Abstract
Pelvic radiotherapy is associated with chronic intestinal dysfunction. Dietary approaches, such as fiber enrichment during and after pelvic radiotherapy, have been suggested to prevent or reduce dysfunctions. In the present paper, we aimed to investigate whether a diet rich in fermentable fiber could have a positive effect on radiation-induced intestinal damage, especially focusing on tuft cells and enteric neurons. Male C57BL/6 mice were fed either a purified non-fiber diet or the same purified diet with 5% or 15% oat fiber added, starting two weeks prior to sham-irradiation or irradiation with four fractions of 8 Gray. The animals continued on the diets for 1, 6 or 18 weeks, after which the gross morphology of the colorectum was assessed together with the numbers of enteric neurons, tuft cells and crypt-surface units. The results showed that dietary fiber significantly affected the intestinal morphometrics, both in the short and long-term. The presence of dietary fiber stimulated the re-emergence of crypt-surface unit structures after irradiation. At 18 weeks, the animals fed with the non-fiber diet displayed more myenteric neurons than the animals fed with the dietary fibers, but irradiation resulted in a loss of neurons in the non-fiber fed animals. Irradiation, but not diet, affected the tuft cell numbers, and a significant increase in tuft cells was found 6 and 18 weeks after irradiation. In conclusion, dietary fiber intake has the potential to modify neuronal pathogenesis in the colorectum after irradiation. The long-lasting increase in tuft cells induced by irradiation may reflect an as yet unknown role in the mucosal pathophysiology after pelvic irradiation.
Highlights
Since the bioprocessed oat bran used in the present study contains dietary fiber and beta-glucans of different chain lengths, one can assume the production of SCFAs throughout the colon, including the irradiated volume
While our findings suggest that dietary fiber may protect against radiation-induced enteric neuronal loss, it should be noted that neuronal function may still be affected
We found that irradiation led to lasting tuft-cell hyperplasia, regardless of the dietary approach
Summary
It has been estimated that approximately 90 percent of pelvic cancer survivors experience permanent changes in their bowel habits, and 50 percent of those with permanent changes perceive that they have a reduced quality of life because of this [3]. Recent studies show favorable outcomes in relation to late pelvic-radiation toxicity in patients given diets rich in fiber [6,7], suggesting that food-based strategies could ameliorate or prevent pelvicradiation damage. In this respect, dietary fiber interventions are attractive since the material is resistant to human enzymatic digestion, reaching the colon and constituting a source of energy and nutrients for the microbiota
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