Abstract
ABSTRACTBackground: The effects of topical application of sucralfate (SCF) on the tissue content of MUC-2 protein have not yet been evaluated in experimental models of diversion colitis. Aim: To measure the tissue content of MUC-2 protein in the colonic mucosa diverted from fecal stream submitted to the SCF intervention. Methods: Thirty-six rats underwent derivation of intestinal transit through proximal colostomy and distal mucous fistula. The animals were divided into three groups which were submitted application of enemas with saline, SCF 1 g/kg/day and SCF 2 g/kg/day. Each group was divided into two subgroups, according to euthanasia was done after two or four weeks. The colitis diagnosis was established by histopathological study and the inflammatory intensity was evaluated by previously validated scale. The MUC-2 protein was identified by immunohistochemistry and the tissue content was measured computerized morphometry). Results: The application of enemas with SCF in the concentration of 2 g/kg/day reduced inflammatory score of the segments that were diverted from fecal stream. The content of MUC-2 in diverted colon of the animals submitted to the intervention with SCF, independently of intervention period and the used concentration, was significantly greater than animals submitted to the application of enemas containing saline (p< 0.01). The content of MUC-2 after the intervention with SCF in the concentration of 2 g/kg/day was significantly higher when compared to the animals submitted to the application containing SCF at concentration of 1.0 g/kg/day (p<0.01). The tissue content of MUC-2 reached the highest values after intervention with SCF in the concentration of 2 g/kg/day for four weeks (p<0.01). Conclusion: The preventive application of enemas containing SCF reduces the inflammatory score and avoids the reduction of tissue content of MUC-2, suggesting that the substance is a valid therapeutic strategy to preserve the mucus layer that covers the intestinal epithelium.
Highlights
The large intestine epithelium constitutes the most perfect morphofunctional barrier of the human body, preventing the penetration of antigens, toxins and bacteria present in the lumen of the colon into the internal environment[3,5,27]. This barrier is composed of different lines of defense, mainly represented by the layer of mucus that covers the colonic mucosa; by a single layer of juxtaposed cells firmly adhered to each other that form the epithelial surface; by the efficient mechanisms of intercellular junctions that connect a cell to its neighbor, by the basement membrane; and by a complex immune defense system[9,28]
It is verified that in animals of the control group there is a clear epithelial loss, disarrangement in the architecture and in the alignment of the colic glands, whereas in the SCF 2 g/kg/day the epithelial surface is preserved, intestinal crypts present aligned with normal distribution pattern and preservation of the integrity of goblet cells
The results showed that SCF intervention, at a concentration of 1 g/kg/day and 2 g/kg/day in the derived colic segment, allowed significantly higher content of MUC-2 after two and four weeks of irrigation when compared to the animals of the group control
Summary
The large intestine epithelium constitutes the most perfect morphofunctional barrier of the human body, preventing the penetration of antigens, toxins and bacteria present in the lumen of the colon into the internal environment[3,5,27]. This barrier is composed of different lines of defense, mainly represented by the layer of mucus that covers the colonic mucosa; by a single layer of juxtaposed cells firmly adhered to each other that form the epithelial surface; by the efficient mechanisms of intercellular junctions that connect a cell to its neighbor, by the basement membrane; and by a complex immune defense system[9,28]. This immune system, considered the most efficient of the human organism, protects the host by hindering the translocation
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