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Adaptation capacity of small intestine in short bowel syndrome and criteria for small intestinal transplantation

短肠综合征小肠适应能力及小肠移植标准

基本信息

批准号：
12470373
负责人：
SUITA Sachiyo
金额：
$ 9.41万
依托单位：
Kyushu University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
2000
资助国家：
日本
起止时间：
2000 至 2003
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-12470373/
关键词：
piglet short bowel syndrome tissue blood flow of liver portal blood flow liver dysfunction liver fibrosis small intestinal transplantation massive resection of small bowel 短腸症候群モデル小腸大量切徐新生児門脈血流計空腸回腸

项目摘要

Background : Regarding complications associated with short bowel syndrome(SBS), progressive liver failure is one of most severe complications known to occur. Although several studies have suggested that many factors interactively influence on this clinical condition, we investigated the relationship between hepatic circulation and hepatic fibrosis, using a neonatal piglet SBS model.Materials & Methods : This study used the following four groups of neonatal piglets : a group with an 80% resection of the small bowel(SBS group), a group with a by-pass operation of the small bowel(functional SBS group), a group with only a laparotomy as a Sham operation(Sham group), and a no operative treatment group(Control group). We measured the hepatic circulation just before and after the reconstruction of the intestine, as well as on 7th and 14th postoperative day. In addition, both blood and hepatic tissue samples were collected to investigate them both biochemically and morphologicallyResults : In the biochemical liver function and the tissue blood flow of liver, there were no significant differences among all groups on any investigated days. However, on both the 7th and 14th postoperative day, the portal venous flow in the SBS group was significantly lower than that in other groups. According to a histological analysis, only hepatic samples on the 14th postoperative day showed mild hepatic fibrosis in the SBS group. In □-smooth muscle actin staining, which expresses active stellate cells, numerous positive cells were distributed in the perisinusoidal space on the 14th postoperative day in the SBS group.Conclusion : Based on our data, a decrease in the hepatic circulation, especially in the portal venous flow, after a massive resection of the intestine, may cause progressive liver dysfunction due to the activation of hepatic stellate cells.

背景：关于与短肠综合征（SBS）相关的并发症，进行性肝衰竭是已知发生的最严重的并发症之一。尽管多项研究表明许多因素相互作用影响这种临床状况，但我们使用新生仔猪SBS模型研究了肝循环与肝纤维化之间的关系。材料与方法：本研究使用以下四组新生仔猪：小肠切除80%的组（SBS组）、小肠绕道手术组（功能性SBS组）、仅进行小肠旁路手术的组（功能性SBS组）。开腹手术为假手术组（假手术组），以及不手术治疗组（对照组）。我们测量了肠道重建前后以及术后第 7 天和第 14 天的肝循环。此外，还采集血液和肝组织样本进行生化和形态学研究。结果：在任何研究日的生化肝功能和肝脏组织血流量方面，各组间均无显着差异。然而，术后第7天和第14天，SBS组的门静脉流量均显着低于其他组。根据组织学分析，SBS组仅术后第14天的肝脏样本显示轻度肝纤维化。在表达活性星状细胞的□-平滑肌肌动蛋白染色中，SBS组术后第14天在窦周间隙分布有大量阳性细胞。结论：根据我们的数据，大肠切除后肝循环，特别是门静脉流量减少，可能会因肝星状细胞活化而导致进行性肝功能障碍。细胞。