1. Morphological adaptation with preserved proliferation/transporter content in the colon of patients with short bowel syndrome
- Author
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Dominique Cazals-Hatem, Francisca Joly, Marie-Louise Noordine, Claire Cherbuy, Pierre-Henri Duée, Bernard Messing, Muriel Thomas, Anne Lavergne-Slove, Camille Mayeur, Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Unité de recherche d'Écologie et Physiologie du Système Digestif (UEPSD), Institut National de la Recherche Agronomique (INRA), Hôpital Lariboisière-Fernand-Widal [APHP], Services déconcentrés d'appui à la recherche Ile-de-France-Versailles-Grignon, Benjamin Delessert Institut, Nutricia, and Assistance Publique des Hopitaux de Paris
- Subjects
Male ,caspase-3 ,Time Factors ,Physiology ,[SDV]Life Sciences [q-bio] ,Apoptosis ,Gastroenterology ,Intestinal malabsorption ,0302 clinical medicine ,Prospective Studies ,colonic hyperplasia ,Intestinal Mucosa ,Prospective cohort study ,Symporters ,biology ,Sodium-Hydrogen Exchanger 3 ,PepT1 ,Middle Aged ,Hyperplasia ,hyperplasie ,Short bowel syndrome ,Adaptation, Physiological ,nutrition ,030220 oncology & carcinogenesis ,Female ,030211 gastroenterology & hepatology ,Ki67 ,Short Bowel Syndrome ,medicine.medical_specialty ,Sodium-Hydrogen Exchangers ,proliferation markers ,PCNA ,Na+/H+ exchanger 3 ,Na+/H+ exchanger 2 ,hyperphagia ,Colon ,Cysteine Endopeptidases ,physiopathologie ,Nutritional Status ,Peptide Transporter 1 ,03 medical and health sciences ,intestin ,hyperphagie ,Physiology (medical) ,Internal medicine ,medicine ,Humans ,RNA, Messenger ,Aged ,Cell Proliferation ,prolifération cellulaire ,Hepatology ,marqueur cellulaire ,Transporter ,medicine.disease ,Proliferating cell nuclear antigen ,Intestinal Absorption ,Case-Control Studies ,biology.protein ,Adaptation - Abstract
In short bowel syndrome (SBS), although a remaining colon improves patient outcome, there is no direct evidence of a mucosal colonic adaptation in humans. This prospective study evaluates morphology, proliferation status, and transporter expression level in the epithelium of the remaining colon of adult patients compared with controls. The targeted transporters were Na+/H+exchangers (NHE2 and 3) and oligopeptide transporter (PepT1). Twelve adult patients with a jejuno-colonic anastomosis were studied at least 2 yr after the last surgery and compared with 11 healthy controls. The depth of crypts and number of epithelial cells per crypt were quantified. The proliferating and apoptotic cell contents were evaluated by revealing Ki67, PCNA, and caspase-3. NHE2, NHE3, PepT1 mRNAs, and PepT1 protein were quantified by quantitative RT-PCR and Western blot, respectively. In patients with SBS compared with controls, 1) hyperphagia and severe malabsorption were documented, 2) crypt depth and number of cells per crypt were 35% and 22% higher, respectively ( P < 0.005), whereas the proliferation and apoptotic levels per crypt were unchanged, and 3) NHE2 mRNA was unmodified; NHE3 mRNA was downregulated near the anastomosis and unmodified distally, and PepT1 mRNA and protein were unmodified. We concluded that, in hyperphagic patients with SBS with severe malabsorption, adaptive colonic changes include an increased absorptive surface with an unchanged proliferative/apoptotic ratio and well-preserved absorptive NHE2, NHE3, and PepT1 transporters. This is the first study showing a controlled nonpharmacological hyperplasia in the colon of patients with SBS.
- Published
- 2009