Stem cell activation during distraction enterogenesis in the murine colon

PurposeShort bowel syndrome (SBS) is a devastating disease. We have proposed spring-mediated distraction enterogenesis for intestinal lengthening. Colonic lengthening is a potential treatment option for SBS to enhance fluid absorption capacity. We hypothesized that intraluminal spring-mediated colonic lengthening is associated with stem cell proliferation.MethodsC57BL/6 mice underwent placement of a gelatin-encapsulated compressed or uncompressed nitinol spring in a cecal segment. Animals were given clear liquid diet until postoperative day (POD) 7, followed by regular diet until POD 14. Cecal lengths were measured at euthanasia, and tissue was formalin fixed for histological processing. For Lgr5-GFP mice, immunohistochemistry against GFP was performed to localize Lgr5+ cells within crypts.ResultsSignificant cecal lengthening with compressed springs and shortening with uncompressed springs were observed on POD 7 and 14. Mucosa of the compressed spring group was significantly thicker on POD 14. The density of Lgr5(+) cells within the crypts in the compressed spring groups was higher than that in the uncompressed spring groups on both POD 7 and 14.ConclusionExpandable springs can be used to lengthen the colon in the mouse model. Colonic lengthening was associated with gradual mucosal thickening and correlated with an increased density of stem cells within the crypts.

Automated summary

Spring-mediated colonic lengthening was achieved by placing compressed springs in a cecal segment. The compressed spring group showed significant colonic lengthening on postoperative day 7 and 14, while the uncompressed spring group showed colonic shortening. Mucosal thickness increased and stem cell density was higher in the compressed spring group.