Intestinal adaptation after massive proximal small-bowel resection in the pig

Lactation from the inside out: Maternal homeorhetic gastrointestinal adaptations regulating energy and nutrient flow into milk production

Lactation invokes homeorhetic processes to ramp up and supply milk synthesis components to fulfil nutritional, immunological and microbiological requirements of developing offspring, overseen by complex neuroendocrine networks. The maternal gut meets these intense metabolic demands, supported by hyperphagia and rapid adjustments to process larger food quantities. Enteroplasticity describes an inherent ability of the gastrointestinal tract to harness metabolic and structural adaptations that increase nutrient absorption. Most shifts in response to increased demands are transitory and by secreting milk, the continuous energetic drain out of the maternal body avoids development of pathological metabolic diseases. Lactation has various positive benefits for long-term maternal health but many females do not lactate for long post pregnancy and younger women are increasingly pre-disposed to excessive body mass and/or metabolic complications prior to reproducing. Inadvertently invoking intestinal adaptations to harvest and store excess nutrients has negative health implications with increased risks for both mother and offspring.

Enterohormone therapy for short bowel syndrome

PURPOSE OF REVIEW

Short bowel syndrome (SBS) patients are at risk to develop intestinal failure when the decreased absorption of macronutrients, water, and electrolytes necessitates parenteral support for survival. The adverse effects of SBS and parenteral support negatively affect the quality of life (QoL) of SBS-intestinal failure patients. However, spontaneous intestinal adaptation along with disease-modifying therapies allow reducing parenteral support, thereby improving QoL.

RECENT FINDINGS

During the first years following extensive surgery, spontaneous structural and functional intestinal changes take place which stimulate a more efficient nutrient and fluid absorption in the remaining bowel. Given their potential role in the ileal braking mechanism, enterohormones, such as glucagon-like peptide (GLP)-2, GLP-1, and peptide YY (PYY), promote an accelerated adaptation or hyperadaptation. While the exact role of GLP-1 and PYY in SBS is still being explored, GLP-2 analogs have clearly shown to be effective in improving outcome in SBS.

SUMMARY

Whereas spontaneous intestinal adaptation improves the nutritional status of SBS patients to a certain extent, GLP-2 analogs can further decrease parenteral support needs through hyperadaptation. There are, however, other promising candidates on the horizon that - alone or in combination - could possibly establish additional disease-modifying effects.

Influence of Different Herbal-Mix Feed Additives on Serological Parameters, Tibia Bone Characteristics and Gut Morphology of Growing Pigs

A sixteen-week study was carried out in order to investigate the effects of different herbal-mix feed additives (Moringa, Basil and Neem) on serological parameters, tibia bone characteristics and gut morphology of growing pigs. Eighty-one Large White breed of pigs with a mean weight of 15.35 ± 1.07 were grouped on weight equalization basis into three treatments with 9 replicates per treatment and 3 pigs per replicate in a completely randomized design. Pigs on treatment 1 were fed a ration without integration of herbal-mix feed additives, those in treatments 2 and 3 were offered a diet that contained moringa-basil leaf meal and neem-basil leaf meal respectively. Blood samples were collected from the experimental pigs on the 12th week of the study for the determination of serum levels, while 1 pig from each replicate group whose weight was close to the mean replicate weight was chosen at the end of the study, fasted for 12 hours, sacrificed and the small intestine and left tibia bone were harvested and used for gut and bone morphology evaluation. These data generated from the study were subjected to a 1-way analysis of variance (ANOVA). The results indicated that herbal-mix feed additives influenced some of the serological parameters, i.e., globulin, glucose, total cholesterol, high- and low-density lipoproteins, and aspartate aminotransferase. These parameters decreased with integration of different herbal-mix in the pigs’ diets except high density lipoprotein that increased statistically. The tibia characteristics such as tibia breaking strength, medial thickness and lateral thickness were also positively impacted by the dietary inclusion of the herbal-mix. Likewise, the villus height of the jejunum was positively enhanced by dietary inclusion of the herbal-mix feed additives. This study concluded that herbal-mix feed additives can be utilized in pigs’ nutrition in enhancing some serological parameters, tibia bone and gut characteristics of growing pigs.

Short bowel syndrome: treatment options

Introduction Short bowel syndrome (SBS) refers to the malabsorptive state that occurs following extensive intestinal resection and is associated with several complications.

Methods The research for this review was conducted in the Pubmed database. Relevant scientific articles dated between 1991 and 2015 and written in Portuguese, Spanish or English were selected.

Results Several therapies, including nutritional support, pharmacological options and surgical procedures have been used in these patients.

Conclusions Over the last decades new surgical and pharmacological approaches emerged, increasing survival and quality of life (QoL) in patients with SBS. All SBS patients ought to have an individualized and multidisciplinary care that promotes intestinal rehabilitation.

Alterations in Small Intestine and Liver Morphology, Immunolocalization of Leptin, Ghrelin and Nesfatin-1 as Well as Immunoexpression of Tight Junction Proteins in Intestinal Mucosa after Gastrectomy in Rat Model

The stomach is responsible for the processing of nutrients as well as for the secretion of various hormones which are involved in many activities throughout the gastrointestinal tract. Experimental adult male Wistar rats (n = 6) underwent a modified gastrectomy, while control rats (n = 6) were sham-operated. After six weeks, changes in small intestine (including histomorphometrical parameters of the enteric nervous plexuses) and liver morphology, immunolocalization of leptin, ghrelin and nesfatin-1 as well as proteins forming adherens and tight junctions (E-cadherin, zonula occludens-1, occludin, marvelD3) in intestinal mucosa were evaluated. A number of effects on small intestine morphology, enteric nervous system ganglia, hormones and proteins expression were found, showing intestinal enteroplasticity and neuroplasticity associated with changes in gastrointestinal tract condition. The functional changes in intestinal mucosa and the enteric nervous system could be responsible for the altered intestinal barrier and hormonal responses following gastrectomy. The results suggest that more complicated regulatory mechanisms than that of compensatory mucosal hypertrophy alone are involved.

Short Bowel Syndrome: A Paradigm for Intestinal Adaptation to Nutrition?

Short bowel syndrome (SBS) is a rare disease that results from extensive resection of the intestine. When the remaining absorption surface of the intestine cannot absorb enough macronutrients, micronutrients, and water, SBS results in intestinal failure (IF). Patients with SBS who suffer from IF require parenteral nutrition for survival, but long-term parenteral nutrition may lead to complications such as catheter sepsis and metabolic diseases. Spontaneous intestinal adaptation occurs weeks to months after resection, resulting in hyperplasia of the remnant gut, modification of gut hormone levels, dysbiosis, and hyperphagia. Oral nutrition and presence of the colon are two major positive drivers for this adaptation. This review aims to summarize the current knowledge of the mechanisms underlying spontaneous intestinal adaptation, particularly in response to modifications of luminal content, including nutrients. In the future, dietary manipulations could be used to treat SBS.

Intestinal plasticity in response to nutrition and gastrointestinal surgery

The plasticity of a material corresponds to its capacity to change its feature under the effect of an external action. Intestinal plasticity could be defined as the ability of the intestine to modify its size or thickness and intestinal cells to modulate their absorption and secretion functions in response to external or internal cues/signals. This review will focus on intestinal adaptation mechanisms in response to diet and nutritional status. These physiological mechanisms allow a fine and rapid adaptation of the gut to promote absorption of ingested food, but they can also lead to obesity in response to overnutrition. This plasticity could thus become a therapeutic target to treat not only undernutrition but also obesity. How the intestine adapts in response to 2 types of surgical remodeling of the digestive tract-extensive bowel resection leading to intestinal failure and surgical treatment of pathological obesity (ie, bariatric surgeries)-will also be reviewed.

Parenteral Nutrition-Dependent Children With Short-Bowel Syndrome Lack Duodenal-Adaptive Hyperplasia but Show Molecular Signs of Altered Mucosal Function

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.

Effect of reducing the ratio of omega-6-to-omega-3 fatty acids in diets of low protein quality on nursery pig growth performance and immune response

A total of 240 newly weaned pigs (5.25 ± 0.15 kg BW) were used to determine the dietary omega-6-to-omega-3 (ω-6:ω-3) fatty acid ratio that optimized growth performance and immune responses when fed corn and soybean meal (SBM)-based diets with low protein quality. Pigs were randomly assigned to 1 of 5 dietary treatments (n = 6 pens per treatment; day 0 of study): [1] positive control (High; included animal proteins and 5% corn oil), [2] negative control (Low0; corn- and SBM-based and 5% corn oil), or 1 of 3 Low diets with increasing supplementation of fish oil to replace corn oil: [3] 1.25% (Low1.25), [4] 2.5% (Low2.5), [5] 5% (Low5) to achieve 5:1, 3:1, and 1:1 ω-6:ω-3 ratios, respectively. Pigs were fed dietary treatments in 2 phases for 7 and 14 d, respectively, followed by a common phase III diet for 21 d. On day 6 and 20, 12 pigs per treatment were immune sensitized with 0.5 mg ovalbumin (OVA) and 0.5 mg Quil A adjuvant in 1 mL saline. The dermal hypersensitivity response (DHR) was evaluated on day 40 in these same pigs, using intradermal injection of OVA; changes in skin-fold thickness were measured. On day 21, 4 pigs per pen were immune challenged with LPS (30 µg Escherichia coli LPS per kg BW) or saline (n = 12); rectal temperature was monitored over 3 h. During phase I only, ADG, ADFI, and G:F were greater for pigs fed the High diet vs. those fed the Low diet (P < 0.05), and increased with increasing fish oil supplementation up to 2.5% (Low2.5), but decreased for pigs fed the Low5 diet (quadratic; P < 0.05, P = 0.086, and P < 0.05 for ADG, ADFI, and G:F, respectively). On day 21, LPS increased rectal temperature (vs. saline at 1-, 2-, and 3-h post-challenge; P < 0.001); fish oil supplementation reduced rectal temperature 2-h post-challenge in the Low-fed pigs (linear; P < 0.05). On day 22, serum haptoglobin was greatest for pigs fed Low0 and decreased with increasing fish oil supplementation (linear; P < 0.05). Immunization with OVA induced a serum anti-OVA IgG response, which was reduced on day 34 among pigs fed Low diets with increasing fish oil supplementation (linear; P = 0.050). On day 40, and 6 h after intradermal injection of OVA, the DHR was least for pigs fed the Low2.5 diet (P < 0.05). Inclusion of 2.5% fish oil (3:1, ω-6:ω-3) optimized growth performance during the early nursery phase when pigs were most sensitive to diets with low protein quality; the ideal ω-6-to-ω-3 fatty acid ratio may differ when using immune responses as the major outcome.

Pediatric Intestinal Failure Review

The term, ‘intestinal failure’, signifies the inability of the body to meet the digestive, absorptive and nutritive needs of the body. As such, these individuals require parenteral nutrition (PN) for survival. The subsequent nutritional, medical and surgical facets to the care are complex. Improved care has resulted in decreased need for intestinal transplantation. This review will examine the unique etiologies and management strategies in pediatric patients with intestinal failure.

Marked stem/progenitor cell expansion occurs early after murine ileostomy: a new model

BACKGROUND

Improving treatment for short bowel syndrome requires a better understanding of how intestinal adaptation is affected by factors like mechanoluminal stimulation. We hypothesized that in mice, luminal diversion via an ileostomy would drive adaptive changes similar to those seen in human intestine after diversion while offering the opportunity to study the immediate events after resection that precede intestinal adaptation.

MATERIALS AND METHODS

With Institutional Animal Care and Use Committee approval, a distal ileostomy with a long distal Hartman's was created in 9- to 14-week-old C57/B6 mice (n = 8). Control mice only had a midline laparotomy without stoma formation (n = 5). A rim of tissue from the proximal stoma was resected as a historical control for the proximal segment. Postoperatively, mice received a high-protein liquid diet and water ad libitum. On day 3, tissue from both the proximal and distal limbs were collected for histologic and RNA analysis. Morphometric measures, immunofluorescent antigen detection, and RNA expression were compared with Student paired t-tests with a P value < 0.05 considered significant.

RESULTS

At 3 d, survival for mice with an ileostomy was 87% and average weight loss was 12.5% of initial weight compared to 6.05% for control mice. Compared to the distal limb, the proximal limb in mice with an ileostomy demonstrated significantly taller villi with deeper and wider crypts. The proximal limb also had decreased expression of intestinal stem cell markers lgr5, bmi1, sox9, and ascl2. Fewer goblet and enteroendocrine cells per hemivillus were also noted in the proximal limb. In control mice, none of these measures were significant between proximal and distal ileum except for villus height.

CONCLUSIONS

This new murine ileostomy model allows study of intestinal adaptation without intestinal anastomosis, which can be technically challenging and morbid.

Duodenal Disaccharidase Activities During and After Weaning off Parenteral Nutrition in Pediatric Intestinal Failure

OBJECTIVES

Data on factors affecting absorptive function in children with intestinal failure (IF) are sparse. We evaluated duodenal disaccharidase activities and inflammation in relation to parenteral nutrition (PN) and intestinal resection in pediatric onset IF.

METHODS

Disaccharidase (maltase, sucrase, and lactase) activities and histologic inflammation were evaluated from duodenal biopsies in 58 patients during PN (n = 23) or full enteral nutrition (n = 40) and in 43 matched controls. The first and the last postresection biopsies were analyzed separately after 4.3 (1.2-9.7) years and 6.5 (2.3-12.4) years, respectively.

RESULTS

During PN, maltase and sucrase activities were 1.6-fold lower and mucosal inflammation more frequent (22% vs 3%) when compared to matched controls (P < 0.05 for both). In patients on full enteral nutrition, activities of maltase and sucrase were significantly higher than that in patients receiving PN and comparable to those of matched controls. Postresection time correlated positively (r = 0.448 and r = 0.369) and percentage length of the remaining small intestine inversely (r = -0.337 and r = -0.407) with maltase and sucrase activity in patients on full enteral nutrition (P < 0.05 for all), whereas proportional length of remaining colon correlated positively with maltase and lactase activity (r = 0.424-0.544, P < 0.05) in patients receiving PN.

CONCLUSIONS

In children with IF, PN dependency associated with decreased duodenal maltase and sucrase activities and mucosal inflammation, which may disturb intestinal absorptive function. Localization and extent of intestinal resection and post-resection time correlated with duodenal disaccharidase activities.

Emerging Piglet Models of Neonatal Short Bowel Syndrome

Short bowel syndrome (SBS) is a growing problem in the human neonatal population. In infants, SBS is the leading cause of intestinal failure, the state of being unable to absorb sufficient nutrients for growth and development. Neonates with SBS are dependent on long-term parenteral nutrition therapy, but many succumb to the complications of sepsis and liver disease. Research in neonatal SBS is challenged by the ethical limits of studying sick human neonates and the heterogeneous nature of the disease process. Outcomes in SBS vary depending on residual intestinal anatomy, intestinal length, patient age, and exposure to nutrition therapies. The neonatal piglet serves as an appropriate translational model of the human neonate because of similarities in gastrointestinal ontogeny, physiological maturity, and adaptive processes. Re-creating the disease process in a piglet model presents a unique opportunity for researchers to discover novel insights and therapies in SBS. Emerging piglet models of neonatal SBS now represent the entire spectrum of disease seen in human infants. This review aims to contextualize these emerging piglet models within the context of SBS as a heterogeneous disease. We first explore the factors that account for SBS heterogeneity and then explore the suitability of the neonatal piglet as an appropriate translational animal model. We then examine differences between the emerging piglet models of neonatal SBS and how these differences affect their translational potential to human neonates with SBS.

Intestinal development and function of broiler chickens on diets supplemented with clinoptilolite

The purpose of this study was to evaluate the effect of natural clinoptilolite (NCLI) and modified clinoptilolite (MCLI) on broiler performance, gut morphology, intestinal length and weight, and gut digestive enzyme activity. A total of 240 d-old male chicks were randomly assigned to 3 treatments, each of which comprised 8 pens of 10 chicks per pen. Birds in the control group were fed the basal diet, while those in the experimental groups were fed diets supplemented with NCLI at 2% (NCLI group), or MCLI at 2% (MCLI group), respectively, for 42 d. Compared with the control, supplementation with NCLI or MCLI had no significant (p>0.05) effects on productive parameters from d 1 to 42. Supplementation with NCLI or MCLI had no influence on the relative length and weight of small intestine at d 1 to 21. But supplementation with NCLI or MCLI significantly reduced the relative weight of duodenum. Supplementation with MCLI and NCLI was associated with greater (p<0.05) villus height in the jejunal and ileal mucosa compared with those areas in the controls from d 1 to 42. However, supplementation with NCLI and MCLI had no significant (p>0.05) influence on the crypt depth in the jejunal and ileal mucosa compared with those in the controls. The addition of either NCLI or MCLI to the diet improved the activities of total protease, and amylase in the small intestinal contents. In conclusion, supplementation with NCLI or MCLI in diets improved intestinal morphology, increased the intestinal length and weigh and gut digestive enzyme activity.

Intestinal adaptation following resection

Intestinal adaptation is a natural compensatory process that occurs following extensive intestinal resection, whereby structural and functional changes in the intestine improve nutrient and fluid absorption in the remnant bowel. In animal studies, postresection structural adaptations include bowel lengthening and thickening and increases in villus height and crypt depth. Functional changes include increased nutrient transporter expression, accelerated crypt cell differentiation, and slowed transit time. In adult humans, data regarding adaptive changes are sparse, and the mechanisms underlying intestinal adaptation remain to be fully elucidated. Several factors influence the degree of intestinal adaptation that occurs post resection, including site and extent of resection, luminal stimulation with enteral nutrients, and intestinotrophic factors. Two intestinotrophic growth factors, the glucagon-like peptide 2 analog teduglutide and recombinant growth hormone (somatropin), are now approved for clinical use in patients with short bowel syndrome (SBS). Both agents enhance fluid absorption and decrease requirements for parenteral nutrition (PN) and/or intravenous fluid. Intestinal adaptation has been thought to be limited to the first 1-2 years following resection in humans. However, recent data suggest that a significant proportion of adult patients with SBS can achieve enteral autonomy, even after many years of PN dependence, particularly with trophic stimulation.

Ursodeoxycholic acid promotes intestinal adaptation in a cat model of short bowel syndrome

The aim of this study was to assess the effect of ursodeoxycholic acid (UDCA) on the morphological and functional adaptive response of the jejunal remnant after massive intestinal resection in a cat model of short bowel syndrome (SBS). UDCA was administered to animals at a daily oral dose of 15 mg/kg for 6 weeks following a 85% jejunoileal resection. Resection alone caused extensive hyperplasia of jejunal mucosa, as evidenced by a significant increase in the weight of jejunal mucosa per unit length as well as by significant increases in DNA and protein concentration but no change in the protein/DNA ratio. Morphometric analysis using microscopy revealed no changes in jejunal mucosa thickness, jejunal crypt depth, villus height and villus surface area, although villus thickness was increased. The specific activities of jejunal sucrase and alkaline phosphatase were unaffected. UDCA treatment of resected animals, using doses that caused no toxicity, as evidenced by the absence of serum biochemistry abnormalities and histopathology, did not induce, compared to resection alone, any changes in mucosal cellularity and did not affect villus morphometry. On the other hand, UDCA administration increased crypt depth and, also, induced a profound increase in the specific activity of sucrase. UDCA improved diarrhoea, a core SBS symptom, reflected in a considerably reduced frequency of defaecation and improved form and texture of faeces. It is concluded that UDCA administration may enhance the natural adaptive response of the intestinal remnant following massive jejunoileal resection and may, thus, be beneficial in SBS treatment.

Recovery of duodenal villi and cells in chickens refed protein, carbohydrate and fat

1. To clarify how histological recovery of villi and cells would be affected after refeeding single nutrients such as protein, carbohydrate and fat, male chickens were divided as follows: (1) intact control fed ad libitum a commercial finisher mash diet (CP, 140 g; ME, 11.71 MJ/kg, ALM), (2) 3 d feed withdrawal (FW), (3) FW followed by one day ad libitum free access to the mash diet (FW-ALM), and FW followed by one day force-feeding of (4) a commercial finisher pellet diet (FW-FFM) and an isocaloric diet of (5) a protein (FW-FFP), (6) a carbohydrate (FW-FFC) or (7) a fat (FW-FFF). 2. After refeeding, the formula diet groups increased in villus height and villus area and tended to increase in cell area and cell mitosis. Furthermore, flat cells on the villus tip in the F group developed to dome-shaped cells. This suggests that nutritionally well-balanced diets can induce histological recovery at villus and cellular levels. 3. Not all of the single nutrient groups recovered to the extent of the formula diet groups in all light microscopic variables after refeeding, suggesting that a single nutrient cannot induce histological recovery of the villus. 4. However, the dome-shaped cells were more distributed on the villus tip in these single nutrient groups than in the well-balanced formula diet groups, although cell diameter of the former groups was smaller than that of the latter. This suggests that the single nutrients would be effectively absorbed from cells and can induce histological recovery at the cellular level.

Intestinal villus histological alterations in broilers fed dietary dried fermented ginger

To evaluate the effect of dietary dried fermented ginger (DFG) on intestinal villous histological alteration and growth performance, 64 Marshall Chunky male broilers were divided into four groups, each with four replicates of four chickens. Birds were fed the basal commercial mash diet supplemented with DFG at 0 (control), 5, 10 and 20 g/kg for 42 days. With increasing dietary DFG levels, feed intake tended to decrease and significantly decreased in the 20 g/kg DFG group (p < 0.05). Weight gain was higher in all the DFG groups, with the highest in the 10 g/kg DFG group (p < 0.05), resulting in an improved feed efficiency in all the DFG groups. Intestinal villus height, villus area, cell area and cell mitosis in all the intestinal segments were higher in all the DFG groups than in the control group. Protuberated cells and cell clusters were found in all the DFG groups, suggesting that the intestinal villi and cells might be hypertrophied. The present results indicate that dietary DFG can be used as a natural feed additive to induce broiler growth performance as a result of stimulation of morphological maturation and in consequence intestinal function.

Morphological, kinetic, membrane biochemical and genetic aspects of intestinal enteroplasticity

The process of intestinal adaptation (“enteroplasticity”) is complex and multifaceted. Although a number of trophic nutrients and non-nutritive factors have been identified in animal studies, successful, reproducible clinical trials in humans are awaited. Understanding mechanisms underlying this adaptive process may direct research toward strategies that maximize intestinal function and impart a true clinical benefit to patients with short bowel syndrome, or to persons in whom nutrient absorption needs to be maximized. In this review, we consider the morphological, kinetic and membrane biochemical aspects of enteroplasticity, focus on the importance of nutritional factors, provide an overview of the many hormones that may alter the adaptive process, and consider some of the possible molecular profiles. While most of the data is derived from rodent studies, wherever possible, the results of human studies of intestinal enteroplasticity are provided.

The influence of polyphenol rich apple pomace or red-wine pomace diet on the gut morphology in weaning piglets

Alternative food ingredients, e.g. secondary plant compounds, are discussed to have beneficial effects and improve gut health. In this study, the effect of three different diets - normal piglets starter without additives, with apple pomace or with red-wine pomace - on the intestinal morphology was investigated from 3 days prior to weaning to 4 weeks post-weaning. At five time points, six piglets from each treatment group were slaughtered; at first time point only six animals from control group were slaughtered. Villus height, crypt depth and breadth of villi and crypts were determined in the jejunum, ileum and colon in 78 piglets. Additionally, the area of the Peyer's patches in the ileum was measured. In jejunum (p < 0.01) and ileum (p < 0.001) the villus length in the control group decreased after weaning but increased over the entire feeding experiment (p < 0.001). In the two-pomace groups, no decrease was measured after weaning. In jejunum, an increase in villi breadth occurred, 73% in the control group and approximately 10% in both treatment groups. A 35% increase was found in the ileum in all groups. Peyer's patches area increased approximately 21% in the control group over 26 days of treatment, whereas in other groups no significant differences were found. Different polyphenol rich pomaces have diverse effects in the gastrointestinal tract. Red-wine pomace has an inhibitory effect on the jejunum villi growth, whereas apple and red-wine pomace have stimulating effect on crypt size in piglet colon. Apple and red-wine pomace can reduce the GALT activation via the Peyer's patches in the ileum. In conclusion, the flavanoids rich feeding regimen showed positive effects on villi morphology, GALT activation and can improve pig health.

Histological alterations of the intestinal villi and epithelial cells in chickens fed dietary sugar cane extract

1. Sugar cane extract (SCE) is the residue after removing glucose, fructose and sucrose from sugar cane juice. To investigate the effects of dietary SCE on growth performance and alterations to intestinal histology, 36 male Sanuki Cochin chickens were divided into three groups: a control group was fed a commercial diet (180 g/kg CP, 13.59 MJ/kg ME) and the treatment groups were fed the commercial diet supplemented with 0.5 or 10 g/kg SCE ad libitum for 35 d. 2. Feed intake and weight gain tended to be higher in the 0.5 and 10 g/kg SCE groups than in the control group. No specific gross morphological alterations were observed in the visceral organs of chickens in any of the groups. However, intestinal villus height, villus area, epithelial cell area and cell mitosis in each intestinal segment had higher values in the SCE groups than in the control group. In the 0.5 and 10 g/kg SCE groups, but not in the control group, the cells on the villus apical surface protuberated and had larger cell clusters and some areas with cells with no microvilli. 3. The observed alterations to intestinal histology in chickens fed dietary SCE diets demonstrate that the function of villi and cells on the villus tip might be activated in all the intestinal segments and that cell turnover is also accelerated. These activated intestinal functions appear to promote growth and immuno-stimulation in chickens fed SCE diets, especially in the 0.5 g/kg group.

Intestinal mucosal adaptation

Intestinal failure is a condition characterized by malnutrition and/or dehydration as a result of the inadequate digestion and absorption of nutrients. The most common cause of intestinal failure is short bowel syndrome, which occurs when the functional gut mass is reduced below the level necessary for adequate nutrient and water absorption. This condition may be congenital, or may be acquired as a result of a massive resection of the small bowel. Following resection, the intestine is capable of adaptation in response to enteral nutrients as well as other trophic stimuli. Identifying factors that may enhance the process of intestinal adaptation is an exciting area of research with important potential clinical applications.

Histological Intestinal Recovery in Chickens Refed Dietary Sugar Cane Extract

Sugar cane extract (SCE), the residue after removing glucose, fructose, and sucrose from sugar cane juice, has growth-promoting, antistress, and immunostimulation effects. The objective of this study was to investigate the effects of refeeding dietary SCE on recovery of BW and intestinal histology after withdrawing feed from chickens. Forty-eight male Sanuki Cochin chickens were assigned randomly to 6 treatments and 8 replicates in a completely randomized design. The 6 treatments were intact control chickens fed ad libitum a basal commercial grower mash diet; 3 d of feed withdrawal; feed withdrawal followed by 1 d of ad libitum access to the same commercial mash diet (AFC); and free access to the commercial mash diet with 0.05, 1, or 3% SCE for 1 d. All SCE groups gained more weight in 1 d of refeeding than the AFC group (P < 0.05). Compared with the AFC group, the SCE groups increased cell mitosis (P < 0.05). On the villus apical surface, flat epithelial cells of the feed withdrawal group developed more protuberated cells than those of the intact control group in all refeeding groups. Compared with the AFC group, the SCE groups showed more protuberated cells. In addition, in the 0.05% SCE group, cell clusters aggregated by many cells were observed on the villus apical surface. The present histological intestinal alterations in chickens refed a SCE-containing diet demonstrate that the villi and epithelial cells might be hypertrophied because of some component in the SCE, resulting in quicker BW recovery in SCE-fed birds compared with those in the AFC group.

Mucosal expression of p21, p27, p53, Bcl-2, and bax after small bowel resection and autotransplantation in pigs

Massive small bowel resection increases ileal villus height as part of normal adaptation. However, despite no gut loss, autotransplantation of the entire small intestine also increases ileal villus height. Our aim was to test whether similar modulation of enterocyte proliferation and apoptosis underpin these comparable increases in villus height. Fifteen pigs were randomly assigned for laparotomy (n=5), 75% proximal small bowel resection (n=5), or jejunoileal autotransplantation (n=5). Eight weeks postoperatively, full-thickness small bowel sections underwent routine immunohistochemistry for cell cycle inhibitors (p53, p21, and p27), antiapoptotic Bcl-2, and proapoptotic bax. The specimens were analyzed semiquantitatively, and the number of intensively positive epithelial cells for each group was compared from 20 digital images (0.32 mm(2)/image). Compared with laparotomy, small bowel resection decreased the number of p27-positive enterocytes in both jejunum and ileum, increased the number of bax-expressing cells in ileum, but decreased the number of bax-expressing cells in jejunum. In contrast, compared with laparotomy, jejunoileal autotransplantation altered neither mucosal bax nor p27 expression. In all groups, Bcl-2 expression was similarly confined to inflammatory cells of the lamina propria, while both p53 and p21 were negative. We conclude that long-term alterations in the enterocytic expression of certain cell cycle and apoptosis markers (p27 and bax) accompany small bowel resection. These changes differ between the jejunum and the ileum and are not seen after whole small bowel autotransplantation. Therefore, increased ileal villus height after autotransplantation, despite resembling postresectional intestinal adaptation, is underpinned by different regulation of enterocyte proliferation and apoptosis.

Intestinal villus histological alterations in piglets fed dietary charcoal powder including wood vinegar compound liquid

To investigate the effects of dietary charcoal powder including wood vinegar compound liquid (CWVC, 4 : 1) on intestinal villus histology, piglets were fed 0, 1, 3 and 5% dietary CWVC diets for 30 days. Feed intake and body weight gain were measured during the experimental period. At the end of the experiments, intestinal villus height, epithelial cell area and cell mitosis were examined using light microscopy (LM), and the duodenal villus tip surface was observed using scanning electron microscopy (SEM). Feed efficiency tended to be improved in the CWVC group. The 3% CWVC group showed the highest value, followed by 1% CWVC group of most LM parameters in most intestinal parts, but the 5% CWVC group showed the almost similar value compared with the control. In addition, on the duodenal villus tip surface, the 3% CWVC group showed a clearer cell outline, larger cells and cells protuberated further into the lumen than those of the 1% CWVC group. However, the 5% CWVC group showed faint SEM features than the 1% CWVC group. The present trend of improved feed efficiency after feedings of dietary CWVC demonstrates that the CWVC could be incorporated into piglet diets up to 3% level, and that the CWVC might activate intestinal functions both at villus and cellular levels.

Influence of diet complexity on intestinal adaptation following massive small bowel resection in a preclinical model

AIMS

To investigate the effect of dietary complexity on intestinal adaptation using a preclinical model.

METHODS

Four-week-old piglets underwent a 75% proximal small bowel resection or transection operation (control). Post-operatively, animals received either pig chow (n = 15), polymeric formula (n = 9), polymeric formula plus fiber (n = 6), or elemental formula (n = 7).

RESULTS

The weight gain of all groups was reduced compared with controls that were fed the same diet. Animals that had a resection, which were fed elemental formula, had significantly reduced weight gain compared with the other groups (4.7 4.2 vs 30.7 7.1 kg chow and 11.5 1.3 kg polymeric formula). Villus height was increased in the jejunum, ileum and terminal ileum of resected animals compared with controls in animals fed with pig chow, polymeric formula and elemental formula. The animals that had a resection had a significant reduction in the transepithelial conductance (10.4 5.5 vs 25.4 6.5 mS/cm2) and 51Chromium-EDTA flux (2.8 1.9 vs 4.8 4.9 microL/h per cm2) compared with the controls.

CONCLUSIONS

A complex diet was found to be superior to an elemental diet in terms of the morphological and functional features of adaptation following massive small bowel resection.

Morphometric and biomechanical remodelling in the intestine after small bowel resection in the rat

The short-bowel syndrome is a clinical condition caused by intestinal resection. As intestinal adaptation occurs after resection, it can be used as a model for studying morphometric and biomechanical remodelling in the small intestine and to get a better understanding of the pathophysiology of the short-bowel syndrome. The resected rats had a 67% resection of jejunum and ileum. Control animals underwent no operation (nonoperated controls) or an ileal transection with subsequent end-to-end anastomosis (sham-resected controls). The animals were followed for up to 4 weeks after the operation. Changes in biomechanical properties were studied in terms of residual strain (the internal strain remaining when all external loads are removed), opening angle and stress--strain relations referenced to the zero-stress state (the cut-open state where external and internal stresses are released). The resected animals gained less weight than the controls. The intestinal length and diameter increased more in the resected groups than the control groups (P < 0.05), resulting in a larger absorptive surface. Resection induced profound gross morphometric changes and histological alterations characterized by proliferative increases in the tissue layers. The opening angle, along with residual strain at the mucosal and serosal surface, increased in the remnant small intestine (P < 0.05). All changes increased as function of postoperative time and were most prominent in the remnant ileum. However, the stress-strain relationship remained unchanged. In conclusion, this study demonstrated that resection of the majority of the small bowel results in significant remodelling in structural and residual strain properties in the remnant small intestine. The remodelling seems to be guided by the need for a greater absorptive surface area rather than for a change in the stress-strain properties.

No effect of bolus glutamine supplementation on the postresectional adaptation of small bowel mucosa in rats receiving chow ad libitum

OBJECTIVE

Early postoperative enteral feeding has been reported to stimulate intestinal mucosa proliferation. Dietary components influence the intestinal adaptive response after resection and glutamine is a preferential nutrient to enterocytes. The purpose of this study was to evaluate the effects of bolus glutamine supplementation on intestinal adaptation.

METHODS

Male Wistar rats underwent a 65% small bowel resection. The rats were divided into three groups receiving glutamine 2 g/kg/day, isonitrogenous glycine or saline by gavage for 10 days. All the rats were provided with ordinary rat chow ad libitum. Sampling was done 10 days after resection. Animals fed ordinary rat chow without surgery or specific treatment served as control.

RESULTS

Mucosal wet weight, DNA, RNA, protein contents and sucrose activity, as well as villus height increased in the ileal remnant. No significant differences in any of these parameters or body weight could be found between the three groups.

CONCLUSION

Postoperative enteral bolus glutamine supplementation at a dose of 2 g/kg b.w. did not enhance the adaptation of the residual intestine 10 days after massive intestinal resection in the rat.

Effects of oral Saccharomyces boulardii on bacterial overgrowth, translocation, and intestinal adaptation after small-bowel resection in rats

BACKGROUND

Small-bowel resection in animals results in alterations of the morphology and functional adaptation in the remaining intestine. The aim of our study was to study the effect of Saccharomyces boulardii versus placebo in rats after 50% small-bowel resection.

METHODS

Sixty-three rats were assigned to one of three groups: small-bowel resection (n = 31), transected surgery controls (n = 16), or non-surgical controls (n = 16). Of the 31 rats with small-bowel resection, 15 were given S. boulardii (140 mg/dl), and 16 were given placebo. Intestinal markers measured included bacterial overgrowth (BO) on days 4 and 8 and translocation into mesenteric lymph nodes, liver, and spleen. Markers of small-bowel adaptation included histomorphology of the mucosa, protein content, and various brush-border enzymes (sucrase, glucoamylase, n-aminopeptidase).

RESULTS

In the jejunal mucosal samples on day 8, S. boulardii-treated rats showed a significant increase in protein content (58.3 +/- 12 mg/10 cm) compared with placebo-treated rats (29.2 +/- 1.8) or non-surgery controls (18.3 +/- 1.2; P < 0.001). S. boulardii-treated rats also had significantly higher levels of all three brush-border enzymes. A significant increase of enzyme-specific activities was observed in the ileum of S. boulardii resected rats compared with the placebo resected group on day 4, and no significant differences were seen in the remnant ileum except an increase in protein content in S. boulardii-treated rats on day 8. Histomorphometric studies showed no differences in ileal villus height or translocation frequencies by day 8 in S. boulardii or placebo resected rats.

CONCLUSIONS

These data indicate that, after resection, S. boulardii does not modify bacterial overgrowth or translocation frequency but does significantly enhance the functional adaptation of the remaining intestinal segments.