Brush Border Enzymes in Evaluation of Acute Small Bowel Rejection

Kuusanmãki, Pekka; Lauronen, Jouni; Paavonen, Timo; Pakarinen, Mikko P.; Savilahti, Erkki; Häyry, P; Halttunen, Jorma

doi:10.1046/j.1365-3083.1996.d01-71.x

Cited by 6 publications

(4 citation statements)

References 20 publications

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“…In spite of the unspecificity, determining the activities would be useful if there were to be a decline in activity before morphological changes are detected. In our previous study on acute porcine small bowel rejection, the activity of disaccharidases decreased 2 days before distinct morphological changes appeared in the mucosal biopsies [24]. In the present study, a slight decline in maltase and sucrase, and a clear decline in lactase activity, was seen in allografts at the 12th week when there were already some histological alterations.…”

Section: Chronic Small Bowel Rejection 517supporting

confidence: 66%

How to Diagnose Chronic Rejection. A Study in Porcine Intestinal Allografts

et al. 1997

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Kuusanmäki P, Lauronen J, Paavonen T, Pakarinen M, Yilmaz S, Häyry P, Halttunen J. How to Diagnose Chronic Rejection. A Study in Porcine Intestinal Allografts. Scand J Immunol 1997;46:514-519 Porcine small bowel allografts were followed for 18 weeks during immunosuppression with cyclosporine-A (CyA), azatioprine and prednisone. The mucosal alterations noted at the 12th week were epithelial vacuolation and loss of Goblet cells. Moderate infiltration of inflammatory cells, mainly lymphocytes, was found in the lamina propria. In addition, a few grafts exhibited oedema and fibrosis. Vessels already showed endothelial swelling and intimal proliferation at the 12th week. In the submucosa, the infiltration of inflammatory cells was not present till the 18th week. Further changes in the mucosa at the 18th week were the blunting of villi, cuboidal epithelium, crypt abscesses and epithelial atrophy. The histological alterations of mucosa and lamina propria existing in the full thickness biopsies were mostly also detectable in mucosal biopsies, provided that multiple biopsies were taken. Thus these parameters analyzed from mucosal biopsy material are suitable for the diagnosis and monitoring of chronic small bowel rejection. In autopsy, the most prominent features were in the mesenterial arteries: intimal proliferation, vasculitis, proliferation of media and endothelial alterations. The activity of the mucosal disaccharidases maltase and sucrase remained near the initial level till the 12th week and had decreased markedly by the 18th week.

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Section: Chronic Small Bowel Rejection 517supporting

confidence: 66%

How to Diagnose Chronic Rejection. A Study in Porcine Intestinal Allografts

et al. 1997

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“…Promising results of DA changes regarding intestinal graft rejection have been shown in other studies, although discrepant results are seen as well. While Kaufman et al (1998) showed that assessment of mucosal disaccharidase activity provides no additional useful information concerning efficacy of anti-rejection therapy as compared to histologic analysis alone, other studies recommend DA assessment as an appropriate marker for study and verification of acute (Kuusanmäki et al, 1996) as well as chronic rejection (Kuusanmäki et al, 1997). Notably a correlation with morphological status was detected for sucrose and maltase, but not when lactase was measured (Teitelbaum et al, 1989).…”

Section: Discussionmentioning

confidence: 99%

The relationship between morphology and disaccharidase activity in ischemia- reperfusion injured intestine.

et al. 2012

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Background: Questions regarding functional markers characterizing injured intestines remain unanswered. Brush border disaccharidases are crucial for the functioning of the intestines. Aims: The study was designed to assess changes in disaccharidase activity (DA) following intestinal injury and to compare them with morphological changes. Methods: Wistar rats, randomly divided into six experimental groups (each n = 6), were subjected to different ischemic/reperfusion injury. One-hour mesenteric ischemia followed by reperfusion for 0, 1, 2, 4, 12 or 24 hours was induced. As a control group sham-operated animals were used (n = 6). Intestine morphology was evaluated using histopathological injury index (HII) and goblet cell (GC) detection. DA (sucrase and maltase) was studied in mucosal scrape or in entire intestinal wall samples. Results: Moderate morphological damage (HII, GC) after mesenteric ischemia was detected. Deepening of the injury was found during reperfusion with a maximum after two hours. Improved morphology with longer reperfusion confirmed reversible damage with almost normal mucosal structure after 24 hours of reperfusion. Similar pattern was observed when DA was measured. The lowest activity was detected after 2 hours of reperfusion followed by increasing activity in the subsequent reperfusion periods. Physiological values after 24 hours of reperfusion were seen only in samples of entire intestinal wall. Conclusions: Significant changes in intestinal DA were observed after intestinal ischemia/reperfusion injury. A similar pattern was seen for morphological characteristics. Although based on microscopic survey the intestine seems to be fairly regenerated, some functional limitation is expected to persist.

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“…The process of acute small-bowel rejection occurs over several days and involves inflammatory infiltration of the lamina propria, villous blunting, sloughing of epithelium, submucosal oedema, and endothelial swelling and proliferation (12,21). Mucosal disaccharidase activity diminishes, and the allograft develops paralysis before distinct morphologic changes (149,179,180). Thus, it seems clear that acute small-bowel rejection leads to the rapid deterioration of absorptive function.…”

Section: Physiology Of the Transplanted Jejunoileummentioning

confidence: 99%