Timeline of Intestinal Adaptation After Malabsortive Surgery: Effect of Luminal Nutrients, Biliopancreatic Secretion, and Glutamine Supplementation.

Autor: Martínez Moreno JM; Department of Surgical Specialities, Biochemistry and Immunology, Faculty of Medicine, University of Málaga, 29071, Málaga, Spain. jmmartinezm@uma.es., Reyes-Ortiz A; Autonomous University of the State of México (UAEMex), Toluca, Mexico., Lage Sánchez JM; 'Virgen de la Victoria' University Hospital, Málaga, Spain., Sánchez-Gallegos P; Department of Surgical Specialities, Biochemistry and Immunology, Faculty of Medicine, University of Málaga, 29071, Málaga, Spain., Garcia-Caballero M; Department of Surgical Specialities, Biochemistry and Immunology, Faculty of Medicine, University of Málaga, 29071, Málaga, Spain.
Jazyk: angličtina
Zdroj: Obesity surgery [Obes Surg] 2017 Dec; Vol. 27 (12), pp. 3133-3141.
DOI: 10.1007/s11695-017-2754-y
Abstrakt: Background: The aim of this study was to study the process of intestinal adaptation in the three limbs of the small intestine after malabsorptive bariatric surgery: the biliopancreatic limb, the alimentary limb, and the common channel. These limbs are exposed to different stimuli, namely, gastrointestinal transit and nutrients in the alimentary limb, biliopancreatic secretions in the biliopancreatic limb, and a mix of both in the common channel. We also wished to investigate the effect of glutamine supplementation on the adaptation process.
Methods: Three types of surgery were performed using a porcine model: biliopancreatic bypass (BPBP), massive (75%) short bowel resection as the positive control, and a sham operation (transection) as the negative control. We measured the height and width of intestinal villi, histidine decarboxylase (HDC) activity, and amount of HDC messenger RNA (mRNA) (standard diet or a diet supplemented with glutamine).
Results: An increase in HDC activity and mRNA expression was observed in the BPBP group. This increase coincided with an increase in the height and width of the intestinal villi. The increase in villus height was observed immediately after surgery and peaked at 2 weeks. Levels remained higher than those observed in sham-operated pigs for a further 4 weeks.
Conclusions: The intestinal adaptation process in animals that underwent BPBP was less intense than in those that underwent massive short bowel resection and more intense than in those that underwent transection only. Supplementation with glutamine did not improve any of the parameters studied, although it did appear to accelerate the adaptive process.
Databáze: MEDLINE
Externí odkaz: