Ischaemia-induced mucus barrier loss and bacterial penetration are rapidly counteracted by increased goblet cell secretory activity in human and rat colon

被引:86
作者
Grootjans, Joep [1 ,2 ]
Hundscheid, Inca H. R. [1 ]
Lenaerts, Kaatje [1 ]
Boonen, Bas [1 ]
Renes, Ingrid B. [3 ]
Verheyen, Fons K. [4 ]
Dejong, Cornelis H. [1 ]
von Meyenfeldt, Maarten F. [1 ]
Beets, Geerard L. [1 ]
Buurman, Wim A. [1 ]
机构
[1] Maastricht Univ, Med Ctr, Dept Surg, NUTRIM Sch Nutr Toxicol & Metab, NL-6229 ER Maastricht, Netherlands
[2] Slotervaartziekenhuis, Dept Internal Med, Amsterdam, Netherlands
[3] Erasmus MC Sophia, Lab Paediat, Div Neonatol, Rotterdam, Netherlands
[4] Maastricht Univ, Dept Mol Cell Biol & Electron Microscopy, CRISP, Med Ctr, NL-6229 ER Maastricht, Netherlands
关键词
COLITIS; INFLAMMATION; PATTERNS; OUTCOMES; HYPOXIA;
D O I
10.1136/gutjnl-2011-301956
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Objective Colonic ischaemia is frequently observed in clinical practice. This study provides a novel insight into the pathophysiology of colon ischaemia/reperfusion (IR) using a newly developed human and rat experimental model. Design In 10 patients a small part of colon that had to be removed for surgical reasons was isolated and exposed to 60 min of ischaemia (60I) with/without different periods of reperfusion (30R and 60R). Tissue not exposed to IR served as control. In rats, colon was exposed to 60I, 60I/30R, 60I/120R or 60I/240R (n = 7 per group). The tissue was snap-frozen or fixed in glutaraldehyde, formalin or methacarn fixative. Mucins were stained with Periodic Acid Schiff/Alcian Blue (PAS/AB) and MUC2/Dolichos biflorus agglutinin (DBA). Bacteria were studied using electron microscopy (EM) and fluorescent in situ hybridisation (FISH). Neutrophils were studied using myeloperoxidase staining. qPCR was performed for MUC2, interleukin (IL)-6, IL-1 beta and tumour necrosis factor a. Results In rats, PAS/AB and MUC2/DBA staining revealed mucus layer detachment at ischaemia which was accompanied by bacterial penetration (in EM and FISH). Human and rat studies showed that, simultaneously, goblet cell secretory activity increased. This was associated with expulsion of bacteria from the crypts and restoration of the mucus layer at 240 min of reperfusion. Inflammation was limited to minor influx of neutrophils and increased expression of proinflammatory cytokines during reperfusion. Conclusions Colonic ischaemia leads to disruption of the mucus layer facilitating bacterial penetration. This is rapidly counteracted by increased secretory activity of goblet cells, leading to expulsion of bacteria from the crypts as well as restoration of the mucus barrier.
引用
收藏
页码:250 / 258
页数:9
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