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Durcan C, Hossain M, Chagnon G, Perić D, Girard E. Mechanical experimentation of the gastrointestinal tract: a systematic review. Biomech Model Mechanobiol 2024; 23:23-59. [PMID: 37935880 PMCID: PMC10901955 DOI: 10.1007/s10237-023-01773-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 09/10/2023] [Indexed: 11/09/2023]
Abstract
The gastrointestinal (GI) organs of the human body are responsible for transporting and extracting nutrients from food and drink, as well as excreting solid waste. Biomechanical experimentation of the GI organs provides insight into the mechanisms involved in their normal physiological functions, as well as understanding of how diseases can cause disruption to these. Additionally, experimental findings form the basis of all finite element (FE) modelling of these organs, which have a wide array of applications within medicine and engineering. This systematic review summarises the experimental studies that are currently in the literature (n = 247) and outlines the areas in which experimentation is lacking, highlighting what is still required in order to more fully understand the mechanical behaviour of the GI organs. These include (i) more human data, allowing for more accurate modelling for applications within medicine, (ii) an increase in time-dependent studies, and (iii) more sophisticated in vivo testing methods which allow for both the layer- and direction-dependent characterisation of the GI organs. The findings of this review can also be used to identify experimental data for the readers' own constitutive or FE modelling as the experimental studies have been grouped in terms of organ (oesophagus, stomach, small intestine, large intestine or rectum), test condition (ex vivo or in vivo), number of directions studied (isotropic or anisotropic), species family (human, porcine, feline etc.), tissue condition (intact wall or layer-dependent) and the type of test performed (biaxial tension, inflation-extension, distension (pressure-diameter), etc.). Furthermore, the studies that investigated the time-dependent (viscoelastic) behaviour of the tissues have been presented.
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Affiliation(s)
- Ciara Durcan
- Zienkiewicz Centre for Modelling, Data and AI, Faculty of Science and Engineering, Swansea University, Swansea, SA1 8EN, UK
- Université Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, TIMC, 38000, Grenoble, France
| | - Mokarram Hossain
- Zienkiewicz Centre for Modelling, Data and AI, Faculty of Science and Engineering, Swansea University, Swansea, SA1 8EN, UK.
| | - Grégory Chagnon
- Université Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, TIMC, 38000, Grenoble, France
| | - Djordje Perić
- Zienkiewicz Centre for Modelling, Data and AI, Faculty of Science and Engineering, Swansea University, Swansea, SA1 8EN, UK
| | - Edouard Girard
- Université Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, TIMC, 38000, Grenoble, France
- Laboratoire d'Anatomie des Alpes Françaises, Université Grenoble Alpes, Grenoble, France
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Gregersen H, Liao D, Brasseur JG. The Esophagiome: concept, status, and future perspectives. Ann N Y Acad Sci 2016; 1380:6-18. [PMID: 27570939 DOI: 10.1111/nyas.13200] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 07/13/2016] [Accepted: 07/14/2016] [Indexed: 12/23/2022]
Abstract
The term "Esophagiome" is meant to imply a holistic, multiscale treatment of esophageal function from cellular and muscle physiology to the mechanical responses that transport and mix fluid contents. The development and application of multiscale mathematical models of esophageal function are central to the Esophagiome concept. These model elements underlie the development of a "virtual esophagus" modeling framework to characterize and analyze function and disease by quantitatively contrasting normal and pathophysiological function. Functional models incorporate anatomical details with sensory-motor properties and functional responses, especially related to biomechanical functions, such as bolus transport and gastrointestinal fluid mixing. This brief review provides insight into Esophagiome research. Future advanced models can provide predictive evaluations of the therapeutic consequences of surgical and endoscopic treatments and will aim to facilitate clinical diagnostics and treatment.
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Affiliation(s)
- Hans Gregersen
- GIOME, College of Bioengineering, Chongqing University, China. .,GIOME, Department of Surgery, Prince of Wales Hospital, College of Medicine, Chinese University of Hong Kong, Hong Kong SAR.
| | - Donghua Liao
- GIOME Academy, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - James G Brasseur
- Aerospace Engineering Sciences, University of Colorado, Boulder, Colorado
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Chen P, Zhao J, Nielsen VH, Clausen T, Gregersen H. Intestinal remodelling in mink fed with reduced protein content. J Biomech 2009; 42:443-8. [PMID: 19159886 DOI: 10.1016/j.jbiomech.2008.11.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2008] [Revised: 11/28/2008] [Accepted: 11/29/2008] [Indexed: 12/26/2022]
Abstract
Low protein intake occurs in humans in relation to diseases, starvation and post-operatively. Low-protein diets may affect the gastrointestinal structure and mechanical function. The aim was to study the passive biomechanical properties and tissue remodelling of the intestine in minks on reduced protein diets. Twenty-seven male minks were divided into three groups receiving different protein level in the diet for 6 weeks: High protein level (group H, 55% energy from protein), moderate protein level (group M, 30% energy from protein) and low protein level (group L, 15% energy from protein) (n=9 for each group). Ten centimetre long segments from duodenum, jejunum and ileum were excised at the end of the study period. The mechanical test was performed as a ramp distension experiment. The intestinal diameter and length, wall thickness, wall area and opening angle were obtained from digitized images of the intestinal segments at pre-selected pressures, no-load and zero-stress states, respectively. Circumferential and longitudinal stresses (force per area) and strains (deformation) were computed. The layer thickness was measured from intestinal histological images. No difference in body weight was found between groups at the start of the experiment. However, at the end of the experiment the body weight was smallest in group L (P=0.0003 and 0.0004 compared with groups H and M). Similarly, the wet weight per unit length, wall thickness and area were smallest in group L (P<0.05, P<0.01). The lowest wall thickness was found in the jejunum and ileum in group L (P<0.05), mainly due to decreased mucosa and submucosa thickness. The smallest opening angle and absolute values of residual strain were found in the jejunal segment in group L (P<0.05). No difference was observed for duodenal and ileal segments among the three groups. Feeding the low-protein diet shifted the stress-strain curves to the right for the circumferential direction, indicating the wall become softer in the circumferential direction. However, no significant difference was observed in the longitudinal direction for any of the intestinal segments. In conclusion, this study demonstrated that low-protein diet in minks induce histomorphometric and biomechanical remodelling of the intestine.
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Affiliation(s)
- Pengmin Chen
- Mech-Sense, Aalborg Hospital Science and Innovation Centre (AHSIC), Sdr. Skovvej 15, DK-9000 Aalborg, Denmark
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Abstract
The gastrointestinal (GI) tract is the system of organs within multi-cellular animals that takes in food, digests it to extract energy and nutrients, and expels the remaining waste. The various patterns of GI tract function are generated by the integrated behaviour of multiple tissues and cell types. A thorough study of the GI tract requires understanding of the interactions between cells, tissues and gastrointestinal organs in health and disease. This depends on knowledge, not only of numerous cellular ionic current mechanisms and signal transduction pathways, but also of large scale GI tissue structures and the special distribution of the nervous network. A unique way of coping with this explosion in complexity is mathematical and computational modelling; providing a computational framework for the multilevel modelling and simulation of the human gastrointestinal anatomy and physiology. The aim of this review is to describe the current status of biomechanical modelling work of the GI tract in humans and animals, which can be further used to integrate the physiological, anatomical and medical knowledge of the GI system. Such modelling will aid research and ensure that medical professionals benefit, through the provision of relevant and precise information about the patient’s condition and GI remodelling in animal disease models. It will also improve the accuracy and efficiency of medical procedures, which could result in reduced cost for diagnosis and treatment.
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Fan Y, Zhao J, Liao D, Gregersen H. The effect of digestion of collagen and elastin on histomorphometry and the zero-stress state in rat esophagus. Dig Dis Sci 2005; 50:1497-505. [PMID: 16110842 DOI: 10.1007/s10620-005-2868-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
To understand the physiology and pathology of the esophagus, it is necessary to know the mechanical properties and their dependence on the structural components. The aim of this study was to investigate the effect of collagenase and elastase on the morphological and biomechanical properties in the no-load and zero-stress states in the rat esophagus. Twenty tissue rings from each esophagus of seven normal rats were sectioned in an organ bath containing calcium-free Krebs solution with dextran and EGTA. After the rings were photographed in the no-load state, 8 of the 20 rings were separated into mucosa-submucosa and muscle rings and the rings were transferred to four different solutions containing collagenase, elastase, or corresponding control solutions. The rings were cut radially to obtain the zero-stress state and photographed again. The thickness, area, and opening angle were measured from the digitized images. The collagen and elastin area fractions were determined from histological slides with Van Gieson and Weigert's elastic stain. The opening angles and residual strain did not differ in the nonseparated enzyme-treated rings and control rings. However, in the separated mucosa-submucosa ring the opening angle was significantly smaller after treatment than that in control rings (P < 0.01). Collagenase and elastase reduced collagen and elastin in the mucosa-submucosa layer about 40% in the nonseparated wall and 54% in the separated mucosa-submucosa layer (P < 0.01). Collagenase and elastase increased the thickness in the separated mucosa-submucosa layer compared to the control (P < 0.05). Disconnection between the epithelia and the lamina propria was histologically observed after elastase digestion. In conclusion, collagenase and elastase caused the opening angle and the residual strain in the separated mucosa-submucosa layer to decrease. The opening angle of the separated mucosa-submucosa layer depended to some extent on the fraction of collagen and elastin.
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Affiliation(s)
- Yanhua Fan
- Center of Excellence in Visceral Biomechanics and Pain, Aalborg Hospital, DK-9100 Aalborg, Denmark
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Zhao J, Liao D, Gregersen H. Tension and stress in the rat and rabbit stomach are location- and direction-dependent. Neurogastroenterol Motil 2005; 17:388-98. [PMID: 15916626 DOI: 10.1111/j.1365-2982.2004.00635.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Distension studies in the stomach are very common. It is assumed in pressure-volume (barostat) studies of tone and tension in the gastric fundus that the fundus is a sphere, i.e. that the tension in all directions is identical. However, the complex geometry of the stomach indicates a more complex mechanical behaviour. The aim of this study was to determine uniaxial stress-strain properties of gastric strips obtained from rats (n=12) and rabbits (n=10). Furthermore, we aimed to study the gastric zero-stress state since the stomach is one of the remaining parts of the gastrointestinal tract where residual strain studies have not been conducted. Longitudinal strips (in parallel with the lesser curvature) and circumferential strips (perpendicular to the lesser curvature) were cut from the gastric fundus (glandular part) and forestomach (non-glandular part). The residual stress was evaluated as bending angles (unit: degree per unit length and negative when bending outwards). The residual strain was computed from the change in length between the zero-stress state and no-load state. The stress-strain test was performed using a tensile test machine. The thickness and width of each strip were measured from digital images. The strips data were compared with data obtained in the intact stomach in vitro. Most residual stresses and strains were bigger in the glandular part than in the forestomach, and in general the rat stomach had higher values than the rabbit stomach. The glandular strips were stiffer than the forestomach strips and the longitudinal glandular strips were stiffer than the circumferential glandular strips (P<0.05). The gastric strips were stiffer in rats than in rabbits (P<0.01). The data obtained in the intact rat stomach confirmed the strips data and indicated that those were obtained in the physiological range. In conclusion, the biomechanical properties of the gastric strips from the rat and rabbit are location-dependent, direction-dependent and species-dependent. The assumption in physiological pressure-volume studies that the stomach is a sphere with uniform tension is not valid. Three-dimensional geometric data obtained using imaging technology and mechanical data are needed for evaluation of the stomach function.
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Affiliation(s)
- J Zhao
- Centre of Excellence in Visceral Biomechanics and Pain, Aalborg Hospital, Aalborg, Denmark
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Zeng YJ, Yang J, Zhao JB, Liao DH, Zhang EP, Gregersen H, Xu XH, Xu H, Xu CQ. Morphologic and biomechanical changes of rat oesophagus in experimental diabetes. World J Gastroenterol 2004; 10:2519-23. [PMID: 15300896 PMCID: PMC4572153 DOI: 10.3748/wjg.v10.i17.2519] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
AIM: To study morphologic and biomechanical changes of oesophagus in diabetes rats.
METHODS: Diabetes was induced by a single injection of streptozotocin (STZ). The type of diabetes mellitus induced by parenteral STZ administration in rats was insulin-dependent (type I). The samples were excised and studied in vitro using a self-developed biomaterial test machine.
RESULTS: The body mass was decreased after 4 d with STZ treatment. The length of esophagus shortened after 4, 7, 14 d. The opening angle increased after 14 d. The shear, longitudinal and circumferential stiffness were obviously raised after 28 d of STZ treatment.
CONCLUSION: The changes of passive biomechanical properties reflect intra-structural alteration of tissue to a certain extent. This alteration will lead to some dysfunction of movement. For example, tension of esophageal wall will change due to some obstructive disease.
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Affiliation(s)
- Yan-Jun Zeng
- Forensic Medicine Department, Medical College, Shantou University, Shantou 515031, Guangdong Province, China.
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Gregersen H, Lu X, Zhao J. Physiological growth is associated with esophageal morphometric and biomechanical changes in rats. Neurogastroenterol Motil 2004; 16:403-12. [PMID: 15305995 DOI: 10.1111/j.1365-2982.2004.00536.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Esophageal geometry and biomechanical changes were studied during physiological growth in rats aged 1-32 weeks. Histological examination was done after the biomechanical study. The esophageal dimensions increased many-fold from 1-32 weeks, e.g. the weight per unit length increased six-fold and the wall cross-sectional area increased eight-fold. The inner and outer circumferential length of the mucosa and muscle, and the thickness and area of the layers increased as function of age. The opening angle was approximately 140 degrees at age 1 and 2 weeks and gradually decreased to approximately 80 degrees after 16 weeks. The circumferential and longitudinal stress-strain curves were exponential. The circumferential stress-strain curves shifted from left to the right up to 4 weeks of age (P < 0.001) where after no further change was observed, i.e. the esophagus became more compliant during the first 4 weeks of life. The longitudinal stress-strain curves shifted from left to the right up to 16 weeks of age (P < 0.001), i.e. the esophagus became more compliant longitudinally during the first 16 weeks of life. Bi-axial stress-strain analysis with determination of mechanical tissue constants showed that the esophagus was stiffer in the longitudinal direction than in the circumferential direction. In conclusion, a pronounced morphometric and biomechanical remodelling was observed in the rat esophagus during physiological growth. The observed changes likely reflect the development of the physiological function of the esophagus since for other tissues the function dictates the form of the tissue, and growth and remodelling depend on the mechanical loading.
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Affiliation(s)
- Hans Gregersen
- Center of Excellence in Visceral Biomechanics and Pain, Aalborg Hospital and Center of Sensory-Motor Interaction, Aalborg University, Hobrovej 42-A, DK-9100 Aalborg, Denmark.
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