Purpose: TNF-α is a pro-inflammatory cytokine believed to be an important mediator of inflammatory bowel disease (IBD). TNF is known to induce cell shedding and increase permeability of the small intestine. We hypothesize that TNF induced intestinal cell shedding contributes to barrier dysfunction and increased antigen presentation. In this study, we used confocal laser endomicroscopy (CLE) and light microscopy (LM), to quantitate TNF induced epithelial cell shedding in the small intestine, and correlated cell shedding with dextran absorption and translocation of commensal bacteria. Methods: 129 Sv/Ev mice were divided into two groups: the treatment group received intraperitoneal injection of TNF-α (0.175μg/ g), while the control group received an equivalent volume of normal saline injection. CLE were performed using Optiscan confocal endomicroscope on exteriorized intestine stained with acriflavine. Epithelial cell shedding was quantitated using density of epithelial gaps created by shedding of intestinal cells. Epithelial density was defined as the total number of epithelial gaps per 1000 cells counted in 5-10 villi per mouse. For LM, frozen sections of the intestine were stained with alcian blue and nuclear fast red. 3D reconstructed CLE images and 2D LM sections were manually counted for epithelial gaps and cells. For FITCdextran absorption study, mice were gavaged with 0.6 mg/g dextran after an overnight fast, blood samples were collected after 4 hr for serum FITC-dextran determination. For translocation studies, mice were gavaged after an overnight fast with 10^10 GFP labelled E. coli JM 109 suspended in 0.17mL LB broth. After 24 hours, liver, spleen and blood samples were obtained for culture. Results: For saline and TNF treated mice (n=6), the CLEdetermined epithelial gap density (mean+SD) was 10.6 ± 2.4 and 47.1 ± 7.4 gaps/1000 cells (P = 0.001), respectively. The LM-determined epithelial gap density was 34.8 ± 6.0 and 64.2 ± 7.4 gaps/1000 cells (P <0.0001), respectively. The discrepancy in the gap density observed between CLE and LM were due to the 3D and 2D nature of image analysis. Serum dextran concentration in the saline and TNF treated mice were 0.59 ± 0.05, and 3.3 ± 0.5 μg/mL (P <0.001), respectively. The liver, spleen and blood cultures from the saline treated mice were all negative, while the TNF treated mice grew 1.4 ± 0.94 E 3 and 1.1 ± 0.5 E 3 cfu/mL of GFP labelled E. colifrom liver and spleen cultures, confirming translocation of commensal bacteria. Conclusion: TNF induced epithelial cell shedding in the small intestine as observed by significant increases in the epithelial gap density of 129 Sv/Ev mice using CLE and LM. This increase in gap density was associated with increased permeability to macromolecules as measured by dextran absorption and translocation of commensal bacteria.
Read full abstract