Basic Research
Copyright ©The Author(s) 2003. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 15, 2003; 9(12): 2776-2781
Published online Dec 15, 2003. doi: 10.3748/wjg.v9.i12.2776
Alterations of intestinal mucosa structure and barrier function following traumatic brain injury in rats
Chun-Hua Hang, Ji-Xin Shi, Jie-Shou Li, Wei Wu, Hong-Xia Yin
Chun-Hua Hang, Ji-Xin Shi, Wei Wu, Hong-Xia Yin, Medical College of Nanjing University; Department of Neurosurgery, Jinling Hospital, Nanjing 210002, Jiangsu Province, China
Jie-Shou Li, Research Institute of General Surgery, Jinling Hospital, Clinical School of Medicine, Nanjing University, Nanjing 210002, Jiangsu Province, China
Author contributions: All authors contributed equally to the work.
Supported by the Scientific Research Foundation of the Chinese PLA Key Medical Programs during the 10th Five-Year Plan Period, No. 01Z011
Correspondence to: Chun-Hua Hang, Department of Neurosurgery, Jinling Hospital, 305 East Zhongshan Road, Nanjing 210002, Jiangsu Province, China.
Telephone: +86-25-4597342 Fax: +86-25-4810987
Received: July 12, 2003
Revised: July 19, 2003
Accepted: July 30, 2003
Published online: December 15, 2003

AIM: Gastrointestinal dysfunction is a common complication in patients with traumatic brain injury (TBI). However, the effect of traumatic brain injury on intestinal mucosa has not been studied previously. The aim of the current study was to explore the alterations of intestinal mucosa morphology and barrier function, and to determine how rapidly the impairment of gut barrier function occurs and how long it persists following traumatic brain injury.

METHODS: Male Wistar rats were randomly divided into six groups (6 rats each group) including controls without brain injury and traumatic brain injury groups at hours 3, 12, 24, and 72, and on day 7. The intestinal mucosa structure was detected by histopathological examination and electron microscopy. Gut barrier dysfunction was evaluated by detecting serum endotoxin and intestinal permeability. The level of serum endotoxin and intestinal permeability was measured by using chromogenic limulus amebocyte lysate and lactulose/mannitol (L/M) ratio, respectively.

RESULTS: After traumatic brain injury, the histopathological alterations of gut mucosa occurred rapidly as early as 3 hours and progressed to a serious state, including shedding of epithelial cells, fracture of villi, focal ulcer, fusion of adjacent villi, dilation of central chyle duct, mucosal atrophy, and vascular dilation, congestion and edema in the villous interstitium and lamina propria. Apoptosis of epithelial cells, fracture and sparseness of microvilli, loss of tight junction between enterocytes, damage of mitochondria and endoplasm, were found by electron microscopy. The villous height, crypt depth and surface area in jejunum decreased progressively with the time of brain injury. As compared with that of control group (183.7 ± 41.8 EU/L), serum endotoxin level was significantly increased at 3, 12, and 24 hours following TBI (434.8 ± 54.9 EU/L, 324.2 ± 61.7 EU/L and 303.3 ± 60.2 EU/L, respectively), and peaked at 72 hours (560.5 ± 76.2 EU/L), then declined on day 7 (306.7 ± 62.4 EU/L, P < 0.01). Two peaks of serum endotoxin level were found at hours 3 and 72 following TBI. L/M ratio was also significantly higher in TBI groups than that in control group (control, 0.0172 ± 0.0009; 12 h, 0.0303 ± 0.0013; 24 h, 0.0354 ± 0.0025; 72 h, 0.0736 ± 0.0105; 7 d, 0.0588 ± 0.0083; P < 0.01).

CONCLUSION: Traumatic brain injury can induce significant damages of gut structure and impairment of barrier function which occur rapidly as early as 3 hours following brain injury and lasts for more than 7 days with marked mucosal atrophy.

Keywords: $[Keywords]