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Does small intestinal atresia affect epithelial protein expression in human newborns?
Maaike W Schaart1, Takeshi Yamanouchi, Danielle J P M van Nispen
1Division of Neonatology, Department of Pediatrics, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
Insights
Newborn intestinal epithelium is mature at birth, regardless of congenital obstruction. Protein expression in enterocytes, goblet cells, and Paneth cells remains normal, suggesting independent maturation.
Area of Science:
- Gastroenterology
- Neonatal research
- Developmental biology
Background:
- Congenital intestinal obstructions, such as jejunal or ileal atresia, raise questions about the maturity of distal bowel segments.
- The role of luminal factors like amniotic fluid and enteral nutrition in activating intestinal epithelial protein expression and differentiation is debated.
Purpose of the Study:
- To investigate cell-type-specific protein expression in human newborns with jejunal or ileal atresias.
- To compare protein expression in bowel segments proximal and distal to the atresia.
Main Methods:
- Immunohistochemical analysis of intestinal tissue specimens from 16 newborns with jejunal or ileal atresia.
- Tissue sections were obtained from both proximal and distal sides of the atretic segments.
Main Results:
- Enterocyte-specific markers (lactase, sucrase-isomaltase, SGLT1, GLUT2, GLUT5, I-FABP, alkaline phosphatase) were expressed in all patients by postnatal day 3, proximal and distal to atresias.
- Goblet cell markers (mucin 2, trefoil factor 3) and Paneth cell marker (lysozyme) expression were maintained on both sides of the atretic segment.
Conclusions:
- The human small intestinal epithelium demonstrates differentiation shortly after birth, based on the evaluated protein markers.
- Disruption of intestinal continuity due to jejunal or ileal atresia does not impede epithelial protein expression.
- These findings suggest that small intestinal epithelial maturation occurs independently of luminal components in newborns.
Objectives:
Bowel segments distal to a congenital intestinal obstruction have been suggested to be immature. In other words, luminal components such as amniotic fluid (before birth) and/or enteral nutrition (after birth) may be required to activate intestinal epithelial protein expression, thereby influencing epithelial differentiation. We investigated cell-type-specific protein expression proximal and distal to jejunal and ileal atresias in human newborns.
Patients And Methods:
We immunohistochemically studied intestinal tissue specimens of 16 newborns who had undergone surgery for jejunal or ileal atresia. Sections were taken from both the proximal and distal sides of the atresias.
Results:
For all patients, the enterocyte-specific markers lactase, sucrase-isomaltase, sodium glucose cotransporter 1, glucose transporters 2 and 5, intestinal fatty acid-binding protein and alkaline phosphatase were expressed at a mean 3 +/- 1 days after birth, both proximal and distal to jejunal and ileal atresias. Expression of goblet cell-specific markers mucin 2 and trefoil factor 3 and that of the Paneth cell marker lysozyme was maintained at either side of the atretic segment.
Conclusions:
With respect to the markers used, the human small intestinal epithelium is already differentiated shortly after birth. The absence of intestinal continuity in case of a jejunal or ileal atresia does not affect epithelial protein expression. This would seem to indicate that the developing small intestinal epithelium matures independently of luminal components.
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