Rapid reversal of human intestinal ischemia-reperfusion induced damage by shedding of injured enterocytes and reepithelialisation

Intestinal ischemia-reperfusion (IR) is a phenomenon related to physiological conditions (e.g. exercise, stress) and to pathophysiological events (e.g. acute mesenteric ischemia, aortic surgery). Although intestinal IR has been studied extensively in animals, results remain inconclusive and data on...

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Bibliographic Details
Published in:PloS one 2008-10, Vol.3 (10), p.e3428-e3428
Main Authors: Derikx, Joep P M, Matthijsen, Robert A, de Bruïne, Adriaan P, van Bijnen, Annemarie A, Heineman, Erik, van Dam, Ronald M, Dejong, Cornelis H C, Buurman, Wim A
Format: Article
Language:English
Subjects:
Adult
Aged
Analysis
Aorta
Apoptosis
Clearing
Complications
Concentration gradient
Critical Care and Emergency Medicine
Damage assessment
Detachment
Enterocytes
Enterocytes - pathology
Epithelial cells
Fatty acid-binding protein
Fatty Acid-Binding Proteins - blood
Fatty acids
Gastroenterology and Hepatology
Gastroenterology and Hepatology/Small Intestine
Humans
Immunology/Immune Response
Immunoreactivity
Intestine
Intestines - blood supply
Intestines - pathology
Ischemia
Jejunum
Kinases
Middle Aged
Nutrition
Physiological aspects
Protein binding
Repair
Reperfusion
Reperfusion Injury - pathology
Rodents
Shedding
Small intestine
Surgery
Surgery/Gastrointestinal Surgery
Surgery/Vascular Surgery
Villus
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Summary:Intestinal ischemia-reperfusion (IR) is a phenomenon related to physiological conditions (e.g. exercise, stress) and to pathophysiological events (e.g. acute mesenteric ischemia, aortic surgery). Although intestinal IR has been studied extensively in animals, results remain inconclusive and data on human intestinal IR are scarce. Therefore, an experimental harmless model for human intestinal IR was developed, enabling us to clarify the sequelae of human intestinal IR for the first time. In 30 patients undergoing pancreatico-duodenectomy we took advantage of the fact that in this procedure a variable length of jejunum is removed. Isolated jejunum (5 cm) was subjected to 30 minutes ischemia followed by reperfusion. Intestinal Fatty Acid Binding Protein (I-FABP) arteriovenous concentration differences across the bowel segment were measured before and after ischemia to assess epithelial cell damage. Tissue sections were collected after ischemia and at 25, 60 and 120 minutes reperfusion and stained with H&E, and for I-FABP and the apoptosis marker M30. Bonferroni's test was used to compare I-FABP differences. Mean (SEM) arteriovenous concentration gradients of I-FABP across the jejunum revealed rapidly developing epithelial cell damage. I-FABP release significantly increased from 290 (46) pg/ml before ischemia towards 3,997 (554) pg/ml immediately after ischemia (p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0003428