Enteropoiesis: structural and functional relationships of the enterocyte

Morphometric analysis of small intestinal mucosa. IV. Determining cell volumes

This study was concerned with the measurement of volumes of surface epithelial cells in human small intestine, both in disease-control subjects and, for comparison, in patients with gluten sensitivity. Four procedures were employed, of which two were geometrical, based on cylindrical or truncated conoid models. The third method evolved from the proportionality of area to volume, and required determination of cellular and nuclear profile areas, and an estimation of nuclear volume based on models conforming to (1) a prolate spheroid, or (2) a cylinder with hemispherical caps. This procedure appeared to underestimate enterocyte volumes and failed to reveal volume differences between controls and gluten-sensitive individuals. Finally, a fourth method was devised, based on traditional intraepithelial profile counts per hundred enterocyte nuclei, calculation of surface epithelial volume and of the absolute number of lymphocytes contained therein. Enterocyte volumes appeared to be overestimated twofold by this procedure compared with the first two geometric methods. The results of this study indicate that the cuboidal-type enterocyte profiles typical of the untreated mucosa in gluten sensitivity are a reflection of cells with a reduced volume. From the number of enterocytes and the absolute lymphocyte population present within a morphometrically defined volume of surface epithelium, the ratios of intraepithelial lymphocytes to enterocytes were found to be 50% less than conventional density-profile counts.

Epithelial proliferation in response to gastrointestinal inflammation

Intestinal inflammation seems invariably to be associated with increased epithelial proliferation. In the small bowel the pathological consequences of this area an increase in the crypt proliferative compartment and a decrease in the absorptive villus compartment, which can lead to malabsorption. In the colon, it is more difficult to examine changes in cell proliferation, but using Ki67, epithelial proliferation has been shown to be increased in ulcerative colitis and parasitic infection. The teleological advantage of increasing epithelial proliferation during intestinal inflammation is presumably in an effort to get rid of parasitized or infected epithelial cells, or to rapidly replace cells which have been lost. Rejection of helminth parasites from rodent small bowel is associated with partial villous atrophy and crypt hypertrophy, which is probably part of the host response making the mucosa inhospitable to the parasites. The short-term nutritional disadvantage of malabsorption is outweighed by the long-term advantage of being parasite-free. However, when the intestinal inflammation is elicited by a dietary constituent, the consequences are only pathological. At the moment there is no information as to the mechanisms by which inflammatory cells alter mucosal morphology and epithelial renewal. The restructuring of mucosal morphology in the flat-mucosa involves considerable adaptation of the connective tissue elements of the lamina propria. Whether this occurs in response to changes in epithelial renewal is not known. Finally, it is clear that activated T cells in the lamina propria can produce a flat-mucosa. In diseases such as Trichuris dysentery and ulcerative colitis there is no or very little T cell activation, even though epithelial proliferation is increased. Increased epithelial proliferation therefore may occur in response to different inflammatory stimuli.

Changes in the rate of crypt epithelial cell proliferation and mucosal morphology induced by a T-cell-mediated response in human small intestine

The rate of crypt epithelial cell proliferation and mucosal morphology have been studied in vitro in explants of fetal human small intestine in organ culture in which a cell-mediated immune response has been elicited by stimulating lamina propria T cells with pokeweed mitogen or monoclonal anti-CD3 antibodies. Twelve hours after the addition of anti-CD3 or pokeweed mitogen, most lamina propria T cells expressed CD25. By 18 and 24 h after the addition of anti-CD3, there were significantly more crypt cells in the cell cycle than in controls, although villus height and crypt depth are the same in both groups. After 3 days, by dissecting microscopy, the villi appeared shorter in cultures in which the T cells were stimulated than in control cultures, and the mucosal surface was obscured by a layer of extruded enterocytes. Villus atrophy was confirmed by direct measurement of Feulgen-stained, microdissected villi. Crypts were longer in T-cell-stimulated cultures, and the rate of crypt epithelial cell proliferation measured by metaphase arrest was increased 10-fold. By electron microscopy, the microvilli and cellular morphology of the surface enterocytes were normal in T-cell-stimulated cultures. These experiments clearly show that a profound immune-mediated crypt epithelial cell hyperplasia can occur in the absence of damage to surface enterocytes.

Studies of intestinal lymphoid tissue. XIII. Immunopathology of the evolving celiac sprue lesion

Observations, by computerised image-analysis on the evolution of flat mucosae in two celiac sprue patients, are described. Initial immunopathologic features comprised infiltration of epithelium of normal villi by small, non-mitotic lymphocytes, accompanied by crypt hypertrophy and increased crypt cell mitotic activity. The subsequent development, several years later, of flat mucosae was accompanied by mitotic, "immunoblastoid" EL thus fulfilling the diagnostic criteria for celiac sprue. These sequential phases in the evolving flat celiac mucosa parallel experimental graft-versus-host reactions, suggesting that they are fundamentally cell-mediated in type. In becoming flat, it appears obligatory for the mucosa to pass through the early "proliferative-infiltrative" stage in which crypt hypertrophy is a prominent feature.

Insights provided by the study of the small intestine in the child and the foetus

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The measurement of villus cell population size in the mouse small intestine in normal and abnormal states: a comparison of absolute measurements with morphometric estimators in sectioned immersion-fixed material

From a functional viewpoint, the most important part of the small intestinal mucosa is the villus epithelium; in the experimental study of intestinal adaptation it is often necessary to estimate the size of the population. For these reasons, a systematic study of methods of measuring the size of the villus cell population was undertaken in villi of normal morphology from control animals, and in villi of abnormal morphology as produced by treatment of mice with cytosine arabinoside (Ara-C). The villus cell population can be measured with precision and accuracy in both normal and abnormal mucosal states, with a relative standard error usually less than 5%, with good reproducibility, and with very low counting errors. In the mouse a practically linear relationship between the villus cell population size and position in the small intestine can be shown. In normal, control animals, linear estimates of villus population, for example the villus height, the villus core height, and the villus row count measured in sections of immersion-fixed material, were found to be rough approximations as indicators of the villus cell population, and were highly correlated with it. Product variables, comprising the products of a height with a width measurement, show a large improvement over the linear variables as estimators of villus cell population. In populations of abnormally shaped villi produced by Ara-C, both linear and product variables showed a considerable decrease in correlation with the villus cell population. Consequently, indirect, linear measurements of the villus population size do not accurately reflect the size of the villus population in abnormal villi. Finally, a method comparing theoretical and measured surface: volume indices was used to indicate that the most appropriate shape for normal mouse villi is a simple cylinder; this method would also be applicable for other villus cell populations.

Effect of orally-administered epidermal growth factor on intestinal iron absorption and mucosal permeability

A progressive increase in intestinal 59Fe3+ absorption was observed on oral feeding of mice with physiological doses of EGF/UGO. Maximal changes were apparent after 3d and appeared to be dose-dependent. In addition to a small increase in intestinal cell proliferation, as reflected by increased ornithine decarboxylase activity, EGF/UGO-feeding increased mucosal permeability (evaluated with [51Cr]-EDTA): the latter could account for the increase in iron absorption. Sialoadenectomy, to remove the major source of endogenous EGF/UGO, had no appreciable effect on the intestinal absorption of iron.

The enterocyte in coeliac disease

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Disease of the small bowel in childhood

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