Novel Neonatal Piglet Models of Surgical Short Bowel Syndrome With Intestinal Failure
Novel Neonatal Piglet Models of Surgical Short Bowel Syndrome With Intestinal Failure
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DOI：
10.1097/mpg.0b013e3181f18ca0
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发表时间：
2011-01-01
影响因子：
2.9
通讯作者：
Pencharz, Paul B.
中科院分区：
文献类型：
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作者：
Turner, Justine M.;Wales, Paul W.;Pencharz, Paul B.
目的：先天性或后天性肠道畸形手术后发生的短肠综合征可引起相当大的新生儿发病率和死亡率。动物模型是一个有价值的研究工具，这个问题，但是，很少有成功的新生儿模型已经开发，大多数不包括远端肠切除常见于人类婴儿。我们报告新的仔猪模型解决这些gaps.Subjects和方法：新生仔猪（1-6天）进行静脉和胃导管插入和75%肠切除术。第1组（n = 6）行中段肠切除空肠回肠吻合术;第2组（n = 5）行远端肠切除空肠结肠吻合术;第3组（n = 5）为假手术对照;第4组（n = 5）为母猪饲养。术后，第1至3组仔猪开始肠外营养（PN），并采用标准方案引入和推进肠内营养。数据收集包括PN天数、体重增加、脂肪吸收、小肠延长和肠/肝histologic.Results：第2组仔猪PN天数较多（P = 0.008），体重增加较少（P = 0.027），吸收不良较多（P = 0.012）。他们没有表现出小肠延长和更多的胆汁淤积性肝病。第1组仔猪有明显的组织学肠适应和1.5倍的肠延长（P = 0.001）。结论：这些新的短肠综合征的仔猪模型是第一个代表的完整的临床谱的肠衰竭，观察人类新生儿。通过考虑不同的短肠解剖结构对适应和生长潜力的影响，这些动物模型是一个重大的进步。它们允许评估新的疗法，以促进肠道适应和减少并发症，如胆汁淤积。
Objectives: Short bowel syndrome occurring after surgery for acquired or congenital intestinal abnormalities causes considerable neonatal morbidity and mortality. Animal models are a valuable research tool for this problem; however, few successful neonatal models have been developed and most do not include distal intestinal resection as seen commonly in human babies. We report novel piglet models addressing these gaps.Subjects and Methods: Neonatal piglets (1-6 days) underwent venous and gastric catheter insertion and 75% intestinal resection. Group 1 (n = 6) had midintestinal resection with jejunoileal anastomosis; group 2 (n = 5) had distal intestinal resection with jejunocolic anastomosis; group 3 (n = 5) were sham controls; and group 4 (n = 5) were sow reared. Postoperatively, groups 1 to 3 piglets commenced parenteral nutrition (PN), and enteral nutrition was introduced and advanced using a standard regimen. Data collection included days on PN, weight gain, fat absorption, small intestine lengthening, and bowel/liver histology.Results: Group 2 piglets had more days on PN (P = 0.008), less weight gain (P = 0.027), and greater malabsorption (P = 0.012). They did not show small intestine lengthening and had more cholestatic liver disease. Group 1 piglets had histological evident intestinal adaptation and 1.5-fold intestinal lengthening (P = 0.001).Conclusions: These novel piglet models of short bowel syndrome are the first to represent the full clinical spectrum of intestinal failure as observed in human neonates. By considering the impact of different short bowel anatomy on potential for adaptation and growth, these animal models are a significant advance. They permit evaluation of new therapies to promote intestinal adaptation and reduce complications, such as cholestasis.