Accelerated Gastric Emptying but No Carbohydrate Malabsorption 1 Year After Gastric Bypass Surgery (GBP)

Wang, Gary; Agenor, Keesandra; Pizot, Justine; Kotler, Donald P.; Harel, Yaniv; Schueren, Bart Van der; Quercia, Iliana; McGinty, James; Laferrère, Blandine

doi:10.1007/s11695-012-0656-6

Cited by 69 publications

(57 citation statements)

References 26 publications

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“…Roux-en-Y gastric bypass is the current most effective surgical treatment for morbid obesity. However, despite the accelerated pouch emptying 1 and intestinal transit 2 following RYGB, carbohydrate absorption is reported to be normal at 1 year 1 . Intestinal sweet taste receptors (STR) sense luminal glucose and rapidly increase levels and function of the glucose transporters SGLT-1 and GLUT-2 in health, yet it is unknown how expression of intestinal STR and glucose transporters are altered by RYGB.…”

Section: Discussionmentioning

confidence: 99%

“…L NAHIDI, 1 ST LEACH, 1 DA LEMBERG, 1,2 AS DAY Introduction: Exclusive enteral nutrition (EEN) is an effective treatment for the induction of remission and mucosal healing in Crohn's disease (CD); however, the mode of action to promote mucosal healing is poorly understood. The aim of this study was to determine the effects of EEN, in contrast with metronidazole and hydrocortisone, upon inflammation and gut barrier function in a colitis mouse model.…”

Section: Is Osteoprotegerin a Pro-inflammatory Cytokine?mentioning

confidence: 99%

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Basic Science Luminal

2013

J of Gastro and Hepatol

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Introduction:We have previously shown that appendicitis following appendicectomy offered protection against trinitrobenzene sulfonic acid induced colitis in an age and antigen dependent fashion (Ng et al, Gut, 2013 in revision). The protective effect was associated with an expansion of regulatory T cells (Tregs) in the colon following migration from the appendix. It was dependent on the production of the immunoregulatory cytokine interleukin (IL)-10 as neutralisation of IL-10 abrogated the protective effect. The mechanisms underlying the Treg expansion following appendicitis induction remain to be elucidated. Retinoic acid (RA) is an active metabolite of vitamin A that regulates various cellular functions such as proliferation and differentiation and mediates its effects through the retinoic acid receptors (RARs). RA has been shown to play a pivotal role in the development of Tregs in the gastrointestinal system. Based on this, the current study seeks to investigate the role of RA signalling in the appendicitis model with the use of a RAR inhibitor. Methods: The RAR inhibitor LE135 is known to be an effective blocker of RARs in vitro; we used it to block RA signaling in vivo in mice with appendicitis. 5-week-old Balb/c mice were injected with 100 μg of LE135 in dimethyl sulfoxide (DMSO) per 20 g of body weight, daily for 3 days. A separate group of mice were injected with DMSO only at the same dose as a control for RA inhibition. Appendicitis was induced in both groups of mice on day 4 and injections were continued for another 4 days. Both groups of mice were sacrificed 24 hours after the last injection and the liver and colon were harvested and processed for histological analysis to assess toxicity of LE135 and DMSO. To determine the effectiveness of RA signalling inhibition by LE135, RNA was collected from control and treated mouse colons (n = 4) and the changes in the mRNA levels of the putative Treg markers FoxP3 and IL-10 and the surrogate marker for RA inhibition MKP-1 were measured via quantitative real time PCR analysis. Results: Histological examination of the liver and colon from control and LE135-treated mice showed no morphological changes, thus confirming LE135 is safe to use in the appendicitis model. LE135 caused a reduction in MKP-1, FoxP3 and IL-10 mRNA levels in colon tissue compared to mice treated with the vehicle control. These results suggest the current dose of LE135 in vivo is effective in inhibiting the RA pathway in the appendicitis model. Conclusion: LE135 caused a reduction in MKP-1, FoxP3 and IL-10 mRNA levels suggesting that LE135 at the dose of 100 μg per 20 g reduced RA signaling in the colon. In future studies we aim examine the effect of RA inhibition in a colitis model as the regulation of Treg differentiation by RA may be a potential mechanism mediating the appendicitis induced protective effect against colitis. stem cell in the gastrointestinal tract, bone and tumour microenvironment DL WORTHLEY, M CHURCHILL, YL SI, N MANIERI, D LEVIN, Y HAYAKAWA, BW RENZ, XW CHEN, S AS...

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Section: Discussionmentioning

confidence: 99%

Section: Is Osteoprotegerin a Pro-inflammatory Cytokine?mentioning

confidence: 99%

Basic Science Luminal

2013

J of Gastro and Hepatol

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“…Available physiological literature data on the digestive process are limited to indirect, with postprandial serum or urine measurements or scintigraphy evaluation of gastric emptying. Gastric emptying is reported to be very rapid for liquids, based on D-xylose in serum, from 18.6 ± 6.9 min prior to GBP to 7.9 ± 2.7 min after GBP (Wang et al, 2012). Extremely rapid pouch emptying was reported for water vs. whey proteins vs. olive oil as preloads (30 min) for a liquid glucose drink (t 50 3.8 ± 0.9 vs. 4.1 ± 0.6 vs. 3.6 ± 0.5 min, respectively) and for a solid beef patty meal (1.6 ± 0.7 vs. 1.1 ± 0.6 vs. 1.3 ± 0.5 min, respectively) (Nguyen et al, 2016).…”

Section: Developing Ivds For Humans With Gi Disordersmentioning

confidence: 99%

Extending in vitro digestion models to specific human populations: Perspectives, practical tools and bio-relevant information

Shani-Levi

Alvito

Andrés

et al. 2017

Trends in Food Science & Technology

154

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a b s t r a c tBackground: In vitro digestion models show great promise in facilitating the rationale design of foods. This paper provides a look into the current state of the art and outlines possible future paths for developments of digestion models recreating the diverse physiological conditions of specific groups of the human population. Scope and approach: Based on a collective effort of experts, this paper outlines considerations and parameters needed for development of new in vitro digestion models, e.g. gastric pH, enzymatic activities, gastric emptying rate and more. These and other parameters are detrimental to the adequate development of in vitro models that enable deeper insight into matters of food luminal breakdown as well as nutrient and nutraceutical bioaccessibility. Subsequently, we present an overview of some new and emerging in vitro digestion models mirroring the gastro-intestinal conditions of infants, the elderly and patients of cystic fibrosis or gastric bypass surgery. Key findings and conclusions: This paper calls for synchronization, harmonization and validation of potential developments in in vitro digestion models that would greatly facilitate manufacturing of foods tailored or even personalized, to a certain extent, to various strata of the human population.

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“…This is particularly concerning for patients taking multiple medications with a large pill burden. Gastric residence time may be variable in RYGB but decreased in sleeve gastrectomy [8][9][10]. An increase in gastric residence time may allow medications to be released slowly and increase absorption for medications that undergo uptake by a saturable transport mechanism [11].…”

Section: Pharmacokinetic Changes After Bariatric Surgerymentioning

confidence: 99%

Pharmacokinetic Changes Secondary to Roux en Y Gastric Bypass

Giuliano¹

2012

Adv Pharmacoepidem Drug Safety

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Objective: To review the influence of Roux-en-Y gastric bypass (RYGB) on pharmacokinetic parameters of medications.Data sources: PubMed was searched from inception to September 2012 to identify studies. Search terms included bariatric surgery, gastric bypass, Roux-en-Y, pharmacokinetic, and absorption. Studies included for this review were limited to English language studies published in full.Data synthesis: Obesity is a major health care concern and is on the rise. This has led to an increasing number of bariatric surgeries. Such procedures may have profound effects on pharmacokinetic parameters of many medications depending on the extent of surgical changes that are made. Surgical procedures such as RYGB are most likely to affect medication absorption. Factors that may affect medication absorption in RYGB patients include changes in intestinal or gastric pH, surface area, intestinal metabolism and transport mechanisms. Published studies have been primarily conducted in RYGB patients and have shown varied effect on overall absorption of medications.Conclusions: RYGB may have profound effects on medication absorption. Predicting absorption is difficult due to interplay of several factors including, changes in intestinal surface area, intestinal metabolism, efflux pumps, active transporters and gastrointestinal pH. Future studies are needed, particularly studies evaluating medications that have a low bioavailability and are commonly used in the bariatric surgery population.

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Accelerated Gastric Emptying but No Carbohydrate Malabsorption 1 Year After Gastric Bypass Surgery (GBP)

Cited by 69 publications

References 26 publications

Basic Science Luminal

Basic Science Luminal

Extending in vitro digestion models to specific human populations: Perspectives, practical tools and bio-relevant information

Pharmacokinetic Changes Secondary to Roux en Y Gastric Bypass

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