Parenteral Nutrition-Dependent Children With Short-Bowel Syndrome Lack Duodenal-Adaptive Hyperplasia but Show Molecular Signs of Altered Mucosal Function
| Autor: | Jouko Lohi, Annika Mutanen, Antti Koivusalo, Markku Heikinheimo, Galina Sanaksenaho, Mikko P. Pakarinen, Antti Kyrönlahti, Marjut Pihlajoki, Nimish Godbole |
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| Rok vydání: | 2019 |
| Předmět: |
Short Bowel Syndrome
medicine.medical_specialty 030309 nutrition & dietetics medicine.medical_treatment Medicine (miscellaneous) Gastroenterology Rats Sprague-Dawley 03 medical and health sciences 0302 clinical medicine Internal medicine Intestine Small medicine Animals Humans Intestinal Mucosa Child 0303 health sciences Nutrition and Dietetics Hyperplasia biology business.industry Infant Bowel resection Short bowel syndrome medicine.disease Glucagon-like peptide-2 Adaptation Physiological Small intestine 3. Good health Rats Disease Models Animal medicine.anatomical_structure Parenteral nutrition Peptide transport Child Preschool biology.protein 030211 gastroenterology & hepatology GLUT1 business |
| Zdroj: | JPEN. Journal of parenteral and enteral nutritionReferences. 44(7) |
| ISSN: | 1941-2444 |
| Popis: | Background Although adaptive mucosal growth of the remaining small intestine is an essential compensatory mechanism to bowel resection in experimental short-bowel syndrome (SBS), only scarce clinical data are available. We studied structural and molecular mechanisms of intestinal adaptation in children with SBS. Methods Fourteen patients, who had been dependent on parenteral nutrition (PN) since neonatal period for a median (interquartile range)1.4 (0.7-6.5) years, were studied at the age of 1.5 (1.0-6.5) years. Median length of remaining small bowel was 33 (12-60) cm, and 6 patients had their ileocecal valve preserved. Six children without gastrointestinal disorders served as age-matched and gender-matched controls. All patients underwent duodenal biopsies. Mucosal microarchitecture, proliferation, apoptosis, inflammation, and epithelial-barrier function were addressed using histology, immunohistochemistry, and quantitative real-time polymerase chain reaction. Results Villus height, crypt depth, enterocyte proliferation, and apoptosis were similar in patients and matched controls. Messenger RNA (mRNA) expression of numerous genes regulating gut epithelial-barrier function (TGFB2, CAV1, CLDN1, MUC2, and NLRC4) was significantly altered. Of various nutrient transporters studied, only expression of SLC2A1 encoding facilitative glucose transporter GLUT1 was increased among patients, whereas RNA expression of genes encoding sodium-dependent glucose, sterol, fatty-acid, and peptide transport remained unchanged. Conclusion Duodenal mucosal hyperplasia has a limited role in mediating physiological adaptation following intestinal resection among PN-dependent children with SBS. Further clinical studies addressing functional significance of the observed alterations in mucosal RNA expression are warranted. |
| Databáze: | OpenAIRE |
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