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Mucosal changes induced by ischemia–reperfusion injury in a jejunal loop transplanted in oropharynx

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Abstract

Tissues exposed to ischemia and reperfusion develop an inflammatory response. We investigate the morphological and immunological changes occurring in the mucosa of a jejunal loop transplanted in the oropharynx of a man undergoing circular pharyngolaryngectomy. Jejunal biopsies were collected during the transplantation procedures (cold and warm ischemia, reperfusion), during the 7 post-operative days through an exteriorized jejunal segment for flap monitoring, and 45 days after transplantation through an upper endoscopy. Matrix metalloproteinase (MMP)-3 and MMP-12 increase was accompanied by a parallel rise in apoptotic enterocytes, and by a concomitant reduction of surface area to volume ratio and enterocyte height. Goblet cell hyperplasia is coupled with Paneth cell disappearance at the crypt base. CD8-positive intraepithelial lymphocytes initially decrease, then they increase in accordance with the peak of enterocyte apoptosis. We identified alterations in lymphocyte infiltration, mucosal architecture and epithelial cell turnover, which may give a window to mechanisms of small bowel ischemia–reperfusion in humans.

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Abbreviations

IEL:

Intraepithelial lymphocyte

IL:

Interleukin

LPMC:

Lamina propria mononuclear cell

MMP:

Matrix metalloproteinase

SV:

Surface area to volume ratio

TUNEL:

Terminal deoxynucleotidyltransferase-mediated digoxigenin-deoxyuridine triphosphate nick end labeling

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Authors and Affiliations

  1. First Department of Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Piazzale Golgi 19, 27100, Pavia, Italy

    Antonio Di Sabatino, Laura Brunetti, Paolo Biancheri, Rachele Ciccocioppo, Marco Guerci, Francesca Vidali & Gino R. Corazza

  2. Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy

    Claudia Casella & Marco Benazzo

  3. Centre for Immunology and Infectious Disease, Blizard Institute of Cell and Molecular Science, Barts and the London School of Medicine and Dentistry, London, UK

    Thomas T. MacDonald

Authors
  1. Antonio Di Sabatino
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  2. Laura Brunetti
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  3. Paolo Biancheri
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  4. Rachele Ciccocioppo
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  9. Marco Benazzo
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  10. Gino R. Corazza
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Correspondence to Antonio Di Sabatino.

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Di Sabatino, A., Brunetti, L., Biancheri, P. et al. Mucosal changes induced by ischemia–reperfusion injury in a jejunal loop transplanted in oropharynx. Intern Emerg Med 8, 317–325 (2013). https://doi.org/10.1007/s11739-011-0615-6

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  • DOI: https://doi.org/10.1007/s11739-011-0615-6

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