110, USA.
J Pediatr Surg. 2023 Jun;58(6):1170-1177. doi: 10.1016/j.jpedsurg.2023.02.016. Epub 2023 Feb 17.
Resection-associated liver steatosis, injury, and fibrosis is a devastating complication associated with massive small bowel resection (SBR). Peroxisome proliferator-activated receptor-alpha (PPARα) is a key regulator of intestinal lipid transport and metabolism whose expression is selectively increased after SBR. Here we asked if attenuating intestinal PPARα signaling would prevent steatosis and liver injury after SBR.
Pparα was deleted selectively in adult mouse intestine using a tamoxifen-inducible Cre-LoxP breeding schema. Mice underwent 50% SBR. At 10 weeks post-operatively, metabolic phenotyping, body composition analysis, in vivo assessment of lipid absorption and intestinal permeability, and assessment of adaptation and liver injury was completed.
Pparα intestinal knockout and littermate control mice were phenotypically similar in terms of weight trends and body composition after SBR. All mice demonstrated intestinal adaptation with increased villus height and crypt depth; however, Pparα intestinal knockout mice exhibited decreased villus growth at 10 weeks compared to littermate controls. Liver injury and fibrosis were similar between groups as assessed by serum AST and ALT levels, Sirius Red staining, and hepatic expression of Col1a1 and Acta2.
Inducible intestinal deletion of Pparα influences structural adaptation but does not mitigate liver injury after SBR. These findings suggest that enterocyte PPARα signaling in adult mice is dispensable for resection-induced liver injury. The results are critical for understanding the contribution of intestinal lipid metabolic signaling pathways to the pathogenesis of hepatic injury associated with short bowel syndrome.
与大量小肠切除(SBR)相关的切除相关的肝脂肪变性、损伤和纤维化是一种破坏性的并发症。过氧化物酶体增殖物激活受体-α(PPARα)是肠道脂质转运和代谢的关键调节剂,其表达在 SBR 后选择性增加。在这里,我们询问是否可以减轻肠道 PPARα 信号来预防 SBR 后的脂肪变性和肝损伤。
使用他莫昔芬诱导的 Cre-LoxP 繁殖方案选择性地在成年小鼠肠道中敲除 Pparα。小鼠接受 50%的 SBR。术后 10 周,完成代谢表型、身体成分分析、体内脂质吸收和肠道通透性评估以及适应性和肝损伤评估。
在 SBR 后体重趋势和身体成分方面,Pparα 肠道敲除和同窝对照小鼠表型相似。所有小鼠均表现出肠道适应性,绒毛高度和隐窝深度增加;然而,与同窝对照相比,Pparα 肠道敲除小鼠在 10 周时的绒毛生长减少。通过血清天冬氨酸转氨酶(AST)和丙氨酸转氨酶(ALT)水平、天狼星红染色以及 Col1a1 和 Acta2 的肝表达评估,肝损伤和纤维化在两组之间相似。
诱导性肠道 Pparα 缺失会影响结构适应性,但不能减轻 SBR 后的肝损伤。这些发现表明,成年小鼠肠上皮细胞的 PPARα 信号对于切除诱导的肝损伤是可有可无的。这些结果对于理解肠道脂质代谢信号通路对与短肠综合征相关的肝损伤发病机制的贡献至关重要。