Effect of ethanol on the morphology of hamster jejunum

Structural and morphometric analysis of murine small intestine after indomethacin administration

Indomethacin, a nonsteroidal anti-inflammatory drug, induces the formation of gastrointestinal ulceration both in experimental animals and in humans. A study of indomethacin-induced ulcers in the mouse showed that two doses of indomethacin, each administered subcutaneously at 85 mg/kg body weight, induced well-defined gastrointestinal ulcers in C57 mice, accompanied by inflammatory and vascular changes in the stomach and small intestine. Maximal damage was observed 20 h after the second dose of indomethacin. Morphometric analysis identified changes in all compartments of the small intestine. There was a marked reduction in the length of the small intestine, intestinal dilatation, a significant decrease in villous height, with the formation of subepithelial blisters or blebs within villi, and submucosal vascular dilatation. There was no change in the number of villi or of submucosal arterioles or in the total amount of muscle present in the wall of the intestine. The tissue changes identified in this study may have implications for gut function at specific periods during indomethacin treatment.

Ethanol-induced jejunal microvascular and morphological injury in relation to histamine release in rabbits

BACKGROUND

To investigate the relation between ethanol-induced jejunal microvascular injury, morphological changes, and histamine release, the present study examined whether the attenuation of microvascular effect of ethanol by 16,16-dimethyl prostaglandin E2 (dmPGE2) (reported by us previously) was associated with an attenuation of epithelial damage and histamine release.

METHODS

Rabbits were used. Mucosal microvascular injury was assessed by determining jejunal plasma protein loss (JPPL), histamine release by measuring histamine concentration of the gut effluent, and epithelial damage by routine histology.

RESULTS

(1) During 90-minute jejunal ethanol perfusion, there was a direct relation between the time course of histamine release and that of JPPL. (2) dmPGE2 attenuated the ethanol-induced JPPL and histamine release, and the decrease in JPPL was directly proportional to the decrease in histamine release. (3) dmPGE2 did not alleviate ethanol-induced epithelial damage. (4) Ketotifen (a mast cell stabilizer), similar to dmPGE2, attenuated ethanol-induced JPPL and histamine release. (5) Ethanol caused histamine release by the jejunum in vitro; this was attenuated by dmPGE2 and also by phloretin (a mast cell stabilizer).

CONCLUSIONS

It appears that (1) ethanol causes JPPL by inducing release of mediators from mucosal mast cells. (2) dmPGE2 attenuates JPPL by stabilizing mast cells. (3) The ethanol-induced mucosal microvascular injury is directly related to histamine release but not to epithelial damage.

Age related changes in functions and physicochemical properties of rat jejunal brush border membrane after chronic ethanol administration

1. We investigated the chronic effects of a 4 week treatment with ethanol on functions and physicochemical properties of BBM of young and adult rats (2 and 7 months old respectively). 2. In the ethanol treated groups the cholesterol/phospholipid and the protein/lipid ratios as well as the D-glucose uptake and lactase specific activity and Vmax were increased. In spite of a minor alcohol consumption the adult group was the more affected. 3. Membranes from the ethanol fed rats were less fluid and more tolerant to the in vitro addition of ethanol.

Effects of ethanol on an intestinal epithelial cell line

The effect of exposure of an intestinal epithelial cell line to various concentrations of ethanol [217 mM (1%) to 652 mM (3%)] during 24, 48, and 72 hr was investigated in vitro using a rat intestinal epithelial cell line (IRD 98). Incubation of these cells in the presence of ethanol significantly decreased cell growth. This inhibition was accompanied by a strong increase in cellular protein. Stimulation of specific disaccharidases, gamma-glutamyl transferase, and aminopeptidase activities by ethanol was dose- and time-dependent. Ethanol induces a change in the relative proportions of the different lipid classes synthesized; triglycerides, fatty acids, and cholesterol esters were preferentially synthethysed. Our findings show that cell lines are good models for investigation of the effects of ethanol, and that alcohol considerably modifies the functions of intestinal epithelial cells.

Proinflammatory effects of local abdominal irradiation on rat gastrointestinal tract

Although the role of inflammatory processes in the genesis of late changes in the gastrointestinal tract following exposure to ionizing irradiation has been extensively studied, few studies have concentrated on the presence of an acute inflammatory response in the period immediately following radiation. We therefore examined, in rats, whether the local application of 10 Gy cobalt-60 irradiation to the abdomen led to changes in the gut within the first 24 hr that were consistent with an acute inflammatory response. In stomach, small intestine, and colon, local irradiation led to a significant increase in the accumulation of plasma within the tissue by 4-8 hr following irradiation. This increase in tissue plasma volume, indicative of an increased microvascular permeability, was then sustained until the end of the 24-hr assessment period in all tissues examined. Concurrent with this was a consistent transient increase in tissue red blood cell volume, suggestive of vasodilation. Of particular note, a significant increase in the number of mucosal neutrophils was also observed between 2 and 12 hr following irradiation. This elevation in mucosal neutrophils was particularly marked in the pericryptal or deep mucosal regions of small intestine and colon and consistently preceded the vasodilation and enhanced permeability. Furthermore these pathophysiological alterations occurred at a time when histological changes in the mucosa consistent with an impaired mucosal microcirculation (ie, edema of the lamina propria and subepithelial bleb formation) were present. These results support the hypothesis that an inflammatory response occurs in the gut during the first 24 hr following abdominal irradiation. Such changes may then further exacerbate the damage initiated by the ionizing radiation.

Mechanism of ethanol-induced jejunal microvascular and morphologic changes in the dog

To study the mechanism of morphologic and microvascular effects of intraluminal ethanol, we perfused jejunal segments of the dog with 6% (wt/vol) ethanol for 0 (control), 10, 20, 30, 60, and 90 min, and measured the time-dependent changes in (a) the prevalence of villi with epithelial damage (i.e., villi with intact blebs plus those with broken blebs) and those without epithelial damage (undamaged villi), (b) the height of the villus core and the patency of lacteals, (c) jejunal albumin loss, and (d) permeability of microvessels of the villus tip by colloidal carbon vascular labeling. We found that (a) the prevalence of villi with epithelial damage or with intact bleb increased progressively during the first 20 min of ethanol perfusion and then declined gradually; (b) the height of the villus core and the patency of lacteals in the undamaged villi and in those with intact bleb decreased during the first 20 min and then gradually increased; and (c) jejunal albumin loss and the prevalence of villi with carbon labeling increased for the first 30 min, after which the former declined gradually whereas the latter remained at a plateau. These findings suggest that contraction of the villus core and compression of the lymphatics are the primary cause of ethanol-induced epithelial damage, which is accentuated by increased microvascular permeability and consequent protein leakage. The mechanism of recovery of most parameters, in spite of continuous ethanol perfusion, remains to be investigated.

Ethanol-induced vascular permeability changes in the jejunal mucosa of the dog

We have demonstrated previously that ethanol causes alterations in jejunal morphology and fluid secretion, and that these changes are accompanied by an increase in mucosal arteriolar blood flow, shunting of blood through noncapillary microvessels, hyperemia, hemoconcentration, and an enhanced loss of plasma protein into the gut lumen. All the microcirculatory changes are compatible with an ethanol-induced mucosal microvascular stasis. The present study was undertaken to examine whether these changes are accompanied by an enhanced mucosal microvascular permeability. Using a colloidal carbon vascular labeling technique, we demonstrated that 6% wt/vol intraluminal ethanol caused marked accumulation of carbon particles in the walls of the capillaries and microvenules of the villus tips. The effect of 3% ethanol was much less pronounced, and the extent of carbon entrapment did not significantly differ from microvessels in villi perfused with Krebs-Ringer solution without ethanol. Electron microscopy indicated that the carbon was localized between the endothelial cell and the basal lamina of the microvessels. Because the carbon accumulation was always localized at the vicinity of endothelial cell junctions, the escape of carbon particles from the lumen probably occurred through these cell junctions. This could have been the result of a transient retraction of endothelial cells. Electron microscopic examination also demonstrated that the lumina of some capillaries and venules of the villus tip of jejunal segments perfused with 6% ethanol were clogged with carbon particles. This latter finding indicates that there was stasis in these vessels at the time of carbon injection. Similar intraluminal carbon accumulation was never seen in control jejunum or jejunum perfused with 3% ethanol. Thus the results of this study indicate that 6% (wt/vol) ethanol causes microvascular injury and stasis. The findings with 6% ethanol are reminiscent of those described by others in the early phases of acute inflammation, and thus it is possible that the microvascular changes caused by ethanol may be related to the liberation of some of the chemical mediators of the immediate response to acute injury.

Induced mucosal penetration and transfer to portal blood of luminal horseradish peroxidase after exposure of mucosa of guinea pig small intestine to ethanol and lysolecithin

The effect of luminal 150 mmol saline, 0.05-0.2% (w/v) lysolecithin, and 5-20% (v/v) ethanol was studied on the mucosal morphology of the proximal small intestine in conscious guinea pigs as well as on the mucosal penetration and transfer to portal venous blood of luminal horseradish peroxidase (HRP). No ultrastructural evidence of mucosal damage was identified in any of the lysolecithin-perfused animals compared with saline controls. Ten and 20% ethanol (v/v) resulted in the appearance of fluid-filled spaces between enterocytes and in cytoplasmic lipid deposits and an increased number of autophagic vesicles within the cells themselves. Tight junctions remained intact. These changes after luminal 5% ethanol (v/v) were much less conspicuous. In the presence of saline, luminal HRP was largely confined to the brush border. Both lysolecithin and ethanol (5% v/v) rapidly induced mucosal penetration of HRP which was seen in cytoplasmic vesicles within enterocytes, between enterocytes, and in the lamina propria. Peak portal venous blood levels of HRP studied in multiple samples over 3 hr were one log unit greater than saline controls. Absorption of HRP was proportional to the luminal concentration of lysolecithin in the range tested. These studies show that mucosal penetration and absorption of functional exogenous macromolecules may be induced, in the absence of morphological evidence of mucosal damage, by luminal constituents which may perturb the structure of enterocyte membranes.

Effect of ethanol on intestinal uptake of fatty acids, fatty alcohols, and cholesterol

The effect of acute exposure of the rabbit jejunum to ethanol on the uptake of fatty acids, fatty alcohols, and cholesterol was examined using a previously validated in vitro technique. The effective resistance of the intestinal unstirred water layer was determined from the rate of uptake of a homologous series of fatty alcohols. The addition of ethanol to the incubation or preincubation solutions had no effect on the uptake of these probes when the bulk phase was stirred at 600 rpm, but uptake was higher in the ethanol-exposed samples when the bulk phase was unstirred. Increasing the concentration of ethanol in the bulk phase was associated with a progressive decline in the rate of uptake of acetic, lauric, myristic, and palmitic acids, whereas the uptake of hexanoic, octanoic, and decanoic acids was unaffected, and the uptake of cholesterol was increased. Acute exposure of the intestine to ethanol was associated with an increase in the electrical conductance of the tissue, with no associated change noted in the tight junctions on transmission electron microscopy or in the surface epithelium on scanning electron microscopy. The results suggest that acute exposure of the rabbit intestine to ethanol is associated with a selective decline in the passive permeability properties of the membrane towards only certain lipids and that the effective resistance of the unstirred layer is influenced by ethanol only when the bulk phase is unstirred and the resistance is high.

Effect of ethanol on morphology and total, capillary, and shunted blood flow of different anatomical layers of dog jejunum

On the basis of previous studies in our laboratory we postulated that the ethanol-induced alteration in jejunal morphology was the result of its effect on the microcirculation. The present study was undertaken to examine the validity of this hypothesis. Accordingly, the effects of intraluminal ethanol perfusion (3.0 and 6.0% w/v) on mucosal morphology; water, glucose, and sodium transport; and regional blood flow were examined in in vivo jejunal segments of pentobarbital-anesthetized dogs. Compared to control segments, those perfused with ethanol exhibited a significant increase in the prevalence of morphological alterations of the mucosa, consisting of subepithelial fluid accumulation (bleb formation) and exfoliation. Those villi with epithelial damage exhibited villus cores significantly shorter than those with a normal, undamaged epithelium. Segments perfused with ethanol exhibited a depressed net water absorption, to the point that net secretion occurred in the segments perfused with 6% ethanol. Net absorption of glucose was similarly depressed by intraluminal perfusion with ethanol, whereas net absorption of sodium was unaffected. Regional jejunal blood flows were estimated using a dual, radiolabeled microsphere technique. Both total jejunal wall and total mucosal blood flow (in ml/min/100 g dry tissue) in the ethanol-perfused segments were significantly increased over control. Similarly, jejunal wall and mucosal capillary blood flows were increased by ethanol perfusion. Neither submucosal nor muscularis blood flows were affected by intraluminal perfusion with ethanol. Compared to control, shunting or nonentrapment of 9-micron microspheres was increased in the mucosa of the ethanol-perfused segments. In contrast to this, shunting of 9-micron microspheres in the submucosa and muscularis was unaffected by intraluminal perfusion with ethanol. It therefore appears that the ethanol-induced mucosal morphological alterations are accompanied by a localized mucosal hyperemia, and an increased shunting of blood through the mucosa. Based on the results of this and other studies, a microvascular mechanism was tentatively proposed to explain the pathogenesis of the ethanol-induced morphological changes.

Low-molecular-weight polyethylene glycol as a probe of gastrointestinal permeability after alcohol ingestion

Gastrointestinal permeability has been assessed previously by the excretion of PEG-400, which consists of inert molecules that are neither degraded nor metabolized and are excreted intact in the urine. We report here the effects of alcohol on gastrointestinal permeability using PEG-400. Ten grams of PEG-400 dissolved in 60 ml of water were given to 12 intoxicated alcoholics (mean blood alcohol: 2406 mg/liter). The mean urinary excretion of PEG-400 in the following 6 hr was 3.75 +/- 0.3 g SEM. When repeated after sobering up (mean elapsed time: 45 hr), all except one subject showed a decrease in PEG-400 excretion (mean: 2.08 +/- 0.2 g) (P less than 0.001). Similar experiments were conducted in two series with 12 normal controls. (1) In 7 subjects the administration on consecutive days of (a) PEG-400 (10 g) alone, (b) 10.2 g (0.42 mol) of ethanol plus PEG-400 (10 g), (c) PEG-400 (10 g) alone, and (d) PEG-400 (10 g) plus a diuretic (40 mg furosemide) resulted in the following values of PEG-400 excretion in urine: (a) 2.12 +/- 0.3 g; (b) 3.5 +/- 0.3 g, P less than 0.005; (c) 2.02 +/- 0.4, NS; and (d) 2.2 +/- 0.2 g, NS. (2) In the second experiment (5 subjects) the administration on subsequent days of (a) PEG-400 (10 g) + 0.42 mol of urea; (b) PEG-400 (10 g) + 19.2 g ethanol; (c) PEG-400 (10 g) + 0.42 mol of urea resulted also, as in the previous experiment, in increased urinary excretion of PEG-400 after the solution (b) containing ethanol (P less than 0.001). Peak serum levels of PEG-400 were (a) 0.094 +/- 0.01 g/liter; (b) 0.152 +/- 0.02 g/liter (P less than 0.05); and (c) 0.095 +/- 0.01 (P less than 0.05). The ratio of urea--creatinine clearance and urinary volumes were the same in the three periods. Therefore, PEG-400 excretion was not related to changes in urinary clearance or in volume, since the furosemide increased the volume but not PEG-400 excretion. It is concluded that ethanol increases the permeability of the gastrointestinal tract as measured by the PEG-400 test, both in chronic alcoholics during intoxication and in nonalcoholics after a small dose of ethanol. The permeability alteration is transient once ethanol ingestion stops.

Ethanol-induced inhibition of glucose transport across the isolated brush-border membrane of hamster jejunum

Acute exposure of jejunal mucosa to ethanol has been reported to produce a depression of transmural glucose transport across this organ in vitro and in vivo. In an attempt to understand the mechanism of action of ethanol on intestinal transport, in the present study we have investigated the effect of ethanol on glucose uptake by purified brush-border membrane vesicles of hamster jejunum. Ethanol, in concentrations found in man after moderate drinking (1-5% w/v), was found to depress glucose uptake by the brush-border membrane in a dose-dependent and time-dependent manner. Mannose was used to measure nonspecific uptake, and we found that the ethanol-induced depression of glucose uptake was not related to an alteration of the nonspecific uptake of this sugar. The inhibition of glucose uptake of the ethanol-treated membranes completely disappeared after repeated washing of the membranes with ethanol-free buffer. Accordingly, the ethanol-induced depression of glucose uptake was not the result of irreversible damage to membrane proteins but was related to a direct effect of ethanol on the brush-border membrane. On the basis of these findings, it is concluded that a direct interference with glucose translocation across the brush border plays an important role in the ethanol-induced depression of transmural jejunal glucose absorption.

Is ethanol-induced damage of the gastric mucosa a hyperosmotic effect? Comparative studies on the effects of ethanol, some other hyperosmotic solutions and acetylsalicylic acid on rat gastric mucosa

The involvement of hyperosmolarity in ethanol-induced gastric mucosal damage was studied by comparing the effects of ethanol on the rat gastric mucosa and those caused by hyperosmotic glucose and choline chloride solutions, and by an almost isosmotic solution of acetylsalicylic acid. Upon intragastric instillation, all test solutions, namely 3M and 5M ethanol (3330 and 5590 mosmol/kg resp.), 3M glucose (3890 mosmol/kg), 1.5 M choline chloride (2840 mosmol/kg) and 20 mM acetylsalicylic acid, also containing 100 mM HCl and 50 mM NaCl, produced macroscopic and microscopic lesions of the gastric mucosa. The haemorrhages induced by ethanol and acetylsalicylic acid solutions were more evenly distributed, whereas most lesions produced by the glucose and choline chloride solutions were located at the rumeno-fundic junction. There were no qualitative differences between the microscopic lesions caused by the various instillates, however. All the test solutions broke the gastric mucosal barrier and increased histamine release and pepsinogen output, but in the rats treated with acetylsalicylic acid these effects were less pronounced. Ethanol, glucose and choline chloride solutions increased gastric mucosal flow and fluid output from the stomach, whereas acetylsalicylic acid had no effect on these. The similarity between the ethanol-induced changes and those caused by hyperosmotic solutions of glucose and choline chloride leads to the suggestion that ethanol may cause damage in the gastric mucosa at least in part, via hyperosmolarity.

Effect of bile salt-binding resins on the morphology of rat jejunum and colon. A scanning electron microscopy study

One mechanism suggested to account for the hypocholesteremic effect of dietary fibers is their ability to sequester bile salts. Since bile salts have been found to alter intestinal structure, the morphological effects of several commonly used, xenobiotic, bile salt-binding agents was investigated. Wistar rats were fed a purified stock diet, ad libitum, for 6 weeks containing either 2% cholestyramine, 2% colestipol, or 2% DEAE-Sephadex. The bile salt-binding capacity of these substances was tested in vitro using taurocholate and glycocholate. The effect of in vivo feeding of the resins was to evoke ultrastructural topographical deviations from control appearance in both jejunal and colonic mucosae. Colonic cell injury was more severe than that observed in the jejunum of both colestipol- and DEAE-Sephadex-fed animals while the reverse was true for the rats fed cholestyramine. The degree of distortion in each condition was positively correlated with the extent of bile salt-binding capability in vitro. The rank order of both effects in terms of increasing severity was DEAE-Sephadex less than colestipol less than cholestyramine.

Villous damage induced by suction biopsy and by acute ethanol intake in normal human small intestine

Previous studies by us indicated that ethanol in concentrations of 2.0-4.8% produced subepithelial blebs in the jejunum of the hamster. In the rat, due to rupture of the blebs, there was denudation of the villus tip epithelium. There are nos similar data on humans. Ethanol, in quantities equivalent to 4.8-6.4 ounces of 80 proof whiskey (diluted to 20% w/v), was infused into stomachs of 20 normal human volunteers. Subjects were divided into groups (Gr) according to the amount or type of alcohol given, and site of biopsies (SB). Gr 1:60 g ethanol, SB = jejunum. Gr 2:45 g ethanol, SB = jejunum. Gr 3:45 g ethanol, SB = duodenum. Gr 4:45 g ethanol as 4.8 oz 80 proof whiskey, SB = duodenum. To compare the morphology in the absence and presence of ethanol, biopsies were obtained from each volunteer before ethanol administration (control period), immediately after peak ethanol concentration in the duodenum or jejunum (ethanol period), and when intraluminal ethanol concentration fell towards zero (recovery period). The mean peak intraluminal ethanol concentrations in the four groups varied between 5.69% and 9.37% (w/v). Ethanol-induced damage was evaluated using strict preset criteria. Coded slides were evaluated by two observers. Suction biopsy damaged 18% of the villi even in biopsies obtained during the control period. Ethanol produced a statistically significant increase in the number of damaged villi (mean of all groups 45%, range: 32% in Gr 2 to 62% in Gr 3). During the recovery period the number of damaged villi fell to that seen in control period biopsies. Ethanol, in quantities equivalent to those ingested during moderate drinking, may produce transient damage to the upper small intestine of man. Conversely, ethanol may simply increase the susceptibility of the mucosa to the unavoidable trauma of suction biopsy. However, the histological and ultrastructural changes were similar to those induced by ethanol in small laboratory animals.

Effect of ethanol on disaccharidases of hamster jejunal brush border membrane

This study was undertaken to investigate the effect of alcohol on the activity of jejunal disaccharidases (DS). The activity of DS in a preparation of purified brush border membrane of hamster jejunum was measured in the absence and in the presence (0.8 to 6.4% wt/vol) of ethanol. To compare the effect of alcohol on DS with its action on a brush border enzyme of a different group, we also measured the activity of alkaline phosphatase (AP) under similar conditions. Ethanol depressed the activity of sucrase, maltase, and lactase in a dose-dependent and time-dependent manner, but it stimulated the activity of AP. The ethanol-induced inhibition of DS was completely reversible. Kinetic studies indicate that ethanol depressed the Vmax and increased the Km of sucrase and lactase. The Vmax of maltase also decreased, but the Km of this hydrolase was not affected by ethanol. From the results of this study it would appear that acute exposure of the jejunal brush border to ethanol depresses the DS activity of the membrane and that (because the AP was not depressed) the ethanol-induced inhibition of DS is not the result of a general inhibition of all enzymes of the brush border.

Effect of ethanol on glucose and water absorption in hamster jejunum in vivo. Methodological problems: anesthesia, nonabsorbable markers, and osmotic effect

We studied the effect of ethanol on glucose and water absorption in vivo. In preliminary experiments, using sodium amytal anesthesia, we found that control animals, whose jejunal segment was perfused without ethanol, required more anesthetic agent than those perfused with ethanol. Thus, to allow for unbiased comparison of the absorption data between the two groups of animals, all absorption studies were carried out on conscious restrained hamsters. We found that ethanol did not influence the permeability of the jejunum to polyethylene glycol (PEG) and meglumine diatrizoate. In addition, ethanol did not influence the time required for the onset of steady-state absorption. Using both the gravimetric and the electrical methods, we were unable to show any measurable osmotic pressure exerted by ethanol (150-1050 mM) on the hamster jejunum. In the absorption studies we found that perfusion of the hamster jejunum with five increasing concentration of ethanol (450-1050 mM) appeared to cause a concentration-dependent depression in steady-state glucose transport. Water transport was depressed only when 4.8% (1050 mM) ethanol was perfused.