Tissue-Engineered Small Intestine Improves Recovery After Massive Small Bowel Resection
- 1 November 2004
- journal article
- other
- Published by Ovid Technologies (Wolters Kluwer Health) in Annals of Surgery
- Vol. 240 (5), 748-754
- https://doi.org/10.1097/01.sla.0000143246.07277.73
Abstract
Objective: Rescue with tissue-engineered small intestine (TESI) after massive small bowel resection (MSBR). Summary Background Data: Short bowel syndrome is a morbid product of massive small bowel resection. We report the first replacement of a vital organ by tissue engineering with TESI after MSBR. Methods: Ten male Lewis rats underwent TESI implantation with green fluorescent protein (GFP)-marked cells (TESI+, n = 5) or sham laparotomy (TESI−, n = 5) followed by MSBR. Side-to-side anastomosis of TESI to proximal small intestine was performed or omitted. TESIØ animals underwent implantation of engineered intestine with no further surgery. Weights were measured QOD until day 40. Transit times were measured. DNA assay was performed with computer morphometry. Northern blots of RNA were probed for intestinal alkaline phosphatase (IAP) and villin. Hematoxylin and eosin, S100, and smooth muscle actin immunohistochemistry were performed. Blood was collected at sacrifice. Results: All 10 rats initially lost then regained weight. The initial rate of weight loss was higher in TESI+ versus TESI−, but the nadir was reached a week earlier with more rapid weight gain subsequently to 98% preoperative weight on day 40 in animals with engineered intestine versus 76% (P < 0.03). Serum B12 was higher at 439 pg/mL versus 195.4 pg/mL. IAP mRNA appeared greater in TESI+ than TESIØ, with constant villin levels. Histology revealed appropriate architecture including nerve. GFP labeling persisted. Conclusions: Anastomosis of TESI significantly improved postoperative weight and B12 absorption after MSBR. IAP, a marker of differentiation in intestinal epithelium, is present in TESI, and GFP labeling was accomplished.Keywords
This publication has 22 references indexed in Scilit:
- Effect of GLP-2 on mucosal morphology and SGLT1 expression in tissue-engineered neointestineAmerican Journal of Physiology-Gastrointestinal and Liver Physiology, 2003
- Tissue-Engineered Large Intestine Resembles Native Colon With Appropriate In Vitro Physiology and ArchitectureAnnals of Surgery, 2003
- Tissue-engineered small intestineTransplantation, 2002
- Comprehensive Modified Diet Simplifies Nutrition Management of Adults with Short-Bowel SyndromeJournal of the American Dietetic Association, 1998
- Preliminary studies of tissue-engineered intestine using isolated epithelial organoid units on tubular synthetic biodegradable scaffoldsTransplantation Proceedings, 1997
- A stable human-derived packaging cell line for production of high titer retrovirus/vesicular stomatitis virus G pseudotypes.Proceedings of the National Academy of Sciences of the United States of America, 1996
- Gastrointestinal hormones in short bowel syndrome. Peptide YY may be the 'colonic brake' to gastric emptying.Gut, 1996
- Sequence of human villin: a large duplicated domain homologous with other actin-severing proteins and a unique small carboxy-terminal domain related to villin specificity.The Journal of cell biology, 1988
- Nucleotide and amino acid sequences of human intestinal alkaline phosphatase: close homology to placental alkaline phosphatase.Proceedings of the National Academy of Sciences of the United States of America, 1987
- Number and evolutionary conservation of α- and β-tubulin and cytoplasmic β- and γ-actin genes using specific cloned cDNA probesCell, 1980