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Intestinal permeability and bacterial translocation are uncoupled after small bowel resection.
David P O'Brien1, Lindsey A Nelson, Christopher J Kemp
1Division of Pediatric Surgery, Children's Hospital Medical Center and Shriner's Hospital for Children, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Journal of Pediatric Surgery
|March 6, 2002
Summary
Massive small bowel resection (SBR) in mice did not increase gut permeability to macromolecules. However, bacterial translocation to lymph nodes and liver was elevated, suggesting mechanisms beyond altered gut barrier function.
Area of Science:
- Gastroenterology
- Surgical Research
- Microbiology
Background:
- Gut barrier dysfunction and bacterial translocation are implicated in short bowel syndrome (SBS) complications.
- Massive small bowel resection (SBR) may compromise intestinal integrity.
- The adaptive changes in the ileum post-SBR require further investigation regarding barrier function.
Purpose of the Study:
- To test if intestinal permeability increases in the adapting remnant ileum after massive small bowel resection (SBR).
- To investigate the relationship between gut permeability and bacterial translocation post-SBR.
Main Methods:
- Male ICR mice underwent 50% proximal SBR or sham operation.
- Ileal permeability to dextran and horseradish peroxidase (HRP) was measured using Ussing chambers at 3, 7, and 14 days post-operation.
- Bacterial translocation was assessed by culturing blood, mesenteric lymph nodes, liver, and spleen.
Main Results:
- Intestinal permeability to dextran was transiently reduced post-SBR, with no significant difference at later time points.
- Permeability to high molecular weight marker HRP remained unchanged at all time points.
- Translocation of Gram-negative bacteria to mesenteric lymph nodes and liver was significantly increased in SBR mice at 3 and 14 days.
Conclusions:
- Massive small bowel resection does not increase intestinal permeability to macromolecules.
- Elevated bacterial translocation post-SBR suggests mechanisms independent of altered gut permeability.
- These findings challenge the direct link between increased permeability and bacterial translocation in the context of SBR.