The influence of nutrients, biliary-pancreatic secretions, and systemic trophic hormones on intestinal adaptation in a Roux-en-Y bypass model

Taqi, Esmaeel; Wallace, Laurie E.; Heuvel, Elaine de; Chelikani, Prasanth; Zheng, Huiyuan; Berthoud, Hans Rudolf; Holst, Jens J.; Sigalet, David L.

doi:10.1016/j.jpedsurg.2010.02.036

Cited by 80 publications

(90 citation statements)

References 47 publications

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“…5,9,10,19 ]. This has most consistently been described in RYGB rats, and the phenomenon seems to be less marked in RYGB mice.…”

Section: Rygb Changes the Gut Morphology In Specific Gut Segmentsmentioning

confidence: 79%

“…Specifically, muscular and mucosal layers are significantly thicker in the alimentary (Roux) limb after RYGB in comparison with corresponding intestinal segments in sham-operated controls; both mucosal crypt depth and villi height increased. Depending on the dimensions of the various limbs after RYGB [5,9,10] , similar changes may also be observed in the common channel of some RYGB models, but not in the biliopancreatic limb.…”

Section: Rygb Changes the Gut Morphology In Specific Gut Segmentsmentioning

confidence: 86%

“…alimentary limb and common channel; see fig. 1 ) [5,9,10] . It must be noted, however, that the contribution of malabsorption to the RYGB-induced body weight loss may increase if animals are maintained on a high-fat diet [11] .…”

Section: Effects Of Rygb On Body Weightmentioning

confidence: 99%

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Physiological Mechanisms behind Roux-en-Y Gastric Bypass Surgery

Lutz¹,

Bueter

2014

Dig Surg

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Obesity and its related comorbidities can be detrimental for the affected individual and challenge public health systems worldwide. Currently, the only available treatment options leading to clinically significant and maintained body weight loss and reduction in obesity-related morbidity and mortality are based on surgical interventions. Apart from the 'gold standard' Roux-en-Y gastric bypass (RYGB), the vertical sleeve gastrectomy and gastric banding are two frequently performed procedures. This review will discuss animal experiments designed to understand the underlying mechanisms of body weight loss after bariatric surgery. While caloric malabsorption and mechanical restriction are no major factors in this respect, alterations in gut hormone levels are invariably found after RYGB. However, their causal role in RYGB effects on eating and body weight has recently been challenged. Other potential factors contributing to the RYGB effects include increased bile acid concentrations and an altered composition of gut microbiota. RYGB is further associated with remarkable changes in the preference for different dietary components such as a decrease in the preference for high fat or sugar; it is important to note that the contribution of altered food preferences to the RYGB effects on body weight is not clear. high fat or sugar; it is important to note that the contribution of altered food preferences to the RYGB effects on body weight is not clear.

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“…5,9,10,19 ]. This has most consistently been described in RYGB rats, and the phenomenon seems to be less marked in RYGB mice.…”

Section: Rygb Changes the Gut Morphology In Specific Gut Segmentsmentioning

confidence: 79%

Section: Rygb Changes the Gut Morphology In Specific Gut Segmentsmentioning

confidence: 86%

See 1 more Smart Citation

Physiological Mechanisms behind Roux-en-Y Gastric Bypass Surgery

Lutz¹,

Bueter

2014

Dig Surg

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“…In a study to assess taste preference after RYGB, Bueter et al (3) found decreased T1R2 levels in the BP limb of bypassed Wistar rats but increased levels in the Roux limb. In their study on SD rats, Taqi et al (26) found an increase in GLUT2 mRNA levels in both the Roux and common limbs, with decreased SGLT1 in the Roux limb. These studies differ from ours in several ways, however, including the fact that they compared RYGB rats to sham animals rather than expression levels of transporters in RYGB limbs after BP limb infusion with different agents.…”

Section: Discussionmentioning

confidence: 93%

Intestinal sweet-sensing pathways and metabolic changes after Roux-en-Y gastric bypass surgery

Bhutta

Deelman

Roux

et al. 2014

American Journal of Physiology-Gastrointestinal and Liver Physi

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Bhutta HY, Deelman TE, le Roux CW, Ashley SW, Rhoads DB, Tavakkoli A. Intestinal sweet-sensing pathways and metabolic changes after Roux-en-Y gastric bypass surgery. Am J Physiol Gastrointest Liver Physiol 307: G588 -G593, 2014. First published July 3, 2014 doi:10.1152/ajpgi.00405.2013.-Studies suggest that improvements in type 2 diabetes (T2D) post-Roux-en-Y gastric bypass (RYGB) surgery are attributable to decreased intestinal glucose absorption capacity mediated by exclusion of sweet taste-sensing pathways in isolated proximal bowel. We probed these pathways in rat models that had undergone RYGB with catheter placement in the biliopancreatic (BP) limb to permit post-RYGB exposure of isolated bowel to sweet taste stimulants. Lean Sprague Dawley (n ϭ 13) and obese Zucker diabetic fatty rats (n ϭ 15) underwent RYGB with BP catheter placement. On postoperative day 11 (POD 11), rats received catheter infusions of saccharin [sweet taste receptor (T1R2/3) agonist] or saline (control). Jejunum was analyzed for changes in glucose transporter/sensor mRNA expression and functional sodium-glucose transporter 1 (SGLT1)-mediated glucose uptake. Saccharin infusion did not alter glucose uptake in the Roux limb of RYGB rats. Intestinal expression of the glucose sensor T1R2 and transporters (SGLT1, glucose transporter 2) was similar in saccharin-vs. saline-infused rats of both strains. However, the abundance of SGLT3b mRNA, a putative glucose sensor, was higher in the common limb vs. BP/Roux limb in both strains of bypassed rats and was significantly decreased in the Roux limb after saccharin infusion. We concluded that failure of BP limb exposure to saccharin to increase Roux limb glucose uptake suggests that isolation of T1R2/3 is unlikely to be involved in metabolic benefits of RYGB, as restimulation failed to reverse changes in intestinal glucose absorption capacity. The altered expression pattern of SGLT3 after RYGB warrants further investigation of its potential involvement in resolution of T2D after RYGB.Roux-en-Y gastric bypass; obesity; type 2 diabetes mellitus; intestinal sweet taste sensor; sodium-glucose transporter 1 IN RECENT DECADES, BARIATRIC SURGERY has evolved into the foremost therapy for obesity. Moreover, one of the weight loss operations, Roux-en-Y Gastric Bypass surgery (RYGB), is associated with a high rate of remission of type 2 diabetes mellitus (T2D), with an early and weight-independent mechanism that improves glucose homeostasis (2, 17). However, the mechanisms mediating the resolution of T2D remain poorly understood.Intense investigation of contributory factors has implicated several mechanisms, including alterations in incretin levels, the gut microbiome, bile acids, and an area of interest to our lab, namely intestinal nutrient sensing. The surgical isolation of duodenum and proximal jejunum appear to be critical in mediating resolution of T2D, supported by outcomes following endoluminal sleeve device insertion and surgical procedures (e.g., RYGB, biliopancreatic diversion), which exclude a sim...

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“…In rodents, RYGB increases bowel width, villus height, crypt depth, and crypt proliferation, maximal in nutrient-stimulated regions (194), and BPD (18) and IT (186) behave similarly. In humans, jejunoileal bypass has been shown to result in enteroendocrine cell hyperplasia (25).…”

Section: Mechanisms Of Weight Loss After Rygbmentioning

confidence: 99%

Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: understanding weight loss and improvements in type 2 diabetes after bariatric surgery

Scott

Batterham

2011

American Journal of Physiology-Regulatory, Integrative and Comp

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Obesity increases the likelihood of diseases like type 2 diabetes (T2D), heart disease, and cancer, and is one of the most serious public health problems of this century. In contrast to ineffectual prevention strategies, lifestyle modifications, and pharmacological therapies, bariatric surgery is a very effective treatment for morbid obesity and also markedly improves associated comorbidities like T2D. However, weight loss and resolution of T2D after bariatric surgery is heterogeneous and specific to type of bariatric procedure performed. Conventional mechanisms like intestinal malabsorption and gastric restriction do not fully explain this, and potent changes in appetite and the enteroinsular axis, as a result of anatomical reorganization and altered hormonal, neuronal, and nutrient signaling, are the portended cause. Uniquely these signaling changes appear to override vigorous homeostatic defenses of stable body weight and compelling self-gratifying motivations to eat and to reverse defects in beta-cell function and insulin sensitivity. Here we review mechanisms of weight loss and T2D resolution after Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy bariatric surgery, two markedly different procedures with robust clinical outcomes.

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The influence of nutrients, biliary-pancreatic secretions, and systemic trophic hormones on intestinal adaptation in a Roux-en-Y bypass model

Cited by 80 publications

References 47 publications

Physiological Mechanisms behind Roux-en-Y Gastric Bypass Surgery

Physiological Mechanisms behind Roux-en-Y Gastric Bypass Surgery

Intestinal sweet-sensing pathways and metabolic changes after Roux-en-Y gastric bypass surgery

Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: understanding weight loss and improvements in type 2 diabetes after bariatric surgery

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