Document Detail


Intestinal adaptation after small bowel resection in human infants.
MedLine Citation:
PMID:  21683196     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: In animal models, the small intestine responds to massive small bowel resection (SBR) through a compensatory process termed adaptation, characterized by increases in both villus height and crypt depth. This study seeks to determine whether similar morphologic alterations occur in humans after SBR.
METHODS: Clinical data and pathologic specimens of infants who had both an SBR for necrotizing enterocolitis and an ostomy takedown from 1999 to 2009 were reviewed. Small intestine mucosal morphology was compared in the same patients at the time of SBR and at the time of ostomy takedown.
RESULTS: For all samples, there was greater villus height (453.6 ± 20.4 vs 341.2 ± 12.4 μm, P < .0001) and crypt depth (178.6 ± 7.2 vs 152.6 ± 6 μm, P < .01) in the ostomy specimens compared with the SBR specimens. In infants with paired specimens, there was an increase of 31.7% ± 8.3% and 22.1% ± 10.0% in villus height and crypt depth, respectively. There was a significant correlation between the amount of intestine resected and the percent change in villus height (r = 0.36, P < .05).
CONCLUSION: Mucosal adaptation after SBR in human infants is similar to what is observed in animal models. These findings validate the use of animal models of SBR used to understand the molecular mechanisms of this important response.
Authors:
Lucas A McDuffie; Brian T Bucher; Christopher R Erwin; Derek Wakeman; Francis V White; Brad W Warner
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  46     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-06-20     Completed Date:  2011-10-31     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1045-51     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Division of Pediatric Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.
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MeSH Terms
Descriptor/Qualifier:
Adaptation, Physiological / physiology*
Cohort Studies
Digestive System Surgical Procedures / methods*
Enterocolitis, Necrotizing / pathology,  surgery*
Enterostomy / methods
Female
Follow-Up Studies
Humans
Immunohistochemistry
Infant, Newborn
Intestinal Mucosa / pathology,  surgery
Intestine, Small / pathology*,  surgery*
Male
Retrospective Studies
Statistics, Nonparametric
Tissue Embedding
Treatment Outcome
Grant Support
ID/Acronym/Agency:
P30 DK052574-12/DK/NIDDK NIH HHS; P30 DK52574/DK/NIDDK NIH HHS; R01 DK059288/DK/NIDDK NIH HHS; R01 DK059288-08/DK/NIDDK NIH HHS; T32 CA009621/CA/NCI NIH HHS; T32 CA009621/CA/NCI NIH HHS; T32 CA009621-15/CA/NCI NIH HHS; T32 GM008795/GM/NIGMS NIH HHS; T32 GM008795-10/GM/NIGMS NIH HHS; T32 GM00879509/GM/NIGMS NIH HHS
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