4.4 Article

Intestinal adaptation following spring insertion into a roux limb in mice

Journal

JOURNAL OF PEDIATRIC SURGERY
Volume 56, Issue 2, Pages 346-351

Publisher

W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.jpedsurg.2020.06.033

Keywords

Short bowel syndrome (SBS); Distraction enterogenesis; Intestinal lengthening; Intestinal failure (IF)

Funding

  1. National Institutes of Health [U01DK085535]

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The study demonstrates that elongation of the intestines, thickening of smooth muscles, and molecular-level adaptations can be achieved through the insertion of compressed springs in a mouse model. Results show that the intestinal segments loaded with compressed springs lengthened significantly, with greater muscularis thickening, crypt depth, and Lgr5+ expression compared to control groups.
Background/Purpose: Intraluminal springs have recently been shown to lengthen segments of intestine in a process known as distraction enterogenesis. We hypothesized that biocompatible springs could be used to lengthen defunctionalized murine small intestine and would lead to identifiable intestinal adaptations at the molecular level. Methods: Age and weight matched C57BL/6 mice underwent surgical insertion of nitinol spring-loaded capsules into a Roux limb of jejunum. Segment lengths were measured at initial spring placement and at euthanasia after 14 and 21 days. Histology and gene expression of the Roux limb were evaluated at scarification and compared to untreated control segments. Results: Intestinal segments loaded with compressed springs lengthened an average of 240%, which was significantly longer than control segments loaded with either empty capsules or uncompressed springs. Muscularis thickening was greater in spring-treated mice compared to controls without springs. Crypt depth and Lgr5 + ex pression was greater in mice that received compressed spring treatments when compared to control groups. Conclusions: Insertion of a compressed nitinol spring into a Roux limb results in significant intestinal lengthening, smooth muscle thickening, and Lgr5 + expression in a mouse model. The ability to increase small bowel length in a defunctionalized murine model may be used to understand the mechanism of distraction enterogenesis. (C) 2020 Elsevier Inc. All rights reserved.

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