The mechanism of the colonic epithelial metaplasia induced by colon valvoplasty in SD rats with short bowel syndrome

doi:10.3969/j.issn.1009-976X.2022.04.011

Abstract

Abstract: Objective The author firstly invented colon valvoplasty to make colonic epithelium have similar absorptive function like small intestine. The study aims to find out the mechanism of the epithelial metaplasia from colon to intestine inducted by colon valvoplasty. Methods Fourty SD rats were randomly divided into two groups （each with 20 SD rats）, and the rats in control group had been removed eighty percent of intestines, while the rats in experimental group had been performed colon valvoplasty in the same time. 30 weeks later, the rats were killed, and the ilium, the colon before and after the valve were tested. Protein Wnt7b and β-catenin were tested by immunofluorescence histochemistry. Results The rats in experimental group were heavier than that in control group. HE examination found that the epithelium before the valve had some features like intestine, including thicker epithelium, longer villi and less goblet cells. Protein Wnt7b and β-catenin of colon epithelium before valve were more than that after the vale. Conclusion Colon valvoplasty increased the absorptive function of colon, and the mechanism was the regeneration of stem cells by the pathway of Wnt/β-catenin, and the procedure had large valve of clinical practice.

Key words: Wnt/β-catenin pathway, colon valvoplasty, short bowel syndrome, rat

摘要： 目的结肠瓣膜成形术可以使瓣膜前结肠上皮具有类似小肠的吸收功能,本研究拟进一步阐明结肠瓣膜成形术诱导结肠上皮向小肠上皮化生的机制。方法将40只大鼠随机分配到两组（各20只）,对照组大鼠切除80%小肠,实验组同时行结肠瓣膜成形术。实验后30周处死大鼠,取回肠、瓣膜前结肠及瓣膜后结肠作检测。原位荧光免疫组化法检测肠上皮细胞内Wnt7b蛋白和β-catenin蛋白。结果实验组大鼠比对照组的大鼠重。HE染色光镜检查发现瓣膜近端的结肠具有类似小肠上皮的特征（上皮增厚、肠隐窝增长以及杯状细胞减少）。免疫组化检查发现瓣膜近端结肠上皮的Wnt7b蛋白和β-catenin蛋白比瓣膜远端结肠上皮的大幅增多。结论结肠瓣膜成形术促进结肠上皮的吸收功能,其机制很可能是Wnt/β-catenin通路介导的肠上皮干细胞再生。

关键词: Wnt/β-catenin通路;, 结肠瓣膜成形术, 短肠综合征, 大鼠

CLC Number:

R656.9

DENG Gao-yan, ZENG Ji-xiao. The mechanism of the colonic epithelial metaplasia induced by colon valvoplasty in SD rats with short bowel syndrome[J]. Lingnan Modern Clinics In Surgery, 2022, 22(04): 373-377.

邓高燕, 曾纪晓. 结肠瓣膜成形术诱导SD大鼠短肠综合征模型结肠上皮化生的机制研究[J]. 岭南现代临床外科, 2022, 22(04): 373-377.

References

[1] Deng G, Deng Z.Enhancement of colonic absorptive function after the massive resection of the small intestine based on the creation of an artificial colonic valve[J]. Sci Rep, 2020, 10(1):818.
[2] Scott A, Rouch JD, Jabaji Z, et al.Long-term renewable human intestinal epithelial stem cells as monolayers:A potential for clinical use[J]. J Pediatr Surg, 2016, 51(6):995-1000.
[3] Rubin DC, Levin MS.Mechanisms of Intestinal Adaptation[J]. Best Pract Res Clin Gastroenterol, 2016, 30(2):237-248.
[4] Weber TR, Vane DW, Grosfeld JL.Tapering enteroplasty in infants with bowel atresia and short gut[J]. Arch Surg, 1982, 117(5):684-648.
[5] Bianchi A.Intestinal loop lengthening--a technique for increasing small intestinal length[J]. J Pediatr Surg, 1980, 15(2):145-151.
[6] Kim HB, Fanza D, Garza J, et al.Serial transverse enteroplasty (STEP):a novel bowel lengthening procedure[J]. J Pediatr Surg, 2003, 38(3):425-429.
[7] Beyer-Berjot L, Joly F, Maggiori L, et al.Segmental reversal of the small bowel can end permanent parenteral nutrition dependency:an experience of 38 adults with short bowel syndrome[J]. Ann Surg, 2012, 256(5):739-744.
[8] Glick PL, de Lorimier AA, Adzick NS, et al. Colon interposition:an adjuvant operation for short-gut syndrome[J]. J Pediatr Surg, 1984, 19(6):719-725.
[9] Sudan DL.Treatment of intestinal failure:intestinal transplantation[J]. Nat Clin Pract Gastroenterol Hepatol, 2007, 4(9):503-510.
[10] Morphy F, Khalil BA, Gozzini S, et al, Controlled tissue expansion in the initial management of the short bowel state[J]. World J Surg, 2015, 35(5):1142-1145.
[11] Huynh N, Dubrovsky G, Rouch JD, et al.Feasibility and scalability of spring parameters in distraction enterogenesis in a murine model[J]. J Surg Res, 2017, 215:219-224.
[12] Yang H, Teitelbaum DH.Novel agents in the treatment of intestinal failure:humoral factors[J]. Gastroenterolog, 2006, 130(Suppl1):S117-121.
[13] Goodlad R, Nightingale J, Playford R. Intestinal adaptation, in Intestinal failure (ed.Nightingale JMD) 243-260 (Greenwich Medical Media, London, 2001).
[14] Seydel AS, Miller JH, Sarac TP, et al.Octreotide diminishes luminal nutrient transport activity, which is reversed by epidermal growth factor[J]. Am J Surg, 1996, 172(3):267-271.
[15] Benhamou PH, Canarelli JP, Richard S, et al.Human recombinant growth hormone increases small bowel lengthening after massive small bowel resection in piglets[J]. J Pediatr Surg, 1997, 32(9):1332-1336.
[16] Thompson IS.Epidermal growth factor and the short bowel syndrome[J]. J Parenter Enteral Nutr, 1999, 23(5 Suppl):S113-116.
[17] Chen K, Okuma T, Okamura K, et al.Insulin like growth factor-I prevents gut atrophy and maintains intestinal integrity in septic rats[J]. J Parenter Enteral Nutr, 1995, 19(2):119-124.
[18] Yazbeck R, Teduglutide. A glucagon-like peptide-2 analog for the treatment of gastrointestinal diseases, including short bowel syndrome[J]. Curr Opin Mol Ther, 2010, 12(6):798-809.
[19] Kato Y, Yu D, Schwartz MZ.Enhancement of intestinal adaptation by hepatocyte growth factor[J]. J Pediatr Surg, 1998, 33(2):235-239.
[20] Nightingale J.The short bowel[M] // Lawrence Erlbaum Associates. Intestinal failure. London:Greenwich Medical Media, 2001:177-198.
[21] Dorney SF, Ament ME, Berquist WE, et al.Improved survival in very short small bowel of infancy with use of long-term parenteral nutrition[J]. J Pediatr, 1985, 107(4):521-525.
[22] Folaranmi S, Rakoczy G, Bruce J, et al.Ileocaecal valve:how important is it?[J]. Pediatr Surg Int, 2011, 27(6):613-615.
[23] Dorney SF, Ament ME, Berquist WE, et al.Improved survival in very short small bowel of infancy with use of long-term parenteral nutrition[J]. J Pediatr, 107,521-525(1985).
[24] King DR, Anvari M, Jamieson GG, King JM.Does the colon adopt small bowel features in a small bowel environment?[J]. Aust N Z J Surg, 1996, 66(8):543-546.
[25] Kono K, Sekikawa T, et al.Interposed colon between remnants of the small intestine exhibits small bowel features in a patient with short bowel syndrome[J]. Dig Surg, 2001, 18(3):237-241.
[26] Salzman NH, Hung K, Haribhai D, et al.Enteric defensins are essential regulators of intestinal microbial ecology[J]. Nat Immunol, 2010, 11(1):76-83.
[27] Trauner M, Boyer JL.Bile salt transporters:molecular characterization, function, and regulation[J]. Physiol Rev, 2003, 83(2):633-671.