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In vitro and in vivo degradation studies for development of a biodegradable patch based on poly(3-hydroxybutyrate).

For the development of a resorbable gastrointestinal patch, the in vitro degradation of solution-cast films of poly(3-hydroxybutyrate) (PHB), modifications of PHB expected to influence its degradation time, as well a poly(L-lactide) (PLLA) was examined. The molecular weight of pure PHB decreased by one-half after 1 year in buffer solution (pH 7.4, 37 degrees C). Acceleration in molecular weight decrease was observed by blending with atactic PHB, whereas no influence was found with low-molecular weight PHB. Leaching of a water-soluble additive led to a slight acceleration of PHB degradability. In contrast, a deceleration in degradation rate was observed with the addition of a hydrophobic plasticizer. In vitro tests indicated an accelerating effect of pancreatin on PHB degradation, whereas PLLA degradation remained essentially uninfluenced. In comparison to simple hydrolysis, the degradation rate of PHB was accelerated about threefold. From the in vitro results, a PHB/atactic PHB blend was selected for repair of a bowel defect in Wistar rats. A patch film was fabricated by a dipping/leaching method. Twenty-six weeks post-implantation, material remnants were found in only one of four animals. The bowel defects were closed in all cases. It could be assessed that the patch material resists the intestinal secretions for a sufficiently long time but that it finally degrades completely.

Animals↗

Distal intestinal obstruction syndrome in adults with cystic fibrosis.

BACKGROUND & AIMS: With the improved survival of patients with cystic fibrosis (CF), gastrointestinal complications become more evident in adults with this condition. The aims of this study were to determine the prevalence and clinical features of distal intestinal obstruction syndrome (DIOS) and its relationship with the cystic fibrosis transmembrane conductance regulator (CFTR) genotype in an adult CF population. METHODS: Cross-sectional study was conducted in an adult CF cohort. RESULTS: Among 171 adults with CF (mean age, 28.9 years), 27 patients (15.8%) reported 43 episodes of DIOS. No significant association was found between DIOS and a history of meconium ileus. The first episode of DIOS occurred in adulthood in 21 cases (77.8%). DIOS recurred in 13 patients (48.1%). All patients who developed DIOS had pancreatic insufficiency. Pulmonary function was significantly more altered in patients with DIOS than in the other patients, but pancreatic insufficiency and age might act as confounding factors. DIOS occurred in 21.9% of patients with a severe CFTR genotype and in only 2.4% of patients with a mild CFTR genotype (P < 0.005). CONCLUSIONS: DIOS is frequent in adults with CF with a severe CFTR genotype and/or advanced-stage pulmonary disease. The relative contributions of malabsorption and impaired intestinal secretion in the development of DIOS are discussed.

Adolescent↗

Central mu, delta- and kappa-opioid influences on intestinal water and electrolyte transport in dogs.

The effects of intracerebroventricular (i.c.v.) administration of opioid peptides with mu-(DAGO), mu- and delta-(DALAMIDE, DADLE) and kappa-(dynorphin) properties on normal and stimulated (cholera toxin) net fluxes of water, Na+ and K+ through a jejunal Thiry-Vella loop were investigated in conscious dogs. Basal net water absorption was slightly, but significantly (P less than 0.05) increased during i.c.v. infusion of DALAMIDE or DAGO (0.5 ng/kg/min) but not DADLE and dynorphin-(1-13) at the same rate; DALAMIDE and DAGO also markedly reduced (by 72.3 and 79.5% respectively) the secretory effects of cholera toxin (0.4 micrograms/ml). Similar effects were obtained with DALAMIDE and DAGO when injected i.c.v. as a bolus (100 ng/kg) prior to cholera toxin infusion; they were suppressed after i.v. pretreatment with naltrexone (0.3 mg/kg) but also with propranolol (0.2 mg/kg). In contrast, i.v. phentolamine (0.2 mg/kg) and bilateral truncal vagotomy, were unable to block their effects. These results suggest that Met-enkephalin can act centrally to affect intestinal transport of (i) water and (ii) electrolytes in dogs. They act probably at central mu-receptors which are involved in the regulation of intestinal secretion mediated through a central or peripheral beta-adrenergic pathway.

Animals↗

Signal transduction pathways for serotonin as an intestinal secretagogue.

This review presents a signal transduction pathways for serotonin (5-hydroxytryptamine, 5-HT) as an intestinal secretagogue and some recently published related findings. 5-HT is a secretagogue in the small and large intestine of all studied species including pig and man. 5-HT mediates intestinal secretion through activation of at least the epithelial 5-HT2, and neuronal 5-HT3, and 5-HT4 receptors in the submucosal plexus, including a reflex arc. 5-HT activates both a cholinergic and a non-cholinergic pathway in its secretory response. Intracellular mediators include at least eicosanoids (prostaglandin E2), calcium, phosphoinositols (1,4,5-inositol trisphosphate) and maybe nitric oxide and cyclic nucleotides. Pig small intestine appears to be an appropriate model for the human small intestine with respect to the signal transduction pathways for 5-HT as an intestinal secretagogue. Species and segmental differences in the signal transduction pathways for 5-HT as an intestinal secretagogues are discussed together with related news on 5-HT receptors, 5-HT antagonists in clinical use, the enteric nervous system, and intracellular mediators.

Animals↗

Cholera toxin induces synthesis of phospholipase A2-activating protein.

The mechanism of cholera toxin (CT)-stimulated arachidonate metabolism was evaluated. CT caused rapid in vitro synthesis of prostaglandin E2 (PGE2) in murine smooth muscle-like cells (BC3H1), reaching maximal levels within 3 to 4 min. In comparison, cyclic AMP (cAMP) levels were unchanged, and addition of dibutyryl cAMP did not affect PGE2 synthesis. CT-induced PGE2 synthesis was prevented by actinomycin D or cycloheximide, indicating a need for de novo protein synthesis. Northern blot analysis of total RNA from BC3H1 cells revealed that exposure to CT resulted in an increase in abundance of mRNA encoding phospholipase A2 (PLA2)-activating protein (PLAP). PLAP is a regulatory protein that increases the enzymatic activity of cellular PLA(2), which in turn causes increased hydrolysis of arachidonate from membrane phospholipids. Furthermore, CT evoked the accumulation of PLAP mRNA in J774 (murine monocyte/macrophage) and Caco-2 (human intestinal epithelial) cells in vitro, but the responses were more delayed than that of BC3H1 cells. A protein band of approximately 35 kDa, which corresponded to the size of PLAP, was observed in sodium dodecyl sulfate extracts of Caco-2 cells by Western blot (immunoblot) analysis using affinity-purified antibodies to PLAP synthetic peptides. Synthesis of PLAP protein was increased after 2 h of exposure to CT. Exposure of mouse intestinal loops to either CT or live Salmonella typhimurium for 3 h increased mucosal PLAP mRNA levels. The role of PLAP in CT-induced PGE2 synthesis provides an attractive explanation for the reported suppression of CT-induced intestinal secretion by inhibitors of protein synthesis.

Amino Acid Sequence↗

Nasal immunization of mice with Cryptosporidium parvum DNA induces systemic and intestinal immune responses.

DNA immunization offers a novel approach to inducing humoral and cellular immunity against infectious pathogens. We examined whether such an approach could be used against cryptosporiodiosis, an intestinal disease caused by the protozoan parasite Cryptosporidium parvum. This infection is a major problem for young ruminants and immunosuppressed individuals in whom cryptosporidiosis causes life-threatening symptoms. The life cycle of C. parvum takes place in the enterocytes of the intestinal epithelium. We therefore focused our attention on a route of immunization that might induce a mucosal immunoglobulin (Ig)A response. Eight-week-old BALB/c mice were immunized intranasally with DNA encoding a 15-kDa C. parvum sporozoite antigen (CP15-DNA) cloned onto the plasmid pcDNA3. CP15-DNA-immunized mice developed specific and longlasting production of anti-CP15 Ig A in intestinal secretions and specific IgG in sera 3 months and 1 year after the first DNA inoculation. CP15-DNA-immunized mice also developed an antigen-specific T lymphocyte proliferative response in both spleen and mesenteric lymph nodes. Control mice that received the pcDNA3 plasmid alone did not develop specific humoral and cellular responses. These results indicate that plasmid DNA may provide a powerful means of eliciting intestinal humoral and cellular responses to C. parvum infections in mammals.

Administration, Intranasal↗

Cloning and expression of the rabbit prostaglandin EP4 receptor.

Prostaglandin E2 (PGE2) is an important regulator of systemic hemodynamics and epithelial ion transport. To further investigate the mechanism of PGE2 action, a clone encoding a PGE2 receptor was isolated from a rabbit kidney cortex cDNA library. Expression of the full-length cDNA in COS-1 cells yielded a ligand-binding profile typical for a butaprost-insensitive Gs-coupled E-prostanoid (EP) receptor. Misoprostol-free acid, a receptor-selective PGE analogue, produced concentration-dependent increases in adenosine 3',5'-cyclic monophosphate production. The data are consistent with the receptor being an EP4 subtype. Ribonuclease protection assays demonstrated that this receptor gene is highly expressed in intestine, uterus, and thymus, with lower but significant expression in kidney, whole adrenal, lung, spleen, and stomach. In situ hybridization in kidney revealed intense hybridization to glomeruli and urothelium of the renal pelvis. This prostanoid receptor was also highly expressed in the duodenal epithelium and adrenal cortex. The tissue distribution suggests a functional role for this receptor in mediating glomerular effects of PGE2 and effects on aldosterone secretion, intestinal transport, and immune function.

Amino Acid Sequence↗

Pharmacokinetics, protein binding and metabolic profile of 3H-icometasone enbutate following intravenous, oral and intratracheal administrations to Sprague-Dawley rats.

Absorption, distribution and excretion of 3H-icometasone enbutate (9 alpha-chloro-11 beta,17 alpha,21-trihydroxy-16 alpha-methylpregna-1,4-diene-3,20-dione, 17-butyrate, 21-acetate, CAS 103466-73-5 CL09) were studied in male and female Sprague-Dawley rats after a single dose administration by intravenous (1 mg/kg), oral and intratracheal (2 mg/kg) routes. The metabolic profile after the different routes and protein binding were also determined. Independent of the route, the radioactivity was mainly excreted in faeces. Less than 10% of the dose were excreted in urine. The majority of the administered doses was recovered within 24 h postdose, and the total recovery of the doses administered was obtained. After oral and intravenous administration to bile-duct cannulated rats, most of the radioactivity was excreted in the bile (80% of the administered dose) and some radioactivity was found in the faeces. It can thus be concluded that some intestinal secretion occurred. After oral administration, mean maximum blood concentrations were obtained about 0.75 h postdose. For the intratracheal route, the radioactive dose administered was too low to determine precise blood pharmacokinetic parameters. However, the distribution study results allowed us to conclude that the drug was absorbed first from the lungs and then from the gastrointestinal tract. Immediately after the intravenous injection, the liver, the kidneys, the small intestine and its contents and the carcass presented the highest levels of radioactivity. 168 h postdose, low radioactivity was still measurable in these organs. In other tissues, the radioactivity decreased reaching the limit of quantification 72 h postdose. After oral administration, the maximum concentrations were observed 1 h after administration in the liver, the small intestine and its contents. Then the radioactivity decreased in most of the tissues but a slight increase at 72 and/or 120 h postdose was noted in large intestine contents, carcass, lungs, eyes. After intratracheal administration, the maximum radioactivity was observed in lungs and trachea. A few minutes later the radioactivity reached the gastrointestinal tract. The protein binding study showed a saturable binding in rat and human plasma without notable differences between the two species. The binding on human serum albumin was shown to be non saturable with a total binding capacity of 7.48 +/- 1.83 mumol/l, suggesting that other proteins were involved in CL09 binding. This binding was demonstrated to be reversible. CL09 was extensively metabolized since no unchanged CL09 was recovered in bile or urine and at least nine metabolites have been detected. The profiles seemed to be different according to the route of administration.

Administration, Oral↗

Segmental colonic duplication presenting as a sigmoid volvulus.

This is a case report of a four-year-old girl who presented with severe intermittent abdominal pain. She had an infra-levator imperforate anus repaired as a newborn. Operation demonstrated duplications of the right and left colons, separated by a normal transverse colon. The left colon duplication was closed at both ends, and it contained 500 cc of intestinal secretions. The sigmoid colon and its duplication volvulized. The terminal ileum was also duplicated; one ileum joining a normal ascending colon duplication, which was patent proximally, but closed distally.

Child, Preschool↗

Oral immunization with a recombinant cysteine-rich section of the Entamoeba histolytica galactose-inhibitable lectin elicits an intestinal secretory immunoglobulin A response that has in vitro adherence inhibition activity.

The LC3-encoded 52-kDa recombinant protein includes amino acids 758 to 1134 of the 170-kDa subunit of the galactose-inhibitable lectin. Oral immunization of BALB/c mice with the LC3-encoded protein and cholera holotoxin induced an intestinal secretory immunoglobulin A (IgA) response (P < 0.01 compared with the control). There was a negative correlation (P = 0.001) between intestinal anti-LC3 IgA and serum IgA and IgG antibody responses. Intestinal secretions from immunized mice completely inhibited the galactose-specific adherence of axenic trophozoites ot Chinese hamster ovary cells (P < 0.01).

Adhesiveness↗

Human small intestinal epithelial cells secrete interleukin-7 and differentially express two different interleukin-7 mRNA Transcripts: implications for extrathymic T-cell differentiation.

The small intestinal epithelium, composed of epithelial cells (EC) and intraepithelial T lymphocytes, is exposed to numerous ingested antigens. Small intestinal EC may act as accessory and/or antigen presenting cells for intestinal T cells, some of which may mature extrathymically and regulate local immunity and tolerance. Since interleukin-7 (IL-7) plays an essential role in T cell maturation and activation, we examined its expression by human small intestinal EC. IL-7 was detected by ELISA in supernatants from 4 of 4 epithelial layer (EpL) cultures. Using RT-PCR, IL-7 mRNA was detected in 4 EpL studied, and two distinct IL-7 transcripts were identified in 3 of the 4. The ratios of the intensities of the larger to the smaller bands varied amongst individuals. Furthermore, the intensity ratios were higher in whole-thickness intestine and lamina propria preparations than in their corresponding EpL. This is the first report of the expression of two IL-7 transcripts in human intestine and of IL-7 secretion by human small intestinal EpL cells. This supports the hypothesis that small intestinal EC may influence differentiation and/or activation of neighboring T cells. The differential expression of the two transcripts may have important implications for immune regulation in the intestinal epithelium.

Biopsy↗

Ketotifen inhibits Clostridium difficile toxin A-induced enteritis in rat ileum.

BACKGROUND: Clostridium difficile toxin A is the principal mediator of inflammatory enterocolitis in experimental animals. The purpose of this study was to explore the effect of ketotifen, an anti-inflammatory drug, on toxin A-induced enterotoxicity in rat ileum. METHODS: The effects of intragastric administration of ketotifen on secretion, mannitol permeability, histological damage, and mucosal levels of leukotriene B4, leukotriene C4, and platelet activating factor in toxin A-exposed rat ileal loops were measured in vivo. The effects of ketotifen on toxin A-mediated release of rat mast cell protease II (rat mucosa mast cell product) release were also measured in rat ileal explants in vitro. The effect of ketotifen on neutrophil migration in vitro was also evaluated. RESULTS: Ketotifen pretreatment inhibited toxin A-associated intestinal secretion by 42.5% and mannitol permeability by 56.3% and reduced epithelial cell inflammation and necrosis. These effects were associated with reduced levels of leukotriene B4 by 65.8%, leukotriene C4 by 88.8%, platelet activating factor by 77.8%, and inhibition of rat mast cell protease II by 58.4%. In addition, pretreatment of neutrophils with ketotifen inhibited neutrophil migration in vitro. CONCLUSIONS: The protective effect of ketotifen in this animal model was associated with significant inhibition of release of mast cells and neutrophil derived mediators, supporting their involvement in C. difficile enteritis.

Animals↗

The expression and role of Fas ligand in intestinal inflammation.

Fas ligand (FasL) is involved in the pathogenesis of inflammatory diseases and immune privilege. We examined the expression of FasL in the enteric nervous system (ENS) in murine colitis and guinea-pig ileitis. We studied FasL immunoreactivity, functional integrity of the ENS, severity of colitis, and distribution of neutrophils in wild type and B6/gld mice that lack functional FasL. In ileitis, the distribution of FasL, CD4+ and CD8+ T cells was examined. FasL expression was increased in the ENS of wild type mice with colitis, but decreased labelling of nerve fibres was noted in B6/gld mice. Neutrophils were more abundant and widely distributed in B6/gld mice. Colitis was more severe and persistent in B6/gld mice 7 days after induction. Functional parameters of intestinal secretion and motility in B6/gld mice were the same as controls. In ileitis, FasL expression was increased in the guinea-pig ENS and returned to control levels following the resolution of inflammation. While T cells were not present in the ENS of controls, they were observed during inflammation, but were excluded from ganglia. The number of enteric neurons was unchanged over the course of inflammation. The expression of FasL is altered in intestinal inflammation and contributes to its resolution in experimental colitis.

Animals↗

In vitro antisecretory effects of trifluoperazine and other neuroleptics in rabbit and human small intestine.

The inhibitory effects of several neuroleptic agents on intestinal secretion were examined in vitro by measuring short-circuit current, net Cl flux, and cyclic nucleotide concentration, In rabbit ileal mu cosa, trifluoperazine (0.2-0.5 mM) did not significantly alter basal transport rates, but partially inhibited responses to the following secretagogues: theophylline, 8-Br-cAMP, VIP, dimethyl-PGE2 and heat-stable Escherichia coli enterotoxin (a cGMP agonist). Trifluoperazine completely inhibited the response to Ca ionophore A23187. In human small intestinal mucosa, trifluoperazine (0.1-0.5 mM) inhibited electrical responses to VIP and theophylline almost completely. The inhibitory action of trifluoperazine was manifest only on serosal addition. Trifluoperazine did not significantly alter cAMP or cGMP concentrations either under basal conditions or in the presence of secretagogues. It also did not diminish the electrical response to luminally added D-glucose. Three other neuroleptics were tested and found to have antisecretory action; the order of potencies were trifluoperazine greater than chlorpromazine greater than haloperidol greater chlorprothixene. Since all four agents are potent inhibitors of calcium-dependent regulator in bovine brain, this ubiquitous protein may also be the target for their antisecretory action in intestine.

16,16-Dimethylprostaglandin E2↗

Antibodies to food and environmental antigens in serum, respiratory tract and intestine of pigs.

Serum antibodies to food, bedding and dust were detected in pigs by precipitation and ELISA. There was an age-related decrease in the number of animals with precipitating antibodies and in the specific activity of IgG and IgM antibodies. Antibodies to food, bedding and dust were detected in respiratory and intestinal secretions, but there were differences in the distribution and isotype of antibodies to these three antigens.

Age Factors↗

Chronic ingestion of a potential food contaminant induces gastrointestinal inflammation in rats: role of nitric oxide and mast cells.

Chronic ingestion of xenobiotics could be pathogenic in the gastrointestinal tract. Recently, we showed that acute low administration of a food contaminant (diquat) induced intestinal secretion involving mast cells and nitric oxide. This work aimed to determine in rats: (1) the influence of a low level (0.1 mg/kg/day per os) chronic ingestion of diquat on gastrointestinal immune cells, and (2) the participation of nitric oxide synthases (NOS) in these effects. Diquat increased both gastric and jejunal myeloperoxidase activities, tissue histamine in vitro release after stimulation by 48/80, and mast cell numbers. Diquat did not alter gastric NOS but increased intestinal inducible NOS (iNOS) activity. L-NAME prevented diquat-induced gastric and intestinal mastocytosis and gastric but not intestinal inflammation. L-NAME reduced gastric constitutive NOS (cNOS) activity and reestablished control iNOS activity. Chronic low level ingestion of diquat induces a low-grade gastric and intestinal inflammation with mastocytosis and enhancement of intestinal iNOS activity.

Animals↗

Diarrhea in terminally ill patients: pathophysiology and treatment.

Diarrhea is a distressing symptom that limits the quality of life in terminally ill patients. In these patients, many factors can affect intestinal secretion, absorption, and motility, including drugs, infective agents, antibiotics, chemotherapy, radiotherapy, surgery, malnutrition, neuroendocrine tumors, and mechanical bowel obstruction. Diarrhea can result in water and electrolyte losses. This review discusses the pathophysiology, assessment, and treatment of diarrhea in advanced cancer patients.

Acquired Immunodeficiency Syndrome↗

Systemic and mucosal antibody responses to toxin A in patients infected with Clostridium difficile.

The systemic and mucosal humoral response to toxin A, the primary virulence factor of Clostridium difficile, was measured in sera and intestinal secretions from 21 patients with C. difficile diarrhea, 9 asymptomatic C. difficile fecal excretors, and 10 noncolonized control subjects. Toxin A-specific IgG was higher in convalescent sera of the patients with diarrhea (mean +/- SE, 990 +/- 260 ng/mL) than in acute sera (620 +/- 150 ng/mL), in sera from asymptomatic excretors (410 +/- 140 ng/mL), or control subjects (320 +/- 50 ng/mL; P < .05 convalescent vs. control). The pattern of toxin A-specific serum IgA and intestinal secretory IgA levels was similar to that of serum IgG in these groups. Neutralization of toxin A was demonstrated in 5 of 14 convalescent sera but only 1 of 13 acute sera (P = .04). However, the presence of neutralizing activity was independent of the subsequent clinical response. Therefore, most patients convalescent from C. difficile diarrhea demonstrate systemic and mucosal antibodies to toxin A, but these antibodies following natural infection do not appear to alter the clinical course of C. difficile infection.

Adult↗