Mucosa Of Duodenum Research Articles

Endoscopic control after retroperitoneal pancreas transplantation with a Roux-en-Y duodenojejunostomy for exocrine drainage

Background. Simultaneous pancreas and kidney transplantation is a gold standard in the treatment of diabetes mellitus complicated by stage 5 chronic kidney disease as a result of diabetic nephropathy. One of the main problems of clinical pancreas transplantation is the pancreas graft exocrine drainage. In order to preserve the advantages of the retroperitoneal graft location and avoid the main disadvantage of duodenal drainage, namely, fatal complications potentially arising in case of necessary graft removal, we have proposed a modified method of retroperitoneal pancreatic transplantation with exocrine drainage via a modified Roux-en-Y duodenojejunostomy. It reduces the number of severe surgical complications and increases the recipient survival rate. When this method was used in previous years, it was not possible to assess the condition of donor duodenum mucosa and interintestinal anastomoses.Objective. To demonstrate the possibility of endoscopic assessment of interintestinal anastomoses when performing retroperitoneal pancreas transplantation with small intestine drainage of exocrine secretions.Results. The article presents the initial experience of endoscopic assessment of the interintestinal anastomoses and the mucous membrane of the donor duodenum after retroperitoneal pancreas transplantation with exocrine drainage via a Roux-en-Y duodenojejunostomy.Conclusion. The presented case demonstrates the feasibility of diagnostic endoscopic interventions when performing retroperitoneal pancreas transplantation with small intestine drainage of pancreatic secretions.

Multi-tissue transcriptome profiling linked the association between tissue-specific circRNAs and the heterosis for feed intake and efficiency in chicken

Heterosis has been widely utilized in chickens. The nonadditive inheritance of genes contributes to this biological phenomenon. However, the role of circRNAs played in the heterosis is poorly determined. In this study, we observed divergent heterosis for residual feed intake (RFI) between 2 crossbreds derived from a reciprocal cross between White Leghorns and Beijing You chickens. Then, circRNA landscape for 120 samples covering the hypothalamus, liver, duodenum mucosa and ovary were profiled to elucidate the regulatory mechanisms of heterosis. We detected that a small proportion of circRNAs (7.83-20.35%) were additively and non-additively expressed, in which non-additivity was a major inheritance of circRNAs in the crossbreds. Tissue-specific expression of circRNAs was prevalent across 4 tissues. Weighted gene co-expression network analysis revealed circRNA-mRNA co-expression modules associated with feed intake and RFI in the hypothalamus and liver, and the co-expressed genes were enriched in oxidative phosphorylation pathway. We further identified 8 nonadditive circRNAs highly correlated with 16 nonadditive genes regulating negative heterosis for RFI in the 2 tissues. Circ-ITSN2 was validated in the liver tissue for its significantly positive correlation with PGPEP1L. Moreover, the bioinformatic analysis indicated that candidate circRNAs might be functioned by binding the microRNAs and interacting with the RNA binding proteins. The integration of multi-tissue transcriptome firstly linked the association between tissue-specific circRNAs and the heterosis for feed intake and efficiency in chicken, which provide novel insights into the molecular mechanism underlying heterosis for feed efficiency. The validated circRNAs can act as potential biomarkers for predicting RFI and its heterosis.

Carbohydrase activity in proximal and distal segments of small intestine in health, irritated bowel syndrome and enteropathy with membrane digestion disturbance

Diagnostics of enteropathy with membrane digestion disturbance (EMDD) is based on the evaluation of carbohydrase activity in duodenal mucosa (DM). There is no information about diagnostic value of ileum mucosa (IM) carbohydrases.
 Aim. Assess the diagnostic value of carbohydrases activity in mucous membrane of duodenum and distal ileum in patients with EMDD and irritable bowel syndrome (IBS).
 Materials and methods. The study includes 12 patients with EMDD, 16 patients with IBS and 12 relatively healthy persons (control group). Study design included analysis of food tolerance and evaluation of activity of sucrase, glucoamylase, maltase and lactase in mucous membrane of duodenum and ileum based on the method of Dahlquist with N.I. Belostotsky modification. Microsoft Office Excel and Statistica 10.0 were used for statistical evaluation of material. Mann–Whitney criterion was used to evaluate the differences between quantitative parameters. The differences were considered to be significant at p0.05. Control group was used for comparison.
 Results. In control group the carbohydrases activity in duodenum mucosa was not significantly statistically different from the one in IM. In patients of the IBS group, the activity of glucoamylase and maltase in the IM was significantly higher than in the duodenum: glucoamylase by 2.2 times, maltase by 2 times. In patients with EMDD the activity of glucoamylase, maltase and sucrase in IM is higher than in DM by 5.2, 3.8 and 2 times respectively, which signifies the formation of compensatory reaction of adaptive shift, initially described by A.M. Ugolev in 1985.
 Conclusion. The evaluation of carbohydrase activity in IM provides more information about pathogenesis of EMDD and its differential diagnosis with IBS.

Divergent selection for feed efficiency in pigs altered the duodenum transcriptomic response to feed intake and its DNA methylation profiles.

Feed efficiency is a trait of interest in pigs as it contributes to lowering the ecological and economical costs of pig production. A divergent genetic selection experiment from a Large White pig population was performed for 10 generations, leading to pig lines with relatively low- (LRFI) and high- (HRFI) residual feed intake (RFI). Feeding behavior and metabolic differences have been previously reported between the two lines. We hypothesized that part of these differences could be related to differential sensing and absorption of nutrients in the proximal intestine. We investigated the duodenum transcriptome and DNA methylation profiles comparing overnight fasting with ad libitum feeding in LRFI and HRFI pigs (n = 24). We identified 1,106 differentially expressed genes between the two lines, notably affecting pathways of the transmembrane transport activity and related to mitosis or chromosome separation. The LRFI line showed a greater transcriptomic response to feed intake than the HRFI line. Feed intake affected genes from both anabolic and catabolic pathways in the pig duodenum, such as rRNA production and autophagy. Several nutrient transporter and tight junction genes were differentially expressed between lines and/or by short-term feed intake. We also identified 409 differentially methylated regions in the duodenum mucosa between the two lines, while this epigenetic mark was less affected by feeding. Our findings highlighted that the genetic selection for feed efficiency in pigs changed the transcriptome profiles of the duodenum, and notably its response to feed intake, suggesting key roles for this proximal gut segment in mechanisms underlying feed efficiency.NEW & NOTEWORTHY The duodenum is a key organ for the hunger/satiety loop and nutrient sensing. We investigated how the duodenum transcriptome and DNA methylation profiles are affected by feed intakes in pigs. We observed thousands of changes in gene expression levels between overnight-fasted and fed pigs in high-feed efficiency pig lines, but almost none in the related low-feed efficiency pig line.

Modulation of Gut Microbiota, and Morphometry, Blood Profiles and performance of Broiler Chickens Supplemented with Piper aduncum, Morinda citrifolia, and Artocarpus altilis leaves Ethanolic Extracts.

Bioactive plants such as P. aduncum, M. citrifolia, and A. altilis might improve intestinal health as an alternative to antibiotic growth promoters. The objective of this study was to determine the effect of the ethanolic extracts (EEs) of these plants on the intestinal health of broiler chickens. Cobb 500 chickens (n = 352) were distributed into eight treatments with four replicates and 11 chickens each. T1 received a base diet, and T2 received a base diet with 0.005% zinc bacitracin. T3, T5, and T7 were supplemented with 0.005% of P. aduncum, M. citrifolia, and A. altilis EE in the diet while T4, T6, and T8 with 0.01% of the extract. The EEs were supplemented with drinking water from 1 to 26 days of age. The following parameters were evaluated: hematological profiles at 28 days of age, blood metabolites profiles at 14, 21, and 28 days; Escherichia coli, Staphylococcus aureus, and Lactobacillus sp. abundance in the ileum mucosa and content at 21 and 28 days, and histomorphometry of the duodenum, jejunum, and ileum mucosa at 14, 21, and 28 d. Final weight (FW), weight gain (WG), feed intake (FI), and feed conversion rate (FCR) were evaluated at seven, 21, and 33 days of age. M. citrifolia and A. altilis EE at 0.01% increased blood glucose levels at 21 and 28 days of age, respectively, and P. aduncum and M. citrifolia EE at 0.01% increased triglycerides at 28 days of age; in addition, this EE did not have any effect on the AST and ALT profiles. The depths of the Lieberkühn crypts and the villi length to the crypt's depth ratio increased with age on supplementation with 0.01% M. citrifolia and A. altilis EE at 21 days of age (p < 0.05). In addition, the depth of the crypts increased at 28 days of age (p < 0.05) in chickens supplemented with 0.01% A. altilis EE. The 0.01% M. citrifolia EE in diet decreased in the Staphylococcus aureus population in the ileal microbiota (p < 0.05). The FW and WG during the fattening and in the three stages overall increased, and the FCR decreased; however, the FI and the carcass yield did not change in the broiler chickens supplemented with 0.01% M. citrifolia EE (p < 0.05). Conclusively, the M. citrifolia EE at 0.01% of the diet improved intestinal health and thus the performance indices of the broiler chickens and did not have a detrimental effect on any of the parameters evaluated, so it is postulated as a potential alternative to AGP in poultry.

Antiulcer activity of Mauritia flexuosa L.f. (Arecaceae) pulp oil: An edible Amazonian species with functional properties

Mauritia flexuosa, known as buriti in Brazil, is a widespread palm tree in Amazonia. It has many ethnobotanical uses, including food, oil, and medicine. The oil obtained from buriti's fruit pulp has high levels of monounsaturated fatty acids, carotenoids, and tocopherols, and is used in the food, cosmetic, and pharmaceutical industries for its antioxidant properties. Many biological activities have been reported for buriti oil, such as antioxidant, antimicrobial, chemopreventive, and immunomodulatory. Due to its high content of bioactive compounds, buriti oil is considered a functional ingredient with possible benefits in preventing oxidative stress and chronic diseases, particularly in the gastrointestinal tract. Peptic ulcer disease is a multifactorial disorder, involving lesions in the stomach and duodenum mucosa, which has a complex healing process. In this context, some nutrients and bioactive compounds help the maintenance of gastrointestinal mucosal integrity and function, such as carotenoids, tocopherols, and unsaturated fatty acids, which makes buriti oil an interesting candidate to be used in the prevention and management of gastrointestinal diseases. This study aimed to evaluate the gastroprotective and antiulcer effects of buriti oil and its possible mechanisms of action. Buriti oil reduced the ulcerative area and lipid peroxidation induced by ethanol. The gastroprotective activity of buriti oil partially depends on nitric oxide and sulfhydryl compounds. In acetic acid-induced gastric ulcers, buriti oil accelerated healing and stimulated the formation of new gastric glands. These results demonstrated the potential of buriti oil as a functional ingredient to promote health benefits in the gastrointestinal tract.

Reduced expression of Ankyrin-G and E-cadherin in duodenal mucosal biopsy of subjects with celiac disease

Confirmatory diagnosis of celiac disease (CD) include histopathology of duodenal biopsy and tissue trans-glutaminase-IgA. Identification of tissue-specific histological markers is warranted to improve the diagnosis. A genetic study in CD identified the association of ankyrin-G that connects E-cadherin with β2-spectrin in epithelial cells of the duodenal tissue. We attempted to investigate the differential expression of ankyrin-G, E-cadherin and β2-spectrin in duodenal biopsy of CD subjects compared to non-CD controls. Duodenal tissue was collected from 83 study participants, of which 50 were CD, and 33 were non-CD controls. Whole RNA was isolated from 32 CD and 23 non-CD controls from available tissues, and differential mRNA expression was measured using real-time PCR. Tissue sections from 18 CD cases and 10 non-CD controls were immunostained using monoclonal antibodies. Tissue immunohistochemistry were evaluated for differential expression and pattern of expression. RT-PCR revealed significantly reduced expression of ankyrin-G (fold change=0.63; p=0.03) and E-cadherin (fold change=0.50; p=0.02) among CD subjects compared to non-CD controls. Tissue immunohistochemistry confirmed the reduced expression of ankyrin-G and E-cadherin in CD. Differential expression is grossly limited within the outer columnar epithelial cell layer. Expression fold change of E-cadherin was seen to partially correlate with the serum tTG level (r=0.4; p=0.04). In CD, reduced expression of two key cytoskeletal proteins (ankyrin-G and E-cadherin) in duodenum mucosa was observed, which indicates its implication in disease biology and could be tested as a tissue-specific biomarker for CD. Functional studies may unravel the specific contribution of these proteins in CD pathophysiology.

Еndoscopic and histological features of the gastroduodenal zone in children with the CagA Helicobacter pylori infection

Introduction. It is known that the presence of the CagA gene in Helicobacter pylori is associated with its increased pathogenicity. However, in children, studies on the effects of this strain on the gastric mucosa are insufficient.Aim. To compare effects of different Helicobacter pylori (HP) strains on the gastric and duodenum mucosa in children to optimize indications for eradication.Materials and methods. 397 adolescents (169 boys and 227 girls) aged 11–18 were examined on the basis of the hospital gastroenterological department: the content of antibodies to the CagA strain of HP was determined by ELISA, esophagogastroduodenoscopy (EFGDS) was performedwith a biopsy of the gastric mucosa and determination of the HP contamination degree, and also HP gene was detected in the feces.According to the results obtained, all children were divided into 3 groups: 131 children (57 boys and 74 girls) infected with CagA by negative HP strains (CagA “-”); 119 children (52 boys and 67 girls) infected with CagA positive HP strains (CagA “+”); 94 children (36 boys and 57 girls) who are not infected with HP (HP “-”).Results. When we analyzed the endoscopic-histological picture of the gastric mucosa in the CagA “+” group, in contrast to the CagA “-” group, it was found that the chances of developing highbacteria contamination of the mucosa increased 4.7 times, II and III degree of gastritis activity – 6.6 times, chronic inflammation – 2.6 times, hyperplastic gastritis – 2.8 times, erosive gastritis or duodenitis – 2.7 times, peptic ulcer – 3.6 times, andalso signs of concomitant candidiasis (the presence of structural elements of the Candida fungus) – 4.1 times.Conclusion. Thus, it is advisable for all children with gastroduodenal pathology to recommend an examination for the detection of the CagA HP antigen with subsequent eradication.

Functional dyspepsia: modern pathogenetic aspects and therapeutic approaches

Functional dyspepsia, affecting up to 20% of individuals worldwide, remains both a cause of decreased activity of patients’ daily life and an obvious economic burden due to healthcare costs. Despite extensive research, the etiology of dyspepsia is unknown in most patients. Intestinal motility dysfunction has long been considered the major culprit, but recent studies suggest that immune pathophysiological and molecular effects in the duodenum are far more likely predisposing factors. Eosinophilia and an increase in mast cells in both the duodenum and gastric mucosa are identified in most patients with this disease. More and more data on the significant role of impaired paracellular permeability of the intestinal mucosa are now available. It is associated with subclinical inflammation in the submucosal layer in patients with functional dyspepsia. This explains the poor effectiveness of the treatments taken. The evidence from practice suggests that symptoms persist or return after eradication therapy in most patients. Proton pump inhibitors and antidepressants do not ease postprandial distress syndrome. Montelukast and cromolyn therapy has been proposed, but this approach is not yet widely popular. Therefore, there is an obvious need in finding other therapeutic approaches. One of them is the increased use of prokinetics, the most recent of which is acotiamide. Its mechanism of action is similar to that of prior generation prokinetics (inhibition of acetylcholinesterase activity), but is distinguished by the absence of impact on dopaminergy, due to which the drug has far fewer side effects. In addition, its effect on the production of ghrelin, which physiological role is being actively studied, is discussed.

The mRNA-lncRNA landscape of multiple tissues uncovers key regulators and molecular pathways that underlie heterosis for feed intake and efficiency in laying chickens

BackgroundHeterosis is routinely exploited to improve animal performance. However, heterosis and its underlying molecular mechanism for feed intake and efficiency have been rarely explored in chickens. Feed efficiency continues to be an important breeding goal trait since feed accounts for 60 to 70% of the total production costs in poultry. Here, we profiled the mRNA-lncRNA landscape of 96 samples of the hypothalamus, liver and duodenum mucosa from White Leghorn (WL), Beijing-You chicken (YY), and their reciprocal crosses (WY and YW) to elucidate the regulatory mechanisms of heterosis.ResultsWe observed negative heterosis for both feed intake and residual feed intake (RFI) in YW during the laying period from 43 to 46 weeks of age. Analysis of the global expression pattern showed that non-additivity was a major component of the inheritance of gene expression in the three tissues for YW but not for WY. The YW-specific non-additively expressed genes (YWG) and lncRNA (YWL) dominated the total number of non-additively expressed genes and lncRNA in the hypothalamus and duodenum mucosa. Enrichment analysis of YWG showed that mitochondria components and oxidation phosphorylation (OXPHOS) pathways were shared among the three tissues. The OXPHOS pathway was enriched by target genes for YWL with non-additive inheritance of expression in the liver and duodenum mucosa. Weighted gene co-expression network analysis revealed divergent co-expression modules associated with feed intake and RFI in the three tissues from WL, YW, and YY. Among the negatively related modules, the OXPHOS pathway was enriched by hub genes in the three tissues, which supports the critical role of oxidative phosphorylation. Furthermore, protein quantification of ATP5I was highly consistent with ATP5I expression in the liver, which suggests that, in crossbred YW, non-additive gene expression is down-regulated and decreases ATP production through oxidative phosphorylation, resulting in negative heterosis for feed intake and efficiency.ConclusionsOur results demonstrate that non-additively expressed genes and lncRNA involved in oxidative phosphorylation in the hypothalamus, liver, and duodenum mucosa are key regulators of the negative heterosis for feed intake and RFI in layer chickens. These findings should facilitate the rational choice of suitable parents for producing crossbred chickens.

Hemp seed (Cannabis sativa L.) cake as sustainable dietary additive in slow-growing broilers: effects on performance, meat quality, oxidative stability and gut health

Hemp seed cake (HSC) (Cannabis sativa L.) is a rich source of polyunsaturated fatty acids, high-quality proteins and essential amino acids. The aim of this study was to evaluate the effects of dietary inclusion of HSC on growth performance, meat quality traits, fatty acids profile and oxidative status, and intestinal morphology in slow-growing broilers. A total of 180 male slow-growing broilers were randomly assigned to one of three dietary treatments containing different levels of HSC: 0 (HSC0), 5 (HSC5) or 10% (HSC10). Birds were slaughtered at 49 days of age: breast and thigh muscles were analysed and duodenum mucosa histomorphological features were evaluated. Regardless the level of HSC inclusion, no differences among groups were found for performance and meat quality traits. The thigh and breast fatty acid profile were significantly improved in both HSC groups, with an increase of the long chain fatty acids of n-3 series and decrease of n-6/n-3 ratio. The HSC diets lowered the MDA concentration and lipid hydroperoxides in breast meat. Histomorphometrical analysis revealed a significant increase in villus height, surface area and villus/crypt ratio, with a decrease of crypt depth, suggesting that dietary supplementation with HSC may boost intestinal health status in poultry. In conclusion, dietary HSC did not affect performance, carcass traits and meat quality, while it positively influenced the lipid profile of meat, and improved the oxidative status and gut health, thus representing a valuable and sustainable alternative ingredient in broiler diet.

Bariatric surgery alters mitochondrial function in gut mucosa.

The obesity pandemic has worsened global disease burden, including type 2 diabetes, cardiovascular disease, and cancer. Metabolic/bariatric surgery (MBS) is the most effective and durable obesity treatment, but the mechanisms underlying its long-term weight loss efficacy remain unclear. MBS drives substrate oxidation that has been linked to improvements in metabolic function and improved glycemic control that are potentially mediated by mitochondria-a primary site of energy production. As such, augmentation of intestinal mitochondrial function may drive processes underlying the systemic metabolic benefits of MBS. Herein, we applied a highly sensitive technique to evaluate intestinal mitochondrial function ex vivo in a mouse model of MBS. Mice were randomized to surgery, sham, or non-operative control. A simplified model of MBS, ileal interposition, was performed by interposition of a 2-cm segment of terminal ileum into the proximal bowel 5mm from the ligament of Treitz. After a four-week recovery period, intestinal mucosa of duodenum, jejunum, ileum, and interposed ileum were assayed for determination of mitochondrial respiratory function. Citrate synthase activity was measured as a marker of mitochondrial content. Ileal interposition was well tolerated and associated with modest body weight loss and transient hypophagia relative to controls. Mitochondrial capacity declined in the native duodenum and jejunum of animals following ileal interposition relative to controls, although respiration remained unchanged in these segments. Similarly, ileal interposition lowered citrate synthase activity in the duodenum and jejunum following relative to controls but ileal function remained constant across all groups. Ileal interposition decreases mitochondrial volume in the proximal intestinal mucosa of mice. This change in concentration with preserved respiration suggests a global mucosal response to segment specific nutrition signals in the distal bowel. Future studies are required to understand the causes underlying these mitochondrial changes.

Mucosal phosphatase activity, phytate degradation, and mineral digestibility in 6-week-old turkeys and broilers at different dietary levels of phosphorus and phytase and comparison with 3-week-old animals

Female turkeys (B.U.T. 6) and broilers (Ross 308) were compared at 6 wk of age to evaluate the effects of species, dietary P, Ca, and phytase levels on myo-inositol hexakisphosphate (InsP6) degradation along the digestive tract, gut mucosal phosphatase activity, P and Ca digestibility, and myo-inositol concentrations in the digesta and blood. The environmental conditions and experimental corn-soybean meal-based diets were the same for both species. Four diets with either combination of 2 levels of P and Ca (CaP-: 4.0 g P/kg, 5.4 g Ca/kg and CaP+: 6.0 g P/kg, 8.0 g Ca/kg) and 2 levels of phytase supplementation (0 and 1,500 FTU/kg) were fed to the animals for 7d at their sixth wk of age. Each diet was randomly assigned to 6 pens per species, with 10 birds each. After slaughter, blood, digesta from the crop, gizzard, duodenum, lower ileum, and jejunal mucosa were collected. Endogenous mucosal phosphatase activity in the jejunum was higher in turkeys than in broilers. Prececal InsP6 disappearance was also higher in turkeys than in broilers when phytase was not supplemented. Phytase supplementation led to a higher prececal InsP6 disappearance in broilers than in turkeys, likely due to different crop conditions such as moisture content. However, prececal P digestibility was higher in turkeys than broilers. Different relationships between myo-inositol concentration in the ileum digesta and blood were found, depending on the species. A comparison of the results with those obtained in 3-wk-old birds of a companion study showed that in diets with low Ca and P levels, prececal InsP6 disappearance increased with age in turkeys, but not in broilers. This coincided with changes in the conditions of the digestive tract, such as the water content in the crop, gizzard pH, and mucosal phosphatase activity. In conclusion, occurrence of differences in phytate degradation between turkeys and broilers, fed the same feed, depended on age and can be explained by different physiological development of the digestive tract.

Vmist prostahlandynu E2 v syrovattsi krovy patsiientiv iz erozyvno-vyrazkovymy urazhenniamy hastroduodenalnoi zony bez i z komorbidnoiu hipertonichnoiu khvoroboiu

Introduction. The combination of erosive-ulcerative lesions (EUI) of the gastroduodenal zone with hypertension (HT) is a common phenomenon and is a modern medicine’s pressing issue. Taking nonsteroidal anti-inflammatory drugs (NSAIDs), including by patients with HT, is accompanied by prostaglandin synthesis suppression due to cyclooxygenase inhibition and results in an arterial pressure increase. Moreover, it should be mentioned that patients with HT have a higher risk of gastroduodenal lesions. The aim of the study. To explore the prostaglandin E2 content in the blood serum of patients with gastroduodenal erosive-ulcerative lesions without and with comorbid hypertension. Materials and methods. The research involved 20 patients with gastroduodenal EUI without comorbid HT and 30 patients with gastroduodenal EUI suffering comorbid HT. All patients went through general clinical examinations, esophagogastroduodenofibroscopy (EGDFS), and stool tests to verify H.pylori infection, with prostaglandin E2 (PGE2) content in blood serum being determined. Results. EGDFS showed that among patients with gastroduodenal EUI without comorbid HT, 25.00 % were diagnosed with gastric EUI; half of the cases (50.00 %) revealed duodenum lesions, and another 25.00 % – combined stomach and duodenum lesions. At the same time, patients with EUI combined with comorbid HT manifested more frequent (p-value less than 0.05) gastric localization of mucosal EUI (50.00 %); 16.67 % of patients had the duodenum lesions, while combined stomach and duodenum defects were observed in 33.33 %. H. pylori infection was confirmed in 13 patients (65.00 %) with EUI without comorbid HT and in 22 examined individuals (73.33 %) with the gastroduodenal zone EUI and comorbid HT. The endogenous PGE2 was significantly higher in patients who had only gastric mucosa and duodenum EUI without comorbid HT and amounted to 2135.79 ± 80.94 pg/ml (p-value less than 0.05), while patients with EUI and comorbid HT were tested a significantly lower PGE2 level in blood serum – 1513.55 ± 92.48 pg/ml. At the same time, the significantly lower PGE2 level in patients with EUI and comorbid HT compared to the similar indicator in patients without it explains the differences in the EUI distribution in both groups of patients revealed during endoscopic examination. Since a significantly weakened PGE2 synthesis leads to lower bicarbonate and mucus secretion and more intensive acid production, the balance between the aggression and protection factors is upset, which contributes to the EUI emergence mainly in the stomach’s antral part. The research has exposed no significant difference in PGE2 content in patients with duodenum mucosa EUI and those with a combination of gastric and duodenum mucosa lesions (p-value more than 0.05). Besides, the PGE2 content was tested significantly lower in patients with EUI gastric localization, than in those with combined ulcers (p-value less than 0.05). The presence or absence of H. pylori infection also did not affect the endogenous PGE2 level (p-value more than 0.05). Conclusions. The prostaglandin E2 content in the blood serum of patients with gastroduodenal erosive-ulcerative lesions with comorbid hypertension was notably lower than in patients with erosive-ulcerative lesions of the gastroduodenal zone without comorbid hypertension. Moreover, a significant prostaglandin E2 decrease in the blood serum of patients with gastroduodenal erosive-ulcerative lesions with comorbid hypertension upsets the balance between aggression and protection factors, which contributes to the emergence of erosive-ulcerative defects, mostly in the stomach.

Cytomegalovirus Graft Duodenitis Diagnosed by Transanal Double-Balloon Endoscopy Technique in an Enteric-Drained Pancreas Transplant Recipient: A Case Report

Duodenal graft complications are not uncommon after pancreas transplant (PTx). Although direct visualization and biopsy of the duodenal graft are important for accurate diagnosis and management, endoscopic access is often limited in cases of enteric-drained PTx. Herein, we present a case of cytomegalovirus (CMV) graft duodenitis that was successfully diagnosed by transanal endoscopy using the double-balloon technique. The patient was a 54-year-old woman who underwent simultaneous pancreas and kidney transplant for type 1 diabetes mellitus and end-stage kidney disease. Enteric drainage was established by anastomosing the graft duodenum to her ileum. One month after the transplant, she developed fever and complained of lower abdominal pain. Graft duodenitis was suspected by laboratory test and imaging study results. Transanal double-balloon endoscopy was performed, and the biopsy specimen of the mucosa of the graft duodenum revealed CMV duodenitis without histopathologic findings of acute rejection. The postendoscopy course was uneventful. Treatment with ganciclovir was promptly initiated, and the CMV duodenitis was resolved with good function of the pancreas graft. In patients who undergo PTx with establishment of exocrine drainage by enteroanastomosis to the recipient ileum, transanal double-balloon endoscopy might be a feasible and safe technique for the surveillance of duodenal graft complications, including CMV duodenitis.

S3402 Enterocolitis Caused by Mycobacterium Avium Complex in an HIV-Infected Patient

Introduction: Diarrhea in patients with human immunodeficiency virus (HIV) can be due to a variety of etiologies including infection, malignancy, and antiretroviral therapy (ART). With increased use of ART, diarrhea due to opportunistic infections has become less common. Here we report a rare case of chronic diarrhea due to Mycobacterium avium complex (MAC) infection involving the duodenum, colon, and rectum of a patient with advanced HIV. Case Description/Methods: A 41-year-old man with HIV infection diagnosed two years earlier presented with progressively worsening diarrhea. Two months prior, his CD4 count was stable at 50 cells/uL and his HIV level was undetectable while on dolutegravir/lamuvidine. He had history of MAC mycobacteremia under treatment with ethambutol, azithromycin, and rifabutin. He also had cytomegalovirus (CMV) viremia treated with valganciclovir. He reported compliance with the above medications. He had eight-month history of frequent, watery diarrhea associated with malaise, nausea, bloating, abdominal pain, and weight loss. He was hospitalized for severe malnutrition and electrolyte abnormalities. Evaluation of his diarrhea included negative C. difficile toxin, enteric pathogen panel, and ova and parasite exam. CMV was detected in the blood at 17,000 IU/mL and HIV viral load was 6,166 IU/mL. Esophagogastroduodenoscopy was performed and revealed diffuse erythema and edema affecting the mucosa of the entire duodenum with associated villous blunting and fissuring (Figure A). Flexible sigmoidoscopy revealed normal appearing mucosa to the level of the ascending colon. Pathology from duodenal biopsies showed extensive histiocytic inflammation with presence of acid-fast bacillus organisms (Figures B and C). Random biopsies from the colon and rectum showed similar findings and no evidence of CMV. Acid-fast bacillus blood cultures grew Mycobacterium avium-intracellulare. His MAC treatment was changed to amikacin, linezolid, rifampin, and ethambutol with subsequent improvement in his diarrhea. Discussion: Gastrointestinal tract involvement by MAC is usually part of a disseminated MAC infection in patients with advanced HIV, especially those with CD4 lymphocyte counts < 50 cells/uL. The duodenum is most often affected, followed by the rectum. We report this case to raise awareness that MAC enterocolitis remains an important etiology of chronic diarrhea in patients with advanced HIV.Figure 1.: A, EGD showing duodenal involvement by MAC causing diffuse erythema and edema with villous blunting and fissuring. B, H&E stain of duodenal mucosa with extensive histiocytic inflammation. C, Ziehl-Neelsen stain of duodenal mucosa with acid-fast bacillus positive organisms consistent with Mycobacterium avium complex.

Effects of Dietary 1,8-Cineole Supplementation on Growth Performance, Antioxidant Capacity, Immunity, and Intestine Health of Broilers.

Simple Summary1,8-cineole is a cyclic monoterpene compound, which can be extracted from plants or synthesized artificially. Dietary supplementation with plant essential oil containing 1,8-cineole can improve the performance of broiler chickens. However, limited literature exists on the supplementation of purified 1,8-cineole in diets for broiler chickens under normal conditions without stress challenging. Therefore, the purpose of this study was to evaluate the effects of purified 1,8-cineole on growth performance, antioxidant capacity, immunity, and intestinal health of broilers and its optimal dose in the diets. The results showed dietary supplementation of 1,8-cineole had positive effects on broilers.This study was conducted to investigate the effects of 1,8-cineole on antioxidant capacity, immunity, and intestinal health of broilers. A total of 540 1-day-old Arbor Acres (AA) male broilers were randomly divided into five treatments with six replicates per treatment, and 18 broilers per replicate for 42 days. Dietary treatments were a corn–soybean meal basal diet supplemented with 0, and 10, 20, 30, and 40 mg/kg 1,8-cineole, respectively. Dietary supplementation with 20~30 mg/kg of 1,8-cineole increased the ADG from d 22 to 42 and d 1 to 42 (p < 0.05), and decreased the FCR (p < 0.05). Dietary supplementation of 10~40 mg/kg of 1,8-cineole increased total antioxidant capacity (TAOC) in serum (p < 0.05), and decreased malondialdehyde (MDA) level in the liver on day 21 (p < 0.05). The supplementation of 20~30 mg/kg of 1,8-cineole increased the activity of total superoxide dismutase (T-SOD) in the serum and liver and TAOC in the serum and the liver (p < 0.05), and decreased the level of MDA in the serum and the liver (p < 0.05) on day 42. Dietary supplementation with 20~30 mg/kg of 1,8-cineole increased serum immunoglobulin A, immunoglobulin G, and immunoglobulin M contents on day 21 (p < 0.05). On day 21, dietary supplementation of 20~30 mg/kg of 1,8-cineole increased the VH and VH/CD (p < 0.05) in the jejunum and ileum. The supplementation of 20~30 mg/kg of 1,8-cineole increased the content of secretory immunoglobulin A in the duodenum and ileum mucosa on d 42 (p < 0.05). In conclusion, dietary supplementation of 1,8-cineole improves the growth performance of broilers by enhancing antioxidant capacity, immunity, and intestinal morphology.

Safety and feasibility of irreversible electroporation for the pancreatic head in a porcine model

BACKGROUNDIrreversible electroporation (IRE) is a local non-thermal ablative technique which has been suggested as a potential cancer therapy. However, the specific anatomic characteristics of the pancreatic head make it challenging to perform any local ablation in this region. Therefore, the safety and feasibility of IRE in the pancreatic head region should be further explored.AIMTo evaluate the safety of IRE in pancreatic head region including its effects on pancreatic ducts, vessels, and adjacent gastrointestinal organs.METHODSEight landrace miniature pigs underwent IRE of pancreatic head tissue successfully, with a total of 16 lesions created. Laboratory testing including white blood cell (WBC) count and serum amylase before IRE with follow-up laboratory analysis and pathological examination at 1, 7, 14, and 28 d postablation were performed. RESULTSAll pigs tolerated the ablation procedure without serious perioperative complications. Transiently elevated WBC count and amylase were observed at 24 h post-IRE, suggesting an acute pancreatic tissue damage which was confirmed by pathological observations. Vascular endothelial cells and pancreatic duct epithelial cells in ablation zone were also positive in terminal deoxynucleotidyl transferase dUTP nick end labeling staining. There was extensive duodenum mucosa damage with local hemorrhage 24 h after ablation, while regeneration of new villous structures were observed at 7 and 28 d post-IRE. Masson’s trichromatic staining showed that the extracellular matrix was still intact in vessels and pancreatic ducts, and even in the duodenum.CONCLUSIONIRE ablation to the pancreatic head may be safe and feasible without long-term damage to the surrounding vital structures. However, risks of stress injuries in acute phase should be taken into consideration to prevent severe perioperative complications.

Altered Tryptophan Metabolism on the Kynurenine Pathway in Depressive Patients with Small Intestinal Bacterial Overgrowth.

The causes of depression are diverse and are still not fully understood. Recently, an increasing role is attributed to nutritional and inflammatory factors. The aim of this study was to evaluate selected metabolites of the tryptophan kynurenine pathway in depressive patients with small intestinal bacterial overgrowth (SIBO). The study involved 40 healthy people (controls) and 40 patients with predominant small intestinal bacterial overgrowth (SIBO-D). The lactulose hydrogen breath test (LHBT) was performed to diagnose SIBO. The severity of symptoms was assessed using the Gastrointestinal Symptom Rating Scale (GSRS–IBS) and the Hamilton Depression Rating Scale (HAM-D). The concentration of tryptophan (TRP), kynurenine (KYN), kynurenic acid (KYNA), and quinolinic acid (QA) in urine was determined using an LC–MS/MS method, before and after cyclic treatment with an antibiotic drug, rifaximin, for three months. The number of intraepithelial lymphocytes (IELs) in the duodenum and small intestinal mucosa, fecal calprotectin (FC) and serum level of C-reactive protein (CRP) were also determined. In patients with SIBO, a higher level of KYN and QA were found as compared to the control group. These two groups also differed in KYN/TRP (higher in SIBO) and KYNA/KYN ratios (lower in SIBO). A positive correlation was found between HAM-D and the number of IELs and the level of FC. Treatment with rifaximin improves the kynurenic pathway, as well as abdominal and mental complaints. Therefore, small intestinal bacterial overgrowth can be a cause of abdominal symptoms, but also mental disorders.

Effect of Raw Chickpea in the Broiler Chicken Diet on Intestinal Histomorphology and Intestinal Microbial Populations.

Simple SummaryRaw chickpea seed (CPR) can be an alternative source of cheaper native proteins in the diet of chickens, replacing the standard soybean meal. The present results were obtained in a study on the addition of raw chickpea seeds to replace 50% of soybean meal (SBM) protein in an experimental feed mixture for broiler chickens. We investigated the effect of the substitution on the intestinal histomorphology, intestinal microbial population, and health of broiler chickens.The aim of the study was to determine the effect of partial replacement of SBM protein with CPR-derived protein in the broiler rearing period from 22 to 42 days of age on the intestinal histomorphology and the composition of the intestinal microbial population. Male broiler chicks aged 1 day were assigned to two groups with different nutrition schemes (n = 100 in each, 5 cages of 20 chicks in each). The chickens were reared for 42 days. All birds were fed isonitrogenous and isoenergetic diets: starter (1 to 21 d), grower (22 to 35 d), and finisher (36 to 42 d). From rearing day 22, different diets were provided to the birds: the SBM group received feed with 100% soybean meal protein, and the diet of the CPR group the protein originated from soybean meal was replaced by 50% chickpea protein. The study results indicated a significant impact of the inclusion of CPR in the diet on the basic intestinal structures (thickness of myenteron: submucosa, jejunum and duodenum mucosa, and jejunum transversal lamina). The addition of CPR led to shortening of intestinal villi, an increase in villus thickness, and reduced intestine absorptive surface in the duodenum and jejunum. The CPR group exhibited a significantly lower villus length-to-crypt depth ratio in the jejunum (p < 0.001). The inclusion of chickpeas in the diet increased the total count of mesophilic bacteria and coliforms in the intestinal contents (p < 0.05). In summary, it has been demonstrated that the inclusion of CPR in the diet induced considerable disturbances in metabolism and intestinal structure. Although CPR is a cheap protein source, its use in poultry diet does not ensure development of the intestinal structure comparable to that in the case of an SBM-only diet.