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Benhaddou S, Ribeiro-Parenti L, Khodorova N, Willemetz A, Chapelais M, Azzout-Marniche D, Le Gall M, Gaudichon C. Effects of gastric bypass on the digestibility and postprandial metabolic fate of 15N dietary protein in rats. PLoS One 2024; 19:e0307075. [PMID: 39102389 PMCID: PMC11299818 DOI: 10.1371/journal.pone.0307075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 06/30/2024] [Indexed: 08/07/2024] Open
Abstract
Roux-en-Y Gastric Bypass may be associated with an alteration of protein bioavailability in relation to intestinal remodeling. Our study aimed to test this hypothesis by Roux-en-Y Gastric Bypass. Diet-induced obese rats underwent Roux-en-Y Gastric Bypass surgery (RYGB rats) while a Sham-operated control group was used. All rats received a 15N-labeled protein meal 1 or 3 months after surgery and were euthanized 6h later. Protein digestibility, 15N recovered in organs and urea pool, fractional protein synthesis rate, and intestinal morphometry were assessed. Protein digestibility was similar in all groups (94.2±0.3%). The small intestine was hypertrophied in RYGB rats 1 month after surgery, weighing 9.1±0.2g vs. 7.0±0.3g in Sham rats (P = 0.003). Villus height and crypt depth were increased in the alimentary limb and ileum of RYGB rats. However, Roux-en-Y Gastric Bypass had no impact on the fractional synthesis rate. In the gastrointestinal tract, 15N retention only differed in the ileal mucosa and was higher in RYGB rats at 1 month (0.48±0.2% vs. 0.3±0.09%, P = 0.03). 15N recovery from the liver, muscle, and skin was lower in RYGB rats at 1 month. 15N recovery from urinary and plasma urea was higher in RYGB rats at both times, resulting in increased total deamination (13.2±0.9% vs. 10.1±0.5%, P<0.01). This study showed that Roux-en-Y Gastric Bypass did not affect protein digestibility. Dietary nitrogen sequestration was transitorily and moderately diminished in several organs. This was associated with a sustained elevation of postprandial deamination after Roux-en-Y Gastric Bypass, whose mechanisms merit further studies.
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Affiliation(s)
- Soukaïna Benhaddou
- AgroParisTech, INRAE, UMR PNCA, Université Paris-Saclay, Palaiseau, France
| | - Lara Ribeiro-Parenti
- Inserm UMRS 1149, Centre de Recherche sur l’Inflammation, Université Paris Cité, Paris, France
- Service de Chirurgie Digestive Oesogastrique et Bariatrique, Hôpital Bichat—Claude‐Bernard, Assistance Publique‐Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Nadezda Khodorova
- AgroParisTech, INRAE, UMR PNCA, Université Paris-Saclay, Palaiseau, France
| | - Alexandra Willemetz
- Inserm UMRS 1149, Centre de Recherche sur l’Inflammation, Université Paris Cité, Paris, France
| | - Martin Chapelais
- AgroParisTech, INRAE, UMR PNCA, Université Paris-Saclay, Palaiseau, France
| | | | - Maude Le Gall
- Inserm UMRS 1149, Centre de Recherche sur l’Inflammation, Université Paris Cité, Paris, France
| | - Claire Gaudichon
- AgroParisTech, INRAE, UMR PNCA, Université Paris-Saclay, Palaiseau, France
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Coupaye M, Ribeiro-Parenti L, Baratte C, Hourseau M, Willemetz A, Duboc H, Ledoux S, Bado A, Couvelard A, Le Gall M. No Long-Term Mucosal Lesions in the Esophagus but More Gastric Mucosal Lesions after Sleeve Gastrectomy in Obese Rats. J Clin Med 2023; 12:jcm12051848. [PMID: 36902635 PMCID: PMC10003321 DOI: 10.3390/jcm12051848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 03/03/2023] Open
Abstract
Sleeve gastrectomy (SG) often induces gastroesophageal reflux, with few and discordant long-term data on the risk of Barrett's esophagus (BE) in operated patients. The aim of this study was to analyze the impact of SG on esogastric mucosa in a rat model at 24 weeks postoperatively, which corresponds to approximately 18 years in humans. After 3 months of a high-fat diet, obese male Wistar rats were subjected to SG (n = 7) or sham surgery (n = 9). Esophageal and gastric bile acid (BA) concentrations were measured at sacrifice, at 24 weeks postoperatively. Esophageal and gastric tissues were analyzed by routine histology. The esophageal mucosa of the SG rats (n = 6) was not significantly different in comparison to that of the sham rats (n = 8), with no esophagitis or BE. However, there was more antral and fundic foveolar hyperplasia in the mucosa of the residual stomach 24 weeks after SG than in the sham group (p < 0.001). Luminal esogastric BA concentrations did not differ between the two groups. In our study, SG induced gastric foveolar hyperplasia but no esophageal lesions at 24 weeks postoperatively in obese rats. Therefore, long-term endoscopic esophageal follow-up that is recommended in humans after SG to detect BE may also be useful for detecting gastric lesions.
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Affiliation(s)
- Muriel Coupaye
- UMRS 1149 Centre de Recherche sur l’Inflammation, Université Paris Cité, Inserm, 75018 Paris, France
- Centre Intégré Nord Francilien de Prise en Charge de l’Obésité (CINFO), Assistance Publique-Hôpitaux de Paris, Service des Explorations Fonctionnelles, Hôpital Louis-Mourier, 92700 Colombes, France
- Correspondence: ; Tel.: +33-1-4760-6256
| | - Lara Ribeiro-Parenti
- UMRS 1149 Centre de Recherche sur l’Inflammation, Université Paris Cité, Inserm, 75018 Paris, France
- Centre Intégré Nord Francilien de Prise en Charge de l’Obésité (CINFO), Assistance Publique-Hôpitaux de Paris, Service de Chirurgie Digestive, Hôpital Bichat-Claude-Bernard, 75018 Paris, France
| | - Clément Baratte
- UMRS 1149 Centre de Recherche sur l’Inflammation, Université Paris Cité, Inserm, 75018 Paris, France
| | - Muriel Hourseau
- Assistance Publique-Hôpitaux de Paris, Service d’Anatomo-Pathologie, Hôpital Bichat-Claude-Bernard, 75018 Paris, France
| | - Alexandra Willemetz
- UMRS 1149 Centre de Recherche sur l’Inflammation, Université Paris Cité, Inserm, 75018 Paris, France
| | - Henri Duboc
- UMRS 1149 Centre de Recherche sur l’Inflammation, Université Paris Cité, Inserm, 75018 Paris, France
- Assistance Publique-Hôpitaux de Paris, Service de Gastroentérologie, Hôpital Louis-Mourier, 92700 Colombes, France
| | - Séverine Ledoux
- UMRS 1149 Centre de Recherche sur l’Inflammation, Université Paris Cité, Inserm, 75018 Paris, France
- Centre Intégré Nord Francilien de Prise en Charge de l’Obésité (CINFO), Assistance Publique-Hôpitaux de Paris, Service des Explorations Fonctionnelles, Hôpital Louis-Mourier, 92700 Colombes, France
| | - André Bado
- UMRS 1149 Centre de Recherche sur l’Inflammation, Université Paris Cité, Inserm, 75018 Paris, France
| | - Anne Couvelard
- Assistance Publique-Hôpitaux de Paris, Service d’Anatomo-Pathologie, Hôpital Bichat-Claude-Bernard, 75018 Paris, France
| | - Maude Le Gall
- UMRS 1149 Centre de Recherche sur l’Inflammation, Université Paris Cité, Inserm, 75018 Paris, France
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Enteroendocrine System and Gut Barrier in Metabolic Disorders. Int J Mol Sci 2022; 23:ijms23073732. [PMID: 35409092 PMCID: PMC8998765 DOI: 10.3390/ijms23073732] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/25/2022] [Accepted: 03/26/2022] [Indexed: 02/06/2023] Open
Abstract
With the continuous rise in the worldwide prevalence of obesity and type 2 diabetes, developing therapies regulating body weight and glycemia has become a matter of great concern. Among the current treatments, evidence now shows that the use of intestinal hormone analogs (e.g., GLP1 analogs and others) helps to control glycemia and reduces body weight. Indeed, intestinal endocrine cells produce a large variety of hormones regulating metabolism, including appetite, digestion, and glucose homeostasis. Herein, we discuss how the enteroendocrine system is affected by local environmental and metabolic signals. These signals include those arising from unbalanced diet, gut microbiota, and the host metabolic organs and their complex cross-talk with the intestinal barrier integrity.
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Kuhn C, Covatti C, Ribeiro LFC, Balbo SL, Torrejais MM. Bariatric surgery induces morphological changes in the extensor digitorum longus muscle in the offspring of obese rats. Tissue Cell 2021; 72:101537. [PMID: 33839601 DOI: 10.1016/j.tice.2021.101537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 03/16/2021] [Accepted: 03/22/2021] [Indexed: 12/18/2022]
Abstract
INTRODUCTION The effects of the maternal nutritional environment on the growth and metabolism of the offspring, and its impacts on health in adult life are defined as metabolic programming. Thus, the objective of this study was to evaluate the effects of Roux-en-Y gastric bypass (RYGB) on the morphology of muscle fiber and neuromuscular junction (NMJ) of the offspring of rats submitted to RYGB. METHODS Three-week-old Wistar rats were separated into two groups: 1) CAF SHAM which received a cafeteria diet and was submitted to a sham operation and 2) CAF RYGB, which received a cafeteria diet and was submitted to RYGB. The first generation (F1) offspring (male) was named according to the treatment of mothers as CAF SHAM-F1 and CAF RYGB-F1 and received a standard diet after weaning. At 17 weeks, the animals were euthanized, and the extensor digitorum longus muscle (EDL) was collected and processed in light microscopy and transmission electron microscopy for morphological and morphometric analysis. RESULTS The CAF RYGB-F1 group showed a reduction in the weight of the EDL muscle and also a reduction in the area of type I, IIa and IIb fibers and a nucleus/fiber ratio. This same group also showed an increase in the capillary density and myofibrillar disorganization and in the Z-line, as well as a reduction in the area of the NMJs. CONCLUSION The RYGB surgery in mothers produced morphological changes in the skeletal striated muscles of the offspring.
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Affiliation(s)
- C Kuhn
- Master's Program in Biosciences and Health, State University of Western Paraná (UNIOESTE), Cascavel, PR, Brazil.
| | - C Covatti
- Master's Program in Biosciences and Health, State University of Western Paraná (UNIOESTE), Cascavel, PR, Brazil
| | - L F C Ribeiro
- Master's Program in Biosciences and Health, State University of Western Paraná (UNIOESTE), Cascavel, PR, Brazil
| | - S L Balbo
- Master's Program in Biosciences and Health, State University of Western Paraná (UNIOESTE), Cascavel, PR, Brazil
| | - M M Torrejais
- Master's Program in Biosciences and Health, State University of Western Paraná (UNIOESTE), Cascavel, PR, Brazil
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Guimarães AGC, Lopes LES, Capelassi AN, Araújo ACF, Balbo SL, Blanc HNH, Freitas IN, Silva JN, Ribeiro RA, Bonfleur ML. Morphological alterations in gastrointestinal organs of western-diet obese rats submitted to vertical sleeve gastrectomy or Roux-en-Y gastric bypass. AN ACAD BRAS CIENC 2021; 93:e20200884. [PMID: 34495204 DOI: 10.1590/0001-3765202120200884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 09/11/2020] [Indexed: 11/22/2022] Open
Abstract
To assess the effect of vertical sleeve gastrectomy (VSG) and Roux-en-Y gastric bypass (RYGB) on the esophageal and intestinal morphology of western diet (WD)-obese rats and to characterize the stomach histopathology of WD rats submitted to VSG. Male Wistar rats received WD from 2-4 months of age, to induce obesity, before randomly submitting them to pseudo (WD-SHAM), VSG (WD-VSG) or RYGB (WD-RYGB) surgeries. Gastrointestinal histomorphometry was performed at 3-months post-surgery. The upper esophagus of VSG and RYGB rats increased luminal area, while reductions in the keratin layer of the mucosa and the tunica muscularis were observed only in the RYGB animals. In the lower esophagus, both surgeries increased keratin layer thickness, but reduced the mucosal mucus content, while RYGB increased the thickness of the tunica mucosa and muscularis. The glandular region of the stomach of WD-VSG rats exhibited hypotrophy, epithelial erosion, fibrosis and moderate inflammatory infiltration. VSG and RYGB increased the villi height in the ileum, and the thickness of the tunica muscularis in the jejunum and ileum of WD rats; furthermore, RYGB augmented the ileal villi height. Thus both approaches induced histomorphological alterations in the esophagus and intestine and VSG damaged the gastric mucosa, even over the long-term.
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Affiliation(s)
- Alana G C Guimarães
- Universidade Federal do Rio de Janeiro, Campus UFRJ-Macaé, Laboratório de Fisiopatologia, Divisão de Pesquisa Integrada em Produtos Bioativos e Biociências (DPBio), Polo Novo Cavaleiros, Rua Aluízio da Silva Gomes, 50, Granja dos Cavaleiros, 27933-378 Macaé, RJ, Brazil
| | - Luana E S Lopes
- Universidade Estadual do Oeste do Paraná (UNIOESTE), Centro de Ciências Biológicas e da Saúde, Laboratório de Fisiologia Endócrina e Metabolismo (LAFEM), Rua Universitária, 1069, 85819-110 Cascavel, PR, Brazil
| | - Angélica N Capelassi
- Universidade Estadual do Oeste do Paraná (UNIOESTE), Centro de Ciências Biológicas e da Saúde, Laboratório de Fisiologia Endócrina e Metabolismo (LAFEM), Rua Universitária, 1069, 85819-110 Cascavel, PR, Brazil
| | - Allan C F Araújo
- Universidade Estadual do Oeste do Paraná (UNIOESTE), Centro de Ciências Médicas e Farmacêuticas, Laboratório de Fisiologia Endócrina e Metabolismo (LAFEM), Rua Universitária, 1069, 85819-110 Cascavel, PR, Brazil
| | - Sandra L Balbo
- Universidade Estadual do Oeste do Paraná (UNIOESTE), Centro de Ciências Biológicas e da Saúde, Laboratório de Fisiologia Endócrina e Metabolismo (LAFEM), Rua Universitária, 1069, 85819-110 Cascavel, PR, Brazil
| | - Helene N H Blanc
- Universidade Federal do Rio de Janeiro, Campus UFRJ-Macaé, Laboratório de Fisiopatologia, Divisão de Pesquisa Integrada em Produtos Bioativos e Biociências (DPBio), Polo Novo Cavaleiros, Rua Aluízio da Silva Gomes, 50, Granja dos Cavaleiros, 27933-378 Macaé, RJ, Brazil
| | - Israelle N Freitas
- Universidade Federal do Rio de Janeiro, Campus UFRJ-Macaé, Laboratório de Fisiopatologia, Divisão de Pesquisa Integrada em Produtos Bioativos e Biociências (DPBio), Polo Novo Cavaleiros, Rua Aluízio da Silva Gomes, 50, Granja dos Cavaleiros, 27933-378 Macaé, RJ, Brazil
| | - Juliana N Silva
- Universidade Federal do Rio de Janeiro, Campus UFRJ-Macaé, Laboratório de Fisiopatologia, Divisão de Pesquisa Integrada em Produtos Bioativos e Biociências (DPBio), Polo Novo Cavaleiros, Rua Aluízio da Silva Gomes, 50, Granja dos Cavaleiros, 27933-378 Macaé, RJ, Brazil
| | - Rosane A Ribeiro
- Universidade Estadual de Ponta Grossa (UEPG), Setor de Ciências Biológicas e da Saúde (SEBISA), Departamento de Biologia Geral, Campos Uvaranas, Avenida General Carlos Cavalcanti, 4748, 84010-330 Ponta Grossa, PR, Brazil
| | - Maria Lúcia Bonfleur
- Universidade Estadual do Oeste do Paraná (UNIOESTE), Centro de Ciências Biológicas e da Saúde, Laboratório de Fisiologia Endócrina e Metabolismo (LAFEM), Rua Universitária, 1069, 85819-110 Cascavel, PR, Brazil
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Steenackers N, Vanuytsel T, Augustijns P, Tack J, Mertens A, Lannoo M, Van der Schueren B, Matthys C. Adaptations in gastrointestinal physiology after sleeve gastrectomy and Roux-en-Y gastric bypass. Lancet Gastroenterol Hepatol 2021; 6:225-237. [PMID: 33581761 DOI: 10.1016/s2468-1253(20)30302-2] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 07/27/2020] [Accepted: 07/29/2020] [Indexed: 01/19/2023]
Abstract
Linked to the growing obesity epidemic, demand for bariatric and metabolic surgery has increased, the most common procedures being sleeve gastrectomy and Roux-en-Y gastric bypass. Originally, bariatric procedures were described as purely restrictive, malabsorptive, or combined restrictive-malabsorptive procedures limiting food intake, nutrient absorption, or both. Nowadays, anatomical alterations are known to affect gastrointestinal physiology, which in turn affects the digestion and absorption of nutrients and drugs. Therefore, understanding gastrointestinal physiology is crucial to prevent postoperative nutritional deficiencies and to optimise postoperative drug therapy. Preclinical and clinical research indicates that sleeve gastrectomy accelerates liquid and solid gastric emptying and small intestinal transit, and increases bile acid serum levels, whereas its effects on gastrointestinal acidity, gastric and pancreatic secretions, surface area, and colonic transit remain largely unknown. Roux-en-Y gastric bypass diminishes gastric acid secretion, accelerates liquid gastric emptying, and increases bile acid serum levels, but its effects on intestinal pH, solid gastric emptying, intestinal transit time, gastric enzyme secretions, and surface area remain largely unknown. In this Review, we summarise current knowledge of the effects of these two procedures on gastrointestinal physiology and assess the knowledge gaps.
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Affiliation(s)
- Nele Steenackers
- Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium
| | - Tim Vanuytsel
- Translational Research Center for Gastrointestinal Disorders, KU Leuven, Leuven, Belgium
| | - Patrick Augustijns
- Department of Chronic Diseases and Metabolism, and Drug Delivery and Disposition, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Jan Tack
- Translational Research Center for Gastrointestinal Disorders, KU Leuven, Leuven, Belgium
| | - Ann Mertens
- Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium
| | - Matthias Lannoo
- Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium
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Ribeiro-Parenti L, Jarry AC, Cavin JB, Willemetz A, Le Beyec J, Sannier A, Benadda S, Pelletier AL, Hourseau M, Léger T, Morlet B, Couvelard A, Anini Y, Msika S, Marmuse JP, Ledoux S, Le Gall M, Bado A. Bariatric surgery induces a new gastric mucosa phenotype with increased functional glucagon-like peptide-1 expressing cells. Nat Commun 2021; 12:110. [PMID: 33397977 PMCID: PMC7782689 DOI: 10.1038/s41467-020-20301-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 11/19/2020] [Indexed: 12/19/2022] Open
Abstract
Glucagon-Like Peptide-1 (GLP-1) undergoes rapid inactivation by dipeptidyl peptidase-4 (DPP4) suggesting that target receptors may be activated by locally produced GLP-1. Here we describe GLP-1 positive cells in the rat and human stomach and found these cells co-expressing ghrelin or somatostatin and able to secrete active GLP-1 in the rats. In lean rats, a gastric load of glucose induces a rapid and parallel rise in GLP-1 levels in both the gastric and the portal veins. This rise in portal GLP-1 levels was abrogated in HFD obese rats but restored after vertical sleeve gastrectomy (VSG) surgery. Finally, obese rats and individuals operated on Roux-en-Y gastric bypass and SG display a new gastric mucosa phenotype with hyperplasia of the mucus neck cells concomitant with increased density of GLP-1 positive cells. This report brings to light the contribution of gastric GLP-1 expressing cells that undergo plasticity changes after bariatric surgeries, to circulating GLP-1 levels.
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Affiliation(s)
- Lara Ribeiro-Parenti
- Université de Paris, Inserm U1149, Centre de Recherche sur l'inflammation, Paris, France
- Service de Chirurgie Générale Œsogastrique et Bariatrique, Hôpital Bichat - Claude-Bernard, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Anne-Charlotte Jarry
- Université de Paris, Inserm U1149, Centre de Recherche sur l'inflammation, Paris, France
| | - Jean-Baptiste Cavin
- Université de Paris, Inserm U1149, Centre de Recherche sur l'inflammation, Paris, France
| | - Alexandra Willemetz
- Université de Paris, Inserm U1149, Centre de Recherche sur l'inflammation, Paris, France
| | - Johanne Le Beyec
- Université de Paris, Inserm U1149, Centre de Recherche sur l'inflammation, Paris, France
- Sorbonne Université, AP-HP, Hôpital Pitié-Salpêtrière-Charles Foix, Biochimie Endocrinienne et Oncologique, Paris, France
| | - Aurélie Sannier
- Department of Pathology Bichat Hospital, AP-HP, 75018, Paris, France
| | - Samira Benadda
- Université de Paris, Inserm U1149, Centre de Recherche sur l'inflammation, Paris, France
- Cell and Tissue Imaging Platform, Inserm, U1149, CNRS, ERL8252, 75018, Paris, France
| | - Anne-Laure Pelletier
- Université de Paris, Inserm U1149, Centre de Recherche sur l'inflammation, Paris, France
| | - Muriel Hourseau
- Department of Pathology Bichat Hospital, AP-HP, 75018, Paris, France
| | - Thibaut Léger
- Université de Paris, Mass Spectrometry Laboratory, Institut Jacques Monod, UMR 7592, CNRS, 75205, Paris, France
- Université Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, 35000, Rennes, France
| | - Bastien Morlet
- Université de Paris, Mass Spectrometry Laboratory, Institut Jacques Monod, UMR 7592, CNRS, 75205, Paris, France
| | - Anne Couvelard
- Université de Paris, Inserm U1149, Centre de Recherche sur l'inflammation, Paris, France
- Department of Pathology Bichat Hospital, AP-HP, 75018, Paris, France
| | - Younes Anini
- Department of Obstetrics and Gynecology, Dalhousie University, IWK Health Centre, Halifax, New Brunswick, Canada
| | - Simon Msika
- Université de Paris, Inserm U1149, Centre de Recherche sur l'inflammation, Paris, France
- Service de Chirurgie Générale Œsogastrique et Bariatrique, Hôpital Bichat - Claude-Bernard, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jean-Pierre Marmuse
- Université de Paris, Inserm U1149, Centre de Recherche sur l'inflammation, Paris, France
- Service de Chirurgie Générale Œsogastrique et Bariatrique, Hôpital Bichat - Claude-Bernard, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Sévérine Ledoux
- Université de Paris, Inserm U1149, Centre de Recherche sur l'inflammation, Paris, France
- Service des Explorations Fonctionnelles Hôpital Louis Mourier, AP-HP, Centre Intégré Nord Francilien de prise en charge de l'Obésité (CINFO), 92701, Colombes, France
| | - Maude Le Gall
- Université de Paris, Inserm U1149, Centre de Recherche sur l'inflammation, Paris, France.
| | - André Bado
- Université de Paris, Inserm U1149, Centre de Recherche sur l'inflammation, Paris, France.
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Sleeve gastrectomy-induced endocrine changes in the remnant stomachs of premenopausal and postmenopausal rats: role of the estrogen receptors. Surg Obes Relat Dis 2020; 17:193-207. [PMID: 33011072 DOI: 10.1016/j.soard.2020.08.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/02/2020] [Accepted: 08/12/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Although alterations in the plasma levels of leptin, glucagon-like peptide-1, and gastrin were linked with bariatric surgery outcomes, gastric production of these peptides was not elucidated before. OBJECTIVE The aim was to evaluate the impact of estrogen depletion and estrogen receptors (ERs) on sleeve gastrectomy (SG)-induced alterations in gastric hormone production, gastric mucosal integrity, and bone mass. SETTING Physiology Research Lab at the University. METHODS Female Sprague-Dawley rats underwent ovariectomy or sham operation (control), and 2 months later SG or sham SG was performed. Rats received either nonselective agonist 17 β, ER-α agonist, ER-β agonist, or vehicle for 3 weeks. Trunk blood and gastric tissues were collected for biochemical measurements, while histopathologic examination was performed in gastric and femur samples. RESULTS In the presence of intact ovaries, SG-induced weight loss was accompanied by reductions in the gastric synthesis of leptin and gastrin, while gastric glucagon-like peptide-1 was additionally decreased when SG was performed at the postmenopausal state. SG elevated the depleted serum estradiol levels of menopause, implicating a beneficial effect, but the occurrence of severe gastric mucosal injury was triggered. On the other hand, using ER agonists upregulated gastrin-expressing cells, ameliorated gastric injury, and improved bone loss. CONCLUSIONS SG, either at premenopausal or postmenopausal state, resulted in considerable loss in bone mass, along with reductions in the gastric levels of gastrin and leptin. Functional status of the ovaries needs to be taken into consideration when monitoring the outcomes of SG, and ER agonists could be of value in controlling SG-induced complications.
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Tessier R, Ribeiro-Parenti L, Bruneau O, Khodorova N, Cavin JB, Bado A, Azzout-Marniche D, Calvez J, Le Gall M, Gaudichon C. Effect of different bariatric surgeries on dietary protein bioavailability in rats. Am J Physiol Gastrointest Liver Physiol 2019; 317:G592-G601. [PMID: 31460792 DOI: 10.1152/ajpgi.00142.2019] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Bariatric surgery may induce protein malabsorption, although data are scarce. This study aims at evaluating dietary protein bioavailability after different bariatric surgeries in rats. Diet-induced obese Wistar rats were operated for vertical sleeve gastrectomy (VSG) or Roux-en-Y gastric bypass (RYGB). The control group was composed of pair-fed, sham-operated rats (Sham). Two weeks after surgery, rats were fed a 15N protein meal. Protein bioavailability was assessed by determination of 15N recovery in the gastrointestinal tract and organs 6 h after the meal. Fractional protein synthesis rate (FSR) was assessed using a flooding dose of 13C valine. Weight loss was the highest in RYGB rats and the lowest in Sham rats. Surprisingly, RYGB (95.6 ± 0.7%) improved protein digestibility (P = 0.045) compared with Sham (93.5 ± 0.5%) and VSG (93.8 ± 0.6%). In contrast, 15N retained in the liver (P = 0.001) and plasma protein (P = 0.037) was lower than in Sham, with a similar trend in muscle (P = 0.052). FSR was little altered by bariatric surgery, except for a decrease in the kidney of RYGB (P = 0.02). The 15N distribution along the small intestinal tissue suggests that dietary nitrogen was considerably retained in the remodeled mucosa of RYGB compared with Sham. This study revealed that in contrast to VSG, RYGB slightly improved protein digestibility but altered peripheral protein bioavailability. This effect may be ascribed to a higher uptake of dietary amino acids by the remodeled intestine.NEW & NOTEWORTHY Using a sensitive 15N meal test, we found that gastric bypass slightly improved protein digestibility compared with sleeve gastrectomy or control but, in contrast, lowered protein retention in the liver and muscles. This paradox can be due to a higher uptake of dietary nitrogen by the intestinal mucosa that was hypertrophied. This study provides new insight on the digestive and metabolic fate of dietary protein in different models of bariatric surgery in rats.
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Affiliation(s)
- Romain Tessier
- UMR Physiology of Nutrition and Ingestive Behavior (PNCA), AgroParisTech, INRA, Université Paris-Saclay, Paris, France.,INSERM UMRS 1149, UFR de Médecine Paris Diderot, Université de Paris, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Lara Ribeiro-Parenti
- INSERM UMRS 1149, UFR de Médecine Paris Diderot, Université de Paris, Assistance Publique-Hôpitaux de Paris, Paris, France.,Department of General and Digestive Surgery, Bichat Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Ouafa Bruneau
- UMR Physiology of Nutrition and Ingestive Behavior (PNCA), AgroParisTech, INRA, Université Paris-Saclay, Paris, France.,INSERM UMRS 1149, UFR de Médecine Paris Diderot, Université de Paris, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Nadezda Khodorova
- UMR Physiology of Nutrition and Ingestive Behavior (PNCA), AgroParisTech, INRA, Université Paris-Saclay, Paris, France
| | - Jean-Baptiste Cavin
- INSERM UMRS 1149, UFR de Médecine Paris Diderot, Université de Paris, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - André Bado
- INSERM UMRS 1149, UFR de Médecine Paris Diderot, Université de Paris, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Dalila Azzout-Marniche
- UMR Physiology of Nutrition and Ingestive Behavior (PNCA), AgroParisTech, INRA, Université Paris-Saclay, Paris, France
| | - Juliane Calvez
- UMR Physiology of Nutrition and Ingestive Behavior (PNCA), AgroParisTech, INRA, Université Paris-Saclay, Paris, France
| | - Maude Le Gall
- INSERM UMRS 1149, UFR de Médecine Paris Diderot, Université de Paris, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Claire Gaudichon
- UMR Physiology of Nutrition and Ingestive Behavior (PNCA), AgroParisTech, INRA, Université Paris-Saclay, Paris, France
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Frohman HA, Rychahou PG, Li J, Gan T, Evers BM. Development of murine bariatric surgery models: lessons learned. J Surg Res 2018; 229:302-310. [PMID: 29937006 DOI: 10.1016/j.jss.2018.04.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 03/27/2018] [Accepted: 04/12/2018] [Indexed: 01/07/2023]
Abstract
Roux-en-Y gastric bypass (RYGB) improves comorbidities such as diabetes and hypertension and lowers the risk of obesity-related cancers. To better understand the physiologic and genetic influences of bariatric surgery, a reliable murine model is needed that can be extended to genetically engineered mice. Given the complexity of these procedures, few researchers have successfully implemented these techniques beyond larger rodent models. The purpose of our study was to develop a technically feasible and reproducible murine model for RYGB and sleeve gastrectomy (SG). Mice were converted to liquid diet perioperatively without fasting and housed in groups on raised wire platforms. SG involved significant reduction of stomach volume followed by multilayer repair of the gastrotomy. RYGB procedure consisted of side-to-side, functional end-to-side bowel anastomoses and exclusion of the stomach medial to the gastroesophageal junction. Sham surgeries consisted of enterotomies and gastrotomy followed by primary repair without resection or rerouting. Survival after incorporation of the aforementioned techniques was 100% in the SG group and 41% in the RYGB group at 1 mo after surgery. Only 26% of RYGB mortality was attributed to leak, obstruction, or stricture; the majority of postoperative mortality was due to stress, dumping, or malnutrition. Much of the survival challenge for this surgical model was related to perioperative husbandry, which is to be expected given their small stature and poor response to stress. Utilization of the perioperative and surgical techniques described will increase survival and feasibility of these technically challenging procedures, allowing for a better understanding of mechanisms to explain the beneficial effects of bariatric surgery.
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Affiliation(s)
- Heather A Frohman
- Department of Surgery, University of Kentucky, Lexington, Kentucky; Markey Cancer Center, University of Kentucky, Lexington, Kentucky
| | - Piotr G Rychahou
- Department of Surgery, University of Kentucky, Lexington, Kentucky; Markey Cancer Center, University of Kentucky, Lexington, Kentucky
| | - Jing Li
- Markey Cancer Center, University of Kentucky, Lexington, Kentucky
| | - Tong Gan
- Department of Surgery, University of Kentucky, Lexington, Kentucky; Markey Cancer Center, University of Kentucky, Lexington, Kentucky
| | - B Mark Evers
- Department of Surgery, University of Kentucky, Lexington, Kentucky; Markey Cancer Center, University of Kentucky, Lexington, Kentucky.
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11
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Rossell J, González M, Mestres N, Pardina E, Ricart-Jané D, Peinado-Onsurbe J, Baena-Fustegueras JA. Diet Change After Sleeve Gastrectomy Is More Effective for Weight Loss Than Surgery Only. Obes Surg 2018; 27:2566-2574. [PMID: 28342156 DOI: 10.1007/s11695-017-2650-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Bariatric surgery with or without diet change has become one of the most effective treatments for obesity. The objective of this study was to observe the effects of vertical sleeve gastrectomy (VSG) and diet change in Sprague-Dawley rats on both body and tissue weights. METHODS Eighteen rats were fed with a standard chow diet (SCD) (C group), and 36 rats were fed with a high-fat diet (HFD) (diet-induced obesity (DIO) group). After 8 weeks, the animals underwent VSG, sham surgery or no surgery (NS). After surgery, a third of the rats fed with the HFD changed to the SCD (DIO + C group). Body weight, food and energy intake were recorded daily during the experiment (12 weeks). Food efficiency (%) (FE) was determined from weekly weight gain and weekly kilocalorie consumed measurements. RESULTS The DIO group had higher and significant weight gain than the C group at the time of surgery (p < 0.001). The major weight loss (WL) was observed in the DIO + C-VSG group, during the 4 weeks after surgery. Adipose tissues in the DIO + C-VSG group were drastically reduced and had a weight similar to those in the C-VSG group. CONCLUSION VSG and the diet change combination led to a greater WL, which was maintained during the 4 weeks post-surgery, leading to a normalization of body weight. VSG and diet change also affected most of the tissues, not only adipose, showing a global change in whole body composition.
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Affiliation(s)
- Joana Rossell
- Departament de Bioquímica i Biomedicina Molecular, Facultat de Biologia, Universitat de Barcelona, Diagonal 643, 08028, Barcelona, Spain
| | - Marta González
- Unitat de Cirurgia, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, Lleida, Spain
| | - Núria Mestres
- Unitat de Cirurgia, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, Lleida, Spain
| | - Eva Pardina
- Departament de Bioquímica i Biomedicina Molecular, Facultat de Biologia, Universitat de Barcelona, Diagonal 643, 08028, Barcelona, Spain
| | - David Ricart-Jané
- Departament de Bioquímica i Biomedicina Molecular, Facultat de Biologia, Universitat de Barcelona, Diagonal 643, 08028, Barcelona, Spain
| | - Julia Peinado-Onsurbe
- Departament de Bioquímica i Biomedicina Molecular, Facultat de Biologia, Universitat de Barcelona, Diagonal 643, 08028, Barcelona, Spain.
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12
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Roux-en-Y Gastric-Bypass and sleeve gastrectomy induces specific shifts of the gut microbiota without altering the metabolism of bile acids in the intestinal lumen. Int J Obes (Lond) 2018; 43:428-431. [PMID: 29453461 DOI: 10.1038/s41366-018-0015-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 12/06/2017] [Accepted: 12/21/2017] [Indexed: 12/12/2022]
Abstract
Some shifts in the gut microbiota composition and its metabolic fingerprints have been associated to Sleeve gastrectomy (SG) and Roux-en-Y Gastric Bypass (RYGB). So far, plasma bile acids have been associated with post-operative glucose improvement and weight loss, but nothing is known about their metabolism in the gut lumen. As bile acids are physiologically transformed by the microbiota into various species, the aim of this work was to study how SG and RYGB-associated dysbiosis impact the bioconversion of bile acids in the intestinal lumen. Comparing SHAM (n = 9) with our validated rat models of SG (n = 5) and RYGB (n = 6), we quantified luminal bile acids along the gut and found that the metabolic transformation of bile acids (deconjugation, dehydroxylation, and epimerization) is not different from the duodenum to the colon. However, in the cecum where the biotransformation mainly takes place, we observed deep alterations of the microbiota composition, which were specific of each type of surgery. In conclusion, despite specific dysbiosis after surgery, the bile acids metabolism in the gut lumen is highly preserved, suggesting that a resilience of the gut microbiota occurs after these procedures.
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13
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Oberbach A, Schlichting N, Heinrich M, Kullnick Y, Retschlag U, Lehmann S, Khashab MA, Kalloo AN, Kumbhari V. Gastric mucosal devitalization reduces adiposity and improves lipid and glucose metabolism in obese rats. Gastrointest Endosc 2018; 87:288-299.e6. [PMID: 28479494 DOI: 10.1016/j.gie.2017.04.038] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 04/17/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS The gastric mucosa is an endocrine organ that regulates satiation pathways by expression of orexigenic and anorexigenic hormones. Vertical sleeve gastrectomy (VSG) excludes gastric mucosa and reduces gastric volume. Our study aimed to investigate the independent effects of altering gastric mucosa on obesity and its related comorbidities. METHODS Gastric mucosa devitalization (GMD) of 70% of the stomach was achieved by argon plasma coagulation in a high-fat diet rat model and was compared with VSG and sham surgery. In an 8-week follow-up study, we quantified body weight, visceral adiposity, insulin resistance index, cholesterol profiles, and free fatty acid profiles by enzyme-linked immunosorbent assay (ELISA). Following a 2-hour oral glucose tolerance test, the kinetics of ghrelin, glucagon-like peptide-1, peptide YY, and serum and liver bile acid levels were measured. Liver lipid content was quantified by ELISA. RESULTS GMD resulted in significant reductions in body weight, visceral and subcutaneous adipose tissue, and hepatic steatosis as well as an improvement in lipid metabolism. GMD resulted in significant reductions in food intake and intestinal malabsorption of free fatty acids, both contributing to improved body composition and metabolic profile. Mechanistically, GMD resulted in a significant reduction in serum palmitate levels as well as an increase in serum and liver bile acid levels, known to alter glucose and lipid metabolism. Similar changes were noted when VSG rats were compared with sham surgery rats. CONCLUSIONS Devitalization of gastric mucosa, independent of altering gastric volume, was able to reduce obesity-related comorbidities. The gastric mucosa may be a potential target for treating obesity and its associated comorbidities.
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Affiliation(s)
- Andreas Oberbach
- Department of Medicine and Division of Gastroenterology and Hepatology, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA; Department of Cardiac Surgery, Ludwig Maximilians University Munich, Munich, Germany; Fraunhofer Institute for Cell Therapy and Immunology, University of Leipzig, Leipzig, Germany
| | - Nadine Schlichting
- Fraunhofer Institute for Cell Therapy and Immunology, University of Leipzig, Leipzig, Germany; Integrated Research and Treatment Center (IFB) Adiposity Diseases, University of Leipzig, Leipzig, Germany
| | - Marco Heinrich
- Fraunhofer Institute for Cell Therapy and Immunology, University of Leipzig, Leipzig, Germany; Integrated Research and Treatment Center (IFB) Adiposity Diseases, University of Leipzig, Leipzig, Germany
| | - Yvonne Kullnick
- Fraunhofer Institute for Cell Therapy and Immunology, University of Leipzig, Leipzig, Germany; Integrated Research and Treatment Center (IFB) Adiposity Diseases, University of Leipzig, Leipzig, Germany
| | - Ulf Retschlag
- Integrated Research and Treatment Center (IFB) Adiposity Diseases, University of Leipzig, Leipzig, Germany
| | - Stefanie Lehmann
- Fraunhofer Institute for Cell Therapy and Immunology, University of Leipzig, Leipzig, Germany; Integrated Research and Treatment Center (IFB) Adiposity Diseases, University of Leipzig, Leipzig, Germany
| | - Mouen A Khashab
- Department of Medicine and Division of Gastroenterology and Hepatology, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
| | - Anthony N Kalloo
- Department of Medicine and Division of Gastroenterology and Hepatology, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
| | - Vivek Kumbhari
- Department of Medicine and Division of Gastroenterology and Hepatology, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
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Cavin JB, Bado A, Le Gall M. Intestinal Adaptations after Bariatric Surgery: Consequences on Glucose Homeostasis. Trends Endocrinol Metab 2017; 28:354-364. [PMID: 28209316 DOI: 10.1016/j.tem.2017.01.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 01/16/2017] [Accepted: 01/17/2017] [Indexed: 12/25/2022]
Abstract
The gastrointestinal (GI) tract can play a direct role in glucose homeostasis by modulating the digestion and absorption of carbohydrates and by producing the incretin hormones. In recent years, numerous studies have focused on intestinal adaptation following bariatric surgeries. Changes in the number of incretin (glucagon-like peptide 1 and glucose-dependent insulinotropic polypeptide) producing cells have been reported, which could result in the modified hormonal response seen after surgery. In addition, the rate of absorption and the intestinal regions exposed to sugars may affect the time course of appearance of glucose in the blood. This review gives new insights into the direct role of the GI tract in the metabolic outcomes of bariatric surgery, in the context of glucose homeostasis.
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Affiliation(s)
- Jean-Baptiste Cavin
- Inserm UMR 1149, UFR de Médecine Paris Diderot, Université Paris Diderot, Sorbonne Paris Cité, DHU Unity AP-HP, F-75890 Paris, France
| | - André Bado
- Inserm UMR 1149, UFR de Médecine Paris Diderot, Université Paris Diderot, Sorbonne Paris Cité, DHU Unity AP-HP, F-75890 Paris, France
| | - Maude Le Gall
- Inserm UMR 1149, UFR de Médecine Paris Diderot, Université Paris Diderot, Sorbonne Paris Cité, DHU Unity AP-HP, F-75890 Paris, France.
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15
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16
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Cavin JB, Voitellier E, Cluzeaud F, Kapel N, Marmuse JP, Chevallier JM, Msika S, Bado A, Le Gall M. Malabsorption and intestinal adaptation after one anastomosis gastric bypass compared with Roux-en-Y gastric bypass in rats. Am J Physiol Gastrointest Liver Physiol 2016; 311:G492-500. [PMID: 27418681 DOI: 10.1152/ajpgi.00197.2016] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 07/08/2016] [Indexed: 01/31/2023]
Abstract
The technically easier one-anastomosis (mini) gastric bypass (MGB) is associated with similar metabolic improvements and weight loss as the Roux-en-Y gastric bypass (RYGB). However, MGB is controversial and suspected to result in greater malabsorption than RYGB. In this study, we compared macronutrient absorption and intestinal adaptation after MGB or RYGB in rats. Body weight and food intake were monitored and glucose tolerance tests were performed in rats subjected to MGB, RYGB, or sham surgery. Carbohydrate, protein, and lipid absorption was determined by fecal analyses. Intestinal remodeling was evaluated by histology and immunohistochemistry. Peptide and amino acid transporter mRNA levels were measured in the remodeled intestinal mucosa and those of anorexigenic and orexigenic peptides in the hypothalamus. The MGB and RYGB surgeries both resulted in a reduction of body weight and an improvement of glucose tolerance relative to sham rats. Hypothalamic orexigenic neuropeptide gene expression was higher in MGB rats than in RYGB or sham rats. Fecal losses of calories and proteins were greater after MGB than RYGB or sham surgery. Intestinal hyperplasia occurred after MGB and RYGB with increased jejunum diameter, higher villi, and deeper crypts than in sham rats. Peptidase and peptide or amino acid transporter genes were overexpressed in jejunal mucosa from MGB rats but not RYGB rats. In rats, MGB led to greater protein malabsorption and energy loss than RYGB. This malabsorption was not compensated by intestinal overgrowth and increased expression of peptide transporters in the jejunum.
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Affiliation(s)
- Jean-Baptiste Cavin
- Inserm UMR 1149, Université Paris Diderot, Sorbonne Paris Cité, DHU Unity AP-HP, Paris, France
| | - Eglantine Voitellier
- Inserm UMR 1149, Université Paris Diderot, Sorbonne Paris Cité, DHU Unity AP-HP, Paris, France
| | - Françoise Cluzeaud
- Inserm UMR 1149, Université Paris Diderot, Sorbonne Paris Cité, DHU Unity AP-HP, Paris, France
| | - Nathalie Kapel
- AP-HP, Hôpital Pitié-Salpêtrière-Charles Foix, Département de Coprologie Fonctionnelle, Paris, France
| | - Jean-Pierre Marmuse
- Inserm UMR 1149, Université Paris Diderot, Sorbonne Paris Cité, DHU Unity AP-HP, Paris, France; Service de Chirurgie Générale et Digestive, AP-HP Hôpital Bichat Claude Bernard, Paris, France
| | - Jean-Marc Chevallier
- Service de Chirurgie Digestive, AP-HP Hôpital Européen Georges Pompidou, Paris, et Université Paris Descartes, Sorbonne Paris Cité, France; and
| | - Simon Msika
- Inserm UMR 1149, Université Paris Diderot, Sorbonne Paris Cité, DHU Unity AP-HP, Paris, France; Service de Chirurgie Digestive, AP-HP Hôpital Louis Mourier, Colombes, France
| | - André Bado
- Inserm UMR 1149, Université Paris Diderot, Sorbonne Paris Cité, DHU Unity AP-HP, Paris, France
| | - Maude Le Gall
- Inserm UMR 1149, Université Paris Diderot, Sorbonne Paris Cité, DHU Unity AP-HP, Paris, France;
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Affiliation(s)
- Maude Le Gall
- INSERM U1149, DHU Unity, Paris Diderot University, Paris, France
| | - André Bado
- INSERM U1149, DHU Unity, Paris Diderot University, Paris, France
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18
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Cavin JB, Couvelard A, Lebtahi R, Ducroc R, Arapis K, Voitellier E, Cluzeaud F, Gillard L, Hourseau M, Mikail N, Ribeiro-Parenti L, Kapel N, Marmuse JP, Bado A, Le Gall M. Differences in Alimentary Glucose Absorption and Intestinal Disposal of Blood Glucose After Roux-en-Y Gastric Bypass vs Sleeve Gastrectomy. Gastroenterology 2016; 150:454-64.e9. [PMID: 26481855 DOI: 10.1053/j.gastro.2015.10.009] [Citation(s) in RCA: 143] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 09/16/2015] [Accepted: 10/07/2015] [Indexed: 12/18/2022]
Abstract
BACKGROUND & AIMS Bariatric procedures, such as Roux-en-Y gastric bypass (RYGB) or vertical sleeve gastrectomy (VSG), are the most effective approaches to resolve type 2 diabetes in obese individuals. Alimentary glucose absorption and intestinal disposal of blood glucose have not been directly compared between individuals or animals that underwent RYGB vs VSG. We evaluated in rats and humans how the gut epithelium adapts after surgery and the consequences on alimentary glucose absorption and intestinal disposal of blood glucose. METHODS Obese male rats underwent RYGB, VSG, or sham (control) operations. We collected intestine segments from all rats; we performed histologic analyses and measured levels of messenger RNAs encoding the sugar transporters SGLT1, GLUT1, GLUT2, GLUT3, GLUT4, and GLUT5. Glucose transport and consumption were assayed using ex vivo jejunal loops. Histologic analyses were also performed on Roux limb sections from patients who underwent RYGB 1-5 years after surgery. Roux limb glucose consumption was assayed after surgery by positron emission and computed tomography imaging. RESULTS In rats and humans that underwent RYGB, the Roux limb became hyperplasic, with an increased number of incretin-producing cells compared with the corresponding jejunal segment of controls. Furthermore, expression of sugar transporters and hypoxia-related genes increased and the nonintestinal glucose transporter GLUT1 appeared at the basolateral membrane of enterocytes. Ingested and circulating glucose was trapped within the intestinal epithelial cells of rats and humans that underwent RYGB. By contrast, there was no hyperplasia of the intestine after VSG, but the intestinal absorption of alimentary glucose was reduced and density of endocrine cells secreting glucagon-like peptide-1 increased. CONCLUSIONS The intestine adapts differently to RYGB vs VSG. RYGB increases intestinal glucose disposal and VSG delays glucose absorption; both contribute to observed improvements in glycemia.
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Affiliation(s)
| | - Anne Couvelard
- INSERM U1149, DHU Unity, Paris Diderot University, Paris, France; Department of Pathology, Bichat Hospital, Paris, France
| | - Rachida Lebtahi
- Department of Nuclear Medicine, Bichat Hospital, Paris, France
| | - Robert Ducroc
- INSERM U1149, DHU Unity, Paris Diderot University, Paris, France
| | - Konstantinos Arapis
- INSERM U1149, DHU Unity, Paris Diderot University, Paris, France; Department of General and Digestive Surgery, Bichat Hospital, Paris, France
| | | | | | - Laura Gillard
- INSERM U1149, DHU Unity, Paris Diderot University, Paris, France
| | | | - Nidaa Mikail
- Department of Nuclear Medicine, Bichat Hospital, Paris, France
| | | | - Nathalie Kapel
- Functional Coprology Service, Pitié Salpétrière Hospital Group, Paris, France
| | | | - André Bado
- INSERM U1149, DHU Unity, Paris Diderot University, Paris, France
| | - Maude Le Gall
- INSERM U1149, DHU Unity, Paris Diderot University, Paris, France.
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Gastrin Secretion After Bariatric Surgery—Response to a Protein-Rich Mixed Meal Following Roux-En-Y Gastric Bypass and Sleeve Gastrectomy: a Pilot Study in Normoglycemic Women. Obes Surg 2015; 26:1448-56. [DOI: 10.1007/s11695-015-1985-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Elliott JA, le Roux CW, Ph.D. F. How long should we make the biliopancreatic limb during Roux-en-Y gastric bypass? Surg Obes Relat Dis 2015; 11:1246-7. [DOI: 10.1016/j.soard.2015.04.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 04/29/2015] [Indexed: 12/21/2022]
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21
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You LL, Cao DH, Jiang J, Hou Z, Suo YE, Wang SD, Cao XY. Transgenic mouse models of gastric cancer: Pathological characteristic and applications. Shijie Huaren Xiaohua Zazhi 2015; 23:2754-2760. [DOI: 10.11569/wcjd.v23.i17.2754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Transgenic animal models of gastric cancer have high specificity and similar tumor characteristics to human gastric cancer. Current research and application of transgenic animal models of gastric cancer are wide, and several models have been developed. In transgenic animal models of gastric cancer, primary gastric carcinoma can develop spontaneously. These transgenic animal models have been widely used to study the mechanism of gastric cancer development, and have great significance for clinical diagnosis and treatment of gastric cancer. This paper systematically summarizes several different kinds of transgenic animal models and describes the molecular pathogenic mechanisms and pathological characteristics of gastric mucosal lesions in these models as well as their applications.
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