Small Intestinal Pathology Research Articles

Primary localized ileal amyloidosis with chronic ileitis: a case report with review of literature

Amyloidosis is a rare condition where fibrillar proteins and abnormal, soluble peptides accumulate throughout the body’s organs. Gastrointestinal symptoms secondary to amyloid deposition vary widely and may be confused with other common small intestine diseases, making the diagnosis challenging. Our case is a 63-year-old male with a past medical history of smoking who showed up in the ED with 5 months of diffuse abdominal pain referred to the back. Pelvis-abdominal ultrasound showed bilateral acute pyelonephritis. A colonoscopy revealed large multiple ileal ulcers about 10 cm from the ileocecal valve with a wide base. Pathology biopsies revealed ileal amyloidosis and chronic ileitis with superficial erosions. The patient has been diagnosed with primary localized ileal AL amyloidosis. The patient has finally been referred for surgical resection. We want to raise awareness of ileal amyloidosis and emphasize the importance of considering uncommon etiologies of small intestine pathology in patients presenting with chronic diarrhea, malabsorption, abdominal pain, and weight loss. Finally, patients with small intestine amyloid disease progressing rapidly and failing to respond to non-surgical treatment should be considered for surgical resection.

TNF ΔARE Pigs: A Translational Crohn's Disease Model.

Crohn's disease [CD] is a major subtype of inflammatory bowel diseases [IBD] with increasing incidence and prevalence. Results of studies using available small and large animal models are often poorly translatable to patients, and few CD models show small intestinal pathology. Due to its similarities to humans, the pig has emerged as a highly suitable translational disease model, particularly for testing novel nutritional and technological interventions. Our goal was to develop a physiologically relevant porcine CD model to facilitate translation of findings and interventions towards the clinic. We generated pigs bearing a 93-bp deletion of the adenosine-uracil-rich element [ARE] and a constitutive-decay element within the 3' untranslated region of the TNF gene. Comparative analysis of physiological, molecular, histological and microbial characteristics was performed between wild-type, TNFΔARE/+ and TNFΔARE/ΔARE animals. Alterations in the microbiome were compared to the TNFΔARE mouse model and IBD patients. TNF ΔARE pigs recapitulate major characteristics of human CD, including ulcerative transmural ileocolitis, increased abundance of proinflammatory cytokines, immune cell infiltration and dysbiotic microbial communities. 16S rRNA gene amplicon sequencing revealed enrichment in members belonging to Megasphaera, Campylobacter, Desulfovibrio, Alistipes and Lachnoclostridum in faecal or mucosa-associated bacteria compared to wild-type littermates. Principal components analysis clustering with a subset of TNFΔARE/+ mice and human IBD patients suggests microbial similarity based on disease severity. We demonstrate that the TNFΔARE pig resembles a CD-like ileocolitis pathophenotype recapitulating human disease. The ability to conduct long-term studies and test novel surgical procedures and dietary interventions in a physiologically relevant model will benefit future translational IBD research studies.

Polyphenolic Profile of Herniaria hemistemon Aerial Parts Extract and Assessment of Its Anti-Cryptosporidiosis in a Murine Model: In Silico Supported In Vivo Study.

Herniaria hemistemon J.Gay is widely used in folk medicine to treat hernia. The present study aimed to annotate the phytoconstituents of H. hemistemon aerial-part extract and investigate its in vivo anticryptosporidial activity. The chemical characterization was achieved via the LC-ESI-MS/MS technique resulting in the annotation of 37 phytocompounds comprising flavonoids and phenolic acids. Regarding the anticryptosporidial activity, fifty dexamethasone-immunosuppressed mice were separated into five groups: GI, un-infected (normal control); GII, infected but not treated (model); GIII, infected and received NTZ, the reference drug; GIV, infected and received H. hemistemon extract (100 mg/kg); and GV, infected and received H. hemistemon extract (200 mg/kg). When GIII, GIV, and GV were compared to GII, parasitological analyses displayed highly significant differences in the mean numbers of Cryptosporidium parvum oocysts in the stool between the different groups. GV demonstrated the highest efficacy of 79%. Histopathological analyses displayed improvement in the small intestine and liver pathology in the treated groups (GIII, IV, and V) related to the model (GII), with GV showing the highest efficacy. Moreover, the docking-based study tentatively highlighted the potential of benzoic acid derivatives as lactate dehydrogenase inhibitors. The docked compounds showed the same binding interactions as oxamic acid, where they established H-bond interactions with ARG-109, ASN-140, ASP-168, ARG-171, and HIS-195. To sum up, H. hemistemon is a promising natural therapeutic agent for cryptosporidiosis.

Effects of Buyang Huanwu Decoction on Intestinal Barrier, Intestinal Flora, and Trimethylamine Oxide in Rats with Heart Failure.

To explore the mechanisms of Buyang Huanwu Decoction (BYHWD) modulating the gut microbiome and trimethylamine oxide (TAMO) to exert cardioprotective effects. Ligation of the left anterior descending coronary artery was performed in rats to induce heart failure (HF). Except for the sham-operation group (n=10), 36 operation-induced models were randomized into 3 groups using a random number table (n=12 in each group): the model group, the BYHWD group (15.02 g/kg BYHWD), and the positive group (4.99 g/kg metoprolol succinate). After 4-week treatment (once daily by gavage), echocardiography was applied to evaluate the cardiac function and the Tei index (the ratio of ventricular isovolumic contraction time (IVCT) and isovolumic diastolic time (IVRT) to ejection time (ET)) was calculated; hematoxylin-eosin (HE) staining was observed to characterize the pathology of the myocardium and small intestinal villi. D-lactic acid was detected by an enzyme-linked immunosorbent assay (ELISA). Expressions of occludin, claudin-1, and zonula occludens (ZO-1) were detected by Western blot. 16S ribosomal ribonucleic acid (16S rRNA) sequencing was used to explore the changes in the intestinal flora. TMAO was detected via liquid chromatography-tandem mass spectrometry (LC-MS/MS). In the echocardiography, the Tei index was considerably lower in the positive and BYHWD groups compared with the model group (P<0.05). Besides, BYHWD improved the pathology of myocardium and small intestine of HF rats and lowered the D-lactic acid content in the serum, when compared with the model group (P<0.05). BYHWD also improved the expression of occludin and claudin-1 (P<0.05); in the gut microbiota analysis, BYHWD slowed down modifications in the structure distribution of gut microbiota and regulated the diversity of intestinal flora in HF rats. The content of TMAO in the serum was significantly lowered by BYWHT compared with the model group (P<0.05). BYHWD may delay progression of HF by enhancing the intestinal barrier structure, and regulating intestinal flora and TAMO.

IL-1β blockade prevents cell death and mucosal damage of the small intestine in a model of sterile inflammation

The intestinal mucosa is covered by a layer of epithelial cells that is constantly challenged by commensal, opportunistic, and pathogenic microorganisms, their components, and harmful compounds. Any inflammatory response to these materials must be tightly controlled to limit tissue damage and restore the integrity of the mucosal barrier. We have shown previously that production of IL-1β via activation of the inflammasome can lead to mucosal damage in the small intestinal pathology that occurs after intragastric administration of a gluten derived peptide, p31–43. Here we show that specific inhibition of caspase-1 or NLRP3 abolishes the damage induced by p31–43, and that antibody-mediated blocking of IL-1β inhibits the both the histological changes and the induction of apoptosis and caspase-3 activation driven by p31–43. Understanding the role of IL-1β in sterile inflammation may help to understand chronic inflammatory pathological processes, and design new intervention strategies.

Role of balloon enteroscopy for obscure gastrointestinal bleeding in those with surgically altered anatomy: A systematic review.

BACKGROUNDObscure gastrointestinal (GI) bleeding is defined as persistent bleeding despite negative evaluation with both esophagogastroduodenoscopy and colonoscopy and can be secondary to small intestinal pathology. Standard endoscopy as well as push endoscopy can be a challenge in those with altered anatomy given inaccessible areas as well as perforation risk. Single and double balloon enteroscopy can be warranted in this patient population in instances of obscure GI bleed. AIMTo assess the safety and diagnostic efficacy of balloon enteroscopy for obscure GI bleeding in patients with surgically altered anatomy. METHODSA search was conducted through PubMed, MEDLINE, Google Scholar, Scopus, and Embase with the key words “enteroscopy,” “obscure bleeding,” and “altered anatomy,” to identify relevant articles in English with no restricted time frame. A search within the Reference Citation Analysis database was conducted to ensure inclusion of the latest high impact articles. Study types included in the review were prospective and retrospective reviews, case series, and case reports. The reference lists of these papers were also reviewed to find further papers that were applicable. The authors extracted the data from the studies that fit inclusion criteria. Data of interest included type of study, type of procedure, and type of altered anatomy, as well as the number of patients with any diagnostic or therapeutic intervention. Data was also recorded on procedure tolerance and complications. The data was analyzed with descriptive statistics. RESULTSOur literature search yielded 14 studies that were included. There were 68 procedures performed with 61 unique patients subjected to these procedures. Forty-four (65%) of the procedures were double balloon, 21 (31%) were single balloon, and 3 (4%) were classified as through the scope balloon assisted. The most common altered anatomy types included Gastric Bypass Roux-en-Y, Pylorus Sparing Whipple, Orthotopic Liver Transplantation with Roux-en-Y, and Gastrojejunostomy Roux-en-Y. The procedures were successfully performed in each patient. There were 5 (7%) procedures that were complicated by perforation. Amongst the available data, the diagnostic yield was 48/59 (81%) and a therapeutic yield of 39/59 (66%). One patient was recommended surgical revision of their altered anatomy following enteroscopy.CONCLUSIONBalloon enteroscopy is a useful diagnostic modality in investigating obscure GI bleeding within those with surgically altered anatomy; however, precautions must be taken as this population may have increased perforation risk.

Endoscopic classification and pathological features of primary intestinal lymphangiectasia.

BACKGROUNDThe appearance of the intestinal mucosa during endoscopy varies among patients with primary intestinal lymphangiectasia (PIL).AIMTo classify the endoscopic features of the intestinal mucosa in PIL under endoscopy, combine the patients’ imaging and pathological characteristics of the patients, and explain their causes.METHODSWe retrospectively analyzed the endoscopic images of 123 patients with PIL who were treated at the hospital between January 1, 2007 and December 31, 2018. We compared and analyzed all endoscopic images, classified them into four types according to the endoscopic features of the intestinal mucosa, and analyzed the post-lymphographic computed tomography (PLCT) and pathological characteristics of each type.RESULTSAccording to the endoscopic features of PIL in 123 patients observed during endoscopy, they were classified into four types: nodular-type, granular-type, vesicular-type, and edematous-type. PLCT showed diffuse thickening of the small intestinal wall, and no contrast agent was seen in the small intestinal wall and mesentery in the patients with nodular and granular types. Contrast agent was scattered in the small intestinal wall and mesentery in the patients with vesicular and edematous types. Analysis of the small intestinal mucosal pathology revealed that nodular-type and granular-type lymphangiectasia involved the small intestine mucosa in four layers, whereas ectasia of the vesicular- and edematous-type lymphatic vessels largely involved the lamina propria mucosae, submucosae, and muscular layers. CONCLUSIONEndoscopic classification, combined with the patients’ clinical manifestations and pathological examination results, is significant and very useful to clinicians when scoping patients with suspected PIL.

Rotavirus exploits SREBP pathway for hyper lipid biogenesis during replication.

Species A rotavirus (RVA) is one of the pathogens causing severe acute gastroenteritis in young children and animals worldwide. RVA replicates and assembles its immature particle within electron dense compartments known as viroplasm. Despite the importance of lipid droplet (LD) formation in the RVA viroplasm, the upstream molecules modulating LD formation have remained elusive. Here, we demonstrate that RVA infection reprogrammes sterol regulatory element binding proteins (SREBPs)-dependent lipogenic pathways in virus-infected cells. Interestingly, silencing of SREBPs significantly reduced RVA protein synthesis, genome replication and progeny virus production. Moreover, knockout of SREBP-1c gene conferred resistance to RVA-induced diarrhoea, reduction of RVA replication, and mitigation of small intestinal pathology in mice. This study identifies SREBPs-mediated lipogenic reprogramming in RVA-infected host cells for facilitating virus replication and SREBPs as a potential target for developing therapeutics against RVA infection.

Клінічні форми лактазної недостатності в дітей

Актуальність. Лактазна недостатність (ЛН) — найбільш часта патологія тонкої кишки, для якої характерний розвиток синдрому порушеного травлення і всмоктування, пов’язаного з відсутністю або недостатньою активністю ферменту лактази. Мета дослідження: вивчити особливості перебігу різних клінічних форм ЛН у дітей. Матеріали та методи. Під спостереженням перебували 40 дітей (21 хлопчик та 19 дівчаток) різних вікових категорій з діагнозом «лактазна недостатність». Проводилося дослідження: копрограма, визначення pH, загальний вміст вуглеводів, навантаження лактозою, вміст лактози в сечі. Оцінка вірогідності здійснювалася за допомогою критерію Стьюдента (t). Результати. Виділено чотири клінічні форми ЛН: перша група — ЛН із повною відсутністю ферменту (алактазія, 4 особи), друга — ЛН із частковою недостатністю ферменту (гіполактазія, 10 осіб), третя — ЛН із лактозурією (4 особи), четверта — транзиторна ЛН (22 особи). Клінічна картина проявлялася рідкими (100 %), пінистими (83,3 %), із кислим запахом (83,3 %) випорожненнями. У третини дітей із ЛН спостерігалися зригування, у 75,0 % — абдомінальні коліки. У всіх дітей відмічалися дефіцит маси тіла та дефіцитні анемії. Висновки. Найбільш часто спостерігається транзиторна (вторинна) лактазна недостатність, що перебігає в легкій формі в дітей різних вікових категорій. Алактазія характерна для дітей до 1 року життя, перебігає з вираженими клінічними ознаками на фоні дефіциту маси тіла та анемії. Гіполактазія перебігає з помірно вираженими клінічними симптомами. ЛН із лактозурією характерна для недоношених дітей.

Histopathological Study of Pathological Specimens of Various Organs in a Tertiary Care Hospital in Bangladesh

This retrospective study of histopathological specimens was done at the Department of Pathology of Rajshahi Medical College, Bangladesh, from July 2019 to June 2020, emphasizing challenges and diagnosis outcomes. Data obtained from their case notes included age at admission, the site from where the specimens were collected, and histopathological diagnosis. Out of the 2026 histopathology samples, chronic cervicitis constitutes about 50% of the cases. Serous cystadenoma (about 1/4th cases) was common among ovarian pathology. 54.16% of the breast pathology exhibited Invasive ductal carcinoma. Reactive follicular hyperplasia and lymphoma constitute 49.44% of the lymph node pathology. About 80% of the gall bladder pathology was chronic cholecystitis, and metastatic adenocarcinoma was the commonest pathology involving the liver. Squamous cell carcinoma constitutes about 40% of the skin pathology. Osteosarcoma, osteochondroma, and giant cell tumor were the common pathologies involved in bones. Transitional cell carcinoma constitutes about 45% of urinary bladder pathology, and renal cell carcinomas were the commonest pathology of the kidney. Adenocarcinoma constitutes about 45 % of stomach pathology, 28% of small intestine pathology, and 14% of large intestine pathology. Histopathological specimens at the pathology Rajshahi Medical College department with a wide range of pathologies are a major problem. From this study necessity of screening programs for early cancer detection appeared as a time-demanding issue.&#x0D; TAJ 2021; 34: No-1: 16-25

Proceedings of the 2020 Classic Examples in Toxicologic Pathology XXVII.

The histopathology slide seminar "Classic Examples in Toxicologic Pathology XXVII" was held on February 21 and 22, 2020, at the Department of Pathology at the University of Veterinary Medicine in Hannover, Germany, with joint organization by the European Society of Toxicologic Pathology. The goal of this annual seminar is to present and discuss classical and actual cases of toxicologic pathology. This article summarizes the presentations given during the seminar, including images of representative lesions. Ten actual and classical cases of toxicologic pathology, mostly induced by a test article, were presented. These included small intestine pathology and transcriptomics induced by a γ-secretase modulator, liver findings in nonhuman primates induced by gene therapy, drug-induced neutropenia in dogs, device-induced growth plate lesions, polycystic lesions in CAR/PXR double knockout mice, inner ear lesions in transgenic mice, findings in Beagle dogs induced by an inhibitor of the myeloid leukemia cell differentiation protein MCL1, findings induced by a monovalent fibroblast growth factor receptor 1 antagonist, kidney lesions induced by a mammalian target of rapamycin inhibitor in combination therapy, and findings in mutation-specific drugs.

Immunoglobulin A–specific deficiency induces spontaneous inflammation specifically in the ileum

ObjectiveAlthough immunoglobulin A (IgA) is abundantly expressed in the gut and known to be an important component of mucosal barriers against luminal pathogens, its precise function remains unclear. Therefore, we...

Exercise and food supplement of vitamin C ameliorate hypertension through improvement of gut microflora in the spontaneously hypertensive rats

AimsExercise and food supplement of vitamin C (VC) are beneficial to human health, especially for those who suffer from hypertension. Here we tend to explore if gut microflora is involved in the anti-hypertensive effects of exercise and VC-supplement therapies. Materials and MethodsWith the spontaneously hypertensive rat (SHR) model, the small intestine pathology and the fecal microbiota was analyzed along with the pro- and anti-inflammatory cytokines (PICs and AICs) and reactive oxygen species (ROS) in the hypothalamus paraventricular nucleus (PVN) and intestine. Key findingsWe found that both exercise and VC intake, individually or combined, were able to alleviate the blood pressure in the SHRs comparing to the normotensive control Wistar-kyoto (WKY) rats. The expression level of PICs in the PVN and intestine of the SHRs was down-regulated while the AICs were up-regulated after treatments, together with down-regulation of ROS in the PVN. At meantime, the gut pathology was dramatically improved in the SHRs with exercise training or VC intake. Analysis of the gut microflora revealed significant changes in their composition. Several important micro-organisms that were deficient in the SHRs were found up-regulated by the treatments, including Turicibacter and Romboutsia which are involved in the short-chain fatty acid production. SignificanceExercise training and VC intake individually can modify the gut microflora composition and improve the inflammatory state in both PVN and intestine, which contribute to their anti-hypertensive function. Combination of the two treatments enhanced their effects and worth to be considered as a non-medical aid for the hypertensive patients.

The assessment of perioperative risk factors of anastomotic leakage after intestinal surgeries; a prospective study

BackgroundAnastomotic leaks (AL) are among the most serious complications due to the substantial impact on the quality of life and mortality. Inspite of the advance in diagnostic tools such as laboratory tests and radiological adjuncts, only moderate improvement has been recorded in the rate of detected leaks. The purpose of the research was to assess the perioperative risk factors for AL.MethodsThis study was achieved at MUH and MIH/Egypt within the period between January 2016 and January 2019 for the candidates who underwent bowel anastomosis for small intestinal (except duodenal one) and colorectal pathology. The collected data were analyzed using SPSS of V-26.ResultsThis study included 315 cases, among them, 27 cases (8.57%) developed AL. The percentage of covering stoma was significantly higher in the non-leakage group vs leakage one (24.3% vs 11.1% respectively). lower albumin, operative timing, perforation, and covering stoma were shown as significant risk factors for leakage, but with multivariate analysis for these factors, the emergency operation, and serum albumin level was the only independent risk factors that revealed the significance consequently (p = 0.043, p = 0.015). The analysis of different predictors of AL on the third day showed that the cut-off point in RR was 29 with 83% sensitivity and 92% specificity in prediction of leakage, the cut-off point in RR was 118 with 74% sensitivity and 87% specificity in prediction of leakage and the cut-off point in CRP was 184.7 with 82% sensitivity and 88% specificity in prediction of AL and all had statistically significant value.ConclusionsThe preoperative serum albumin level and the emergency operations are independent risk factors for anastomotic leakage. Moreover, leakage should be highly suspected in cases with rising respiratory rate, heart rate, and CRP levels.

A19 NOVEL HLA-DQ2 TRANSGENIC MICE DEVELOP GLUTEN-IMMUNOPATHOLOGY FOLLOWING GLUTEN SENSITIZATION

Abstract Background Celiac disease (CeD), an autoimmune and chronic inflammatory enteropathy triggered by the ingestion of gluten, is associated with HLA-DQ2 (~90%) and, to a lesser extent, HLA-DQ8. We previously characterized a humanized mouse model of gluten sensitivity that expresses the HLA-DQ8 allele, and that develops mild innate and adaptive immune pathways related to DQ8+ CeD patients. Gluten peptides recognized in the context of DQ2 differ from those bound to DQ8 molecules and homozygous carriage of HLA-DQ2 provides higher risk for CeD development. Thus, characterization of a transgenic HLA-DQ2 model would allow for the investigation of disease pathways that affect the majority of celiac patients. Aims Our aim was to determine gluten-immune responses and small intestinal pathology in C57BL/6 mice humanized with the HLA DR3-DQ2 gene. Methods To break oral tolerance to gluten, DR3-DQ2 mice were orally sensitized with gliadin (5mg/mL) and cholera toxin (CT; 2.5mg/mL) before being challenged with gluten (10mg/mL) for three weeks. Non-sensitized DR3-DQ2 controls mice received CT and a sham challenge. To determine the effects of long-term exposure to gluten, gliadin sensitized DR3-DQ2 mice were placed on a gluten-containing diet for twelve weeks. Controls were given CT and remained on a gluten-free diet. Pathology was evaluated by CD3+ intraepithelial lymphocytes (IELs) counts; villus-crypt (V/C) ratios. Gluten-induced immune responses were evaluated by anti-tissue transglutaminase-2 (tTG) and anti-gliadin antibodies, inflammatory gene expression by Nanostring Technology, and CD4+ T cell proliferation using flow cytometry. Intestinal permeability was measured in vitro by Ussing Chamber. Results DR3-DQ2 mice that were sensitized and challenged with gluten for three weeks had higher IEL counts, lower V/C ratios, higher anti-gliadin and tTG antibodies, which are used in the serological diagnosis of the disease. Gluten sensitized mice also has higher expression of pro-inflammatory genes, and an induction of gluten specific T cells, but no changes in permeability compared to control mice. DR3-DQ2 mice given a gluten-containing diet for 12 weeks also had higher IEL counts, lower V/C ratios, and higher anti-gliadin and tTG antibodies, but had no changes in permeability compared to controls. Conclusions These results indicate that mice humanized with the HLA DR3-DQ2 gene show innate and gluten-specific immune responses following sensitization. Thus, mice expressing HLA-DQ2 represents a novel model of gluten sensitivity that can be used to investigate celiac disease pathways related to gluten peptide repertoire that binds to DQ2 MHC class II, encoded by the HLA gene expressed by the majority of celiac patients. Supported by CIHR to EFV and OGS to AVC Funding Agencies CIHROGS

Small Intestine Ultrasound Findings on Horses Following Exploratory Laparotomy, Can We Predict Postoperative Reflux?

Simple SummaryPostoperative reflux is a well-recognized complication after exploratory laparotomy, particularly in horses that present with small intestine pathology. Even though much has been written about the pathophysiology and management of this postsurgical complication, we could not find a study that describes the monitoring of small intestine appearance after laparotomy via transcutaneous abdominal ultrasound. Therefore, the aim of the study was to provide clinical evidence of ultrasound finds in 58 horses over three days post exploratory laparotomy. The results from these exams were compared to the abdominal ultrasounds of 20 horses undergoing general anesthesia for an elective procedure, which were used as a control group. Differences were found between horses with versus without small intestinal pathology. Horses operated on because of large colon pathology had similar ultrasound findings to the control group during the postoperative period. In contrast, horses that were presented with small intestinal pathology had more visible small intestine loops, increased loop diameter, and wall thickness, before and after surgery, particularly those cases that had undergone a resection and anastomosis. A quick abdominal ultrasound in horses, during the postoperative period after colic surgery, was a useful method to identify horses with abnormal small intestinal parameters, both pre- and post-surgery. Further investigation as to whether these parameters can be used to predict postoperative reflux (POR) in a larger population is warranted.Postoperative reflux (POR) is a well-recognized complication after colic surgery in horses, particularly when presenting small intestinal pathology. Even though much has been written about the pathophysiology and management of POR, additional clinical studies are needed to better understand and anticipate this complication. The aim of the study was to provide clinical evidence of ultrasound findings in the postoperative period (three days). The study is based on transcutaneous abdominal ultrasounds of the caudoventral abdomen during the postoperative period (three days), in 58 horses, presented for an exploratory laparotomy, and compared to 20 horses that underwent general anesthesia for an elective surgical procedure. Small intestine (SI) images and videos were analyzed for loop number, loop diameter, wall thickness, motility, and echogenic type of loop contents. Ultrasound findings of horses that had a large colon pathology were similar to those of the control group. Interestingly, horses that presented an SI pathology had significantly thicker SI walls, increased loop diameter, slower motility, and hypoechoic contents, particularly in horses that had undergone small intestinal resection and anastomosis. Although the number of horses that developed POR in our study was too small for statistical analysis, they all had the aforementioned ultrasonographic changes. Abdominal ultrasound, during the postoperative period (three days), was a useful method to identify horses with abnormal small intestinal parameters. Further investigation as to whether these parameters can be used to predict POR in a larger population is warranted.

Prebiotics Fructo-, Galacto-, and Mannan-Oligosaccharide Do Not Protect against 5-Fluorouracil–Induced Intestinal Mucositis in Rats

Prebiotics selectively stimulate the growth of beneficial bacteria within the gastrointestinal tract, and have been investigated in human and animal studies for their capacity to improve intestinal health. We investigated the prebiotics fructo-oligosaccharide (FOS), galacto-oligosaccharide (GOS), and mannan-oligosaccharide (MOS) for their potential to alleviate intestinal damage in rats. Female Dark Agouti rats (6-8 wk old, 110-150 g) were allocated to 1 of the following treatment groups (n=8/group): saline/water, saline/FOS, saline/GOS, saline/MOS, 5-fluorouracil (5FU)/water, 5FU/FOS, 5FU/GOS, and 5FU/MOS. Rats were pretreated with either 5% GOS, MOS, or FOS or vehicle (water) from day -12 to day 0. On day 0, rats received a single intraperitoneal injection of saline or 5FU. Metabolic data were recorded daily and all rats were killed on day 3. Histopathology was quantified in hematoxylin and eosin-stained sections. Intestinal sucrase and myeloperoxidase activity were quantified by biochemical assay. Fecal SCFAs-acetic, propionic, and butyric acid-were also measured. Statistical analysis was by repeated-measures, 2-factor ANOVA or Kruskal-Wallis and Mann-Whitney U test; P<0.05 was considered statistically significant. Body weight was significantly decreased in all treatment groups after 5FU injection, with no change in body weight observed in any prebiotic treatment group. Total food intake was lower by ≥7% in the GOS treatment group pre-5FU than in all other groups (P<0.05). Ileal villus height was 18% higher in GOS-treated rats pre-5FU than in respective water controls (P<0.05). Jejunal and ileal villus height and crypt depth were significantly decreased in all treatment groups after 5FU injection, with no prebiotic effect observed. SCFAs were differentially increased in prebiotic treatment groups compared with water-only controls (P<0.05). FOS, GOS, and MOS have differential effects in modifying small intestinal pathology and SCFA profiles in rats with healthy and damaged small intestinal mucosa.

Steatorrhea in young children: what to do?

Making sure that the child is absorbing properly the main nutrients such as proteins, fats, carbohydrates, and vitamins, macro- and micronutrients is a key influencer when it comes to the harmonious growth and development. In infants, triglycerides digestion starts in the stomach, where three lipases – human milk, gastric and lingual lipases – split triglycerides. The participation of breast milk lipase stimulated by bile salts in the duodenum in splitting fats is an important feature of digestion in breastfed babies. The absorption of fatty acids differs depending on the length of the carbon chain and the location of the fatty acid in the glycerol molecule. Short-chain and medium-chain fatty acids, as well as glycerine, choline are hydrophilic compounds, which are absorbed without pancreatic lipase and bile acids, directly into the blood, bypassing the lymphatic system. The specific configuration of human milk triglycerides improves the absorption of fatty acids. In situations where lipids digestion or absorption appears impaired, one may talk of steatorrhea. If young children have type I steatorrhea (the presence of neutral fat in stool), it is first required to exclude absolute exocrine pancreatic insufficiency: cystic fibrosis, Shwachman-Diamond syndrome, Pearson syndrome, isolated lipase deficiency (Sheldon – Ray syndrome), etc. Type II steatorrhea (excretion of fatty acids in stool) is not a specific symptom of certain diseases, but is often observed in the small intestine pathology.

Toxoplasma gondii infection triggers chronic cachexia and sustained commensal dysbiosis in mice.

Toxoplasma gondii is a protozoan parasite with a predation-mediated transmission cycle between rodents and felines. Intermediate hosts acquire Toxoplasma by eating parasite cysts which invade the small intestine, disseminate systemically and finally establish host life-long chronic infection in brain and muscles. Here we show that Toxoplasma infection can trigger a severe form of sustained cachexia: a disease of progressive lean weight loss that is a causal predictor of mortality in cancer, chronic disease and many infections. Toxoplasma cachexia is characterized by acute anorexia, systemic inflammation and loss of 20% body mass. Although mice recover from symptoms of peak sickness, they fail to regain muscle mass or visceral adipose depots. We asked whether the damage to the intestinal microenvironment observed at acute time points was sustained in chronic infection and could thereby play a role in sustaining cachexia. We found that parasites replicate in the same region of the distal jejunum/proximal ileum throughout acute infection, inducing the development of secondary lymphoid structures and severe, regional inflammation. Small intestine pathology was resolved by 5 weeks post-infection. However, changes in the commensal populations, notably an outgrowth of Clostridia spp., were sustained in chronic infection. Importantly, uninfected animals co-housed with infected mice display similar changes in commensal microflora but never display symptoms of cachexia, indicating that altered commensals are not sufficient to explain the cachexia phenotype alone. These studies indicate that Toxoplasma infection is a novel and robust model to study the immune-metabolic interactions that contribute to chronic cachexia development, pathology and potential reversal.

Sa1987 - small Intestinal MRI Pathology Inflammation Score (Simple) Predicts Disease Severity and Response to Therapy in Experimental Crohn's Disease (CD)

Sa1987 - small Intestinal MRI Pathology Inflammation Score (Simple) Predicts Disease Severity and Response to Therapy in Experimental Crohn's Disease (CD)