AJP - Gastrointestinal and Liver Physiology

Kwon, Yun Han; Blass, Benjamin E.; Wang, Huaqing; Grondin, Jensine A.; Banskota, Suhrid; Korzekwa, Kenneth; Ye, Min; Gordon, John C.; Colussi, Dennis; Blattner, Kevin M.; Canney, Daniel J.; Khan, Waliul I.

doi: 10.1152/ajpgi.00299.2023pmid: 38713616

Inflammatory bowel disease (IBD) encompasses a number of debilitating chronic gastrointestinal (GI) inflammatory disorders, including Crohn's disease and ulcerative colitis. In both conditions, mucosal inflammation is a key clinical presentation and is associated with altered serotonin (5-hydroxytryptamine; 5-HT) signaling. This altered 5-HT signaling is also found across various animal models of colitis. Of the 14 known receptor subtypes, 5-HT receptor type 7 (5-HT7) is one of the most recently discovered. We previously reported that blocking 5-HT signaling, with either a selective 5-HT7 receptor antagonist (SB-269970) or genetic ablation alleviated intestinal inflammation in murine experimental models of colitis. Here, we developed novel antagonists, namely MC-170073 and MC-230078, which target 5-HT7 receptors with high selectivity. We also investigated the in vivo efficacy of these antagonists in experimental colitis by utilizing dextran sulfate sodium (DSS) and the transfer of CD4+CD45RBhigh T cells to induce intestinal inflammation. Inhibition of 5-HT7 receptor signaling with the antagonists, MC-170073 and MC-230078, ameliorated intestinal inflammation in both acute and chronic colitis models, which was accompanied by lower histopathological damage and diminished levels of pro-inflammatory cytokines in comparison to vehicle-treated controls. Together, the data reveal that the pharmacological inhibition of 5-HT7 receptors by these selective antagonists ameliorates the severity of colitis across various experimental models and may, in the future, serve as a potential treatment option for patients with IBD. In addition, these findings support that 5-HT7 is a viable therapeutic target for IBD.

Jahangir, Sarah; Khatua, Biswajit; Smichi, Nabil; Rajalingamgari, Prasad; Narayana Pillai, Anoop; Summers, Megan J.; McFayden, Bryce; Kostenko, Sergiy; Gades, Naomi M.; Singh, Vijay P.

doi: 10.1152/ajpgi.00083.2024pmid: 38651230

Acute pancreatitis (AP) is a common disease with no targeted therapy and has varied outcomes ranging from spontaneous resolution to being lethal. While typically painful, AP can also be painless. Various agents, including opioids are used for pain control in AP; the risks, and benefits of which are often debated. Since experimental AP in mice is used to study the efficacy of potential therapies, we studied the effect of a commonly used opioid buprenorphine on the initiation and progression of AP. For this we administered extended-release buprenorphine subcutaneously prior to inducing the previously established severe AP model that uses Interleukins 12 and 18 (IL12,18) in genetically obese (ob/ob) mice and compared this to mice with AP but without the drug. Mice were monitored over 3 days and parameters of AP induction and progression were compared. Buprenorphine significantly reduced the serum amylase, lipase, pancreatic necrosis, and AP associated fat necrosis which is ubiquitous in obese mice and humans. Buprenorphine delayed the AP associated reduction of carotid artery pulse distention, and development of hypothermia, hastened renal injury, and muted the early increase in respiratory rate vs. IL12,18 alone. The site of buprenorphine injection appeared erythematous, inflamed, and microscopically showed thinning, loss of epidermal layers which had increased apoptosis. In summary, subcutaneous extended-release buprenorphine interfered with the induction of AP by reducing serum amylase, lipase, pancreatic and fat necrosis, the worsening of AP by delaying hypotension, hypothermia, while hastening renal injury, respiratory depression, and causing cutaneous injury at the site of injection.

Jiang, Haojie; Xie, Weidong; Chen, Qinbo; Li, Yiling; Yu, Zhen; Liu, Naxin

doi: 10.1152/ajpgi.00262.2023pmid: 38742280

Acute pancreatitis (AP) is an acute inflammatory reaction of the pancreatic tissue, which involves auto-digestion, oedema, haemorrhage, and necrosis. AP can be categorized into mild, moderately severe and severe AP, with severe pancreatitis also referred to as acute necrotizing pancreatitis (ANP). ANP is characterized by the accumulation of necrotic material in the peritoneal cavity. This can result in intestinal injury. However, the mechanism of ANP-associated intestinal injury remains unclear. We established an ANP-associated intestinal injury rat model (ANP-IR model) by injecting pancreatitis-associated ascites fluid (PAAF) and necrotic pancreatic tissue at various proportions into the triangular area formed by the left renal artery and ureter. The feasibility of the ANP-IR model was verified by comparing the similar changes in indicators of intestinal inflammation and barrier function between the two rat models. In addition, we detected changes in apoptosis levels and YAP protein expression in the ileal tissues of rats in each group and validated them in vitro in rat epithelial crypt cells (IEC-6) to further explore the potential injury mechanisms of ANP-associated intestinal injury. We also collected clinical data from patients with ANP to validate the effects of PAAF and pancreatic necrosis on intestinal injury. Our findings offer a theoretical basis for restricting the buildup of peritoneal necrosis in individuals with ANP, thus promoting the restoration of intestinal function and enhancing treatment efficacy. The use of the ANP-IR model in further studies can help us better understand the mechanism and treatment of ANP-associated intestinal injury.

Simmonds, Sam; Matthee, Ashton; Dowrick, Jarrah M.; Taberner, Andrew J.; Du, Peng; Angeli-Gordon, Timothy R.

doi: 10.1152/ajpgi.00018.2024pmid: 38772901

Introduction: Few biomarkers support diagnosis and treatment of disorders of gut-brain interaction (DGBI), although gastroduodenal junction (GDJ) electromechanical coupling is a target for novel interventions. Rhythmic 'slow waves', generated by interstitial cells of Cajal (ICC), and myogenic 'spikes' are bioelectrical mechanisms underpinning motility. In this study, simultaneous in-vivo high-resolution electrophysiological and impedance planimetry measurements were paired with immunohistochemistry to elucidate GDJ electromechanical coupling. Methods: Following ethical approval, the GDJ of anaesthetized pigs (N=12) was exposed. Anatomically-specific, high-resolution electrode arrays (256 electrodes) were applied to the serosa. EndoFLIP catheters (16 electrodes; Medtronic, MN, USA) were positioned luminally to estimate diameter. Post-mortem tissue samples were stained with Masson's trichrome and Ano1 to quantify musculature and ICC. Results: Electrical mapping captured slow-waves (N=512) and spikes (N=1071). Contractions paralleled electrical patterns. Localized slow waves and spikes preceded rhythmic contractions of the antrum, and non-rhythmic contractions of the duodenum. Slow-wave and spike amplitudes were correlated in the antrum (r=0.74, p<0.001) and duodenum (r=0.42, p<0.001). Slow-wave and contractile amplitudes were correlated in the antrum (r=0.48, p<0.001) and duodenum (r=0.35, p<0.001). Distinct longitudinal and circular muscle layers of the antrum and duodenum had a total thickness of (2.8 ± 0.9) mm and (0.4 ± 0.1) mm, respectively. At the pylorus, muscle layers merged and thickened to (3.5 ± 1.6) mm. Pyloric myenteric ICC covered less area (1.5 ± 1.1 %) compared to the antrum (4.2 ± 3.0 %) and duodenum (5.3 ± 2.8 %). Conclusions: Further characterization of electromechanical coupling and ICC biopsies may generate DGBI biomarkers.

Edmonds, Chloe E.; Robbins, Kaitlyn N.; Dvorak, Elizabeth G.; Howe, Stephen P.; Sheldon, Sarah A.; Mayerl, Christopher J.; Owairu, Brianna A.; Young, Brady M.; German, Rebecca Z.

doi: 10.1152/ajpgi.00027.2024pmid: 38772905

The neural connectivity among the oral cavity, pharynx, and esophagus is a critical component of infant feeding physiology. Central integration of oral and pharyngeal afferents alters motor outputs to structures that power swallowing, but the potential effects of esophageal afferents on pre-esophageal feeding physiology are unclear. These effects may explain the prevalence of oropharyngeal dysphagia in infants suffering from gastroesophageal reflux (GER), though the mechanism underlying this relationship remains unknown. Here we use the validated infant pig model to assess the impacts of simulated GER on pre-esophageal feeding parameters. We used high-speed videofluoroscopy and electromyography to record bottle-feeding prior to and following infusion of a capsaicin-containing solution into the lower esophagus. Sucking parameters were minimally affected by capsaicin exposure, such that genioglossus activity was unchanged and tongue kinematics were largely unaffected. Aspects of the pharyngeal swallow were altered with simulated GER, including increased thyrohyoid muscle activity, increased excursions of the hyoid and thyroid per swallow, decreased swallow frequency, and increased bolus sizes. These results suggest that esophageal afferents can elicit changes in pharyngeal swallowing. Additionally, decreased swallowing frequency may be the mechanism by which esophageal pathologies induce oropharyngeal dysphagia. While recent work indicates that oral or pharyngeal capsaicin may improve dysphagia symptoms, the decreased performance following esophageal capsaicin exposure highlights the importance of designing sensory interventions based upon neurophysiology and the mechanisms underlying disordered feeding. This mechanistic approach requires comprehensive data collection across the entirety of the feeding process, which can be achieved using models such as the infant pig.

Butt, Elke; Günder, Thorsten; Stürzebecher, Paulina; Kowalski, Isabel; Schneider, Pia; Buschmann, Nils; Schäfer, Sarah; Bender, Alicia; Hermanns, Heike M.; Zernecke, Alma

doi: 10.1152/ajpgi.00222.2023pmid: 38713618

Cholesterol is essential for the stability and architecture of the plasma membrane and a precursor of bile acids and steroid hormones in mammals. Excess dietary cholesterol uptake leads to hypercholesterolaemia, atherosclerosis and plays a role in cancer development. The role of actin-binding scaffolding protein LIM and SH3 protein 1 (LASP1) in cholesterol trafficking has not been investigated previously. Cholesterol levels, its uptake and excretion were studied in mice deficient for low density lipoprotein receptor and Lasp1 (Ldlr-/-Lasp1-/- mice) upon feeding a high fat diet, and in LASP1-knockdown, differentiated human intestinal epithelial Caco-2 cells. Compared to diet-fed Ldlr-/- control mice, Ldlr-/-Lasp1-/- mice displayed a reduction in serum cholesterol levels. Mechanistically, we identified a new role of LASP1 in controlling the translocation of the intestinal cholesterol transporter Niemann-Pick C1-like 1 (NPC1L1) to the apical cell surface, which was limited in LASP1-knockdwon human CaCo-2 enterocytes and in the intestine of Ldlr-/- Lasp1-/- compared to Ldlr-/- mice, linked to LASP1-pAKT signaling but not CDC42 activation. In line, a reduction in cholesterol reabsorption was noted in LASP1-knockdown CaCo-2 cells in vitro, and an enhanced cholesterol excretion via the feces was observed in Ldlr-/- Lasp1-/- mice. These data uncover a novel function of Lasp1 in cholesterol trafficking, promoting cholesterol reabsorption in the intestine. Targeting LASP1 locally could thus represent a novel targeting strategy to ameliorate hypercholesterolemia and associated diseases.

Seidelin, Jakob B.; Bronze, Mariana; Poulsen, Anja; Attauabi, Mohamed; Woetmann, Anders; Mead, Benjamin E.; Karp, Jeffrey M.; Riis, Lene B.; Bjerrum, Jacob T.

doi: 10.1152/ajpgi.00074.2024pmid: 38713614

Although impaired regeneration is important in many gastrointestinal diseases including ulcerative colitis (UC), the dynamics of mucosal regeneration in humans are poorly investigated. We have developed a model to study these processes in vivo in humans. Epithelial restitution (ER) and extracellular matrix (ECM) regulation after an experimental injury of the sigmoid colonic mucosa was assessed by repeated high resolution endoscopic imaging, histologic assessment, RNA sequencing, deconvolution analysis, and 16S rDNA sequencing of the injury niche microbiome of 19 UC patients in remission and 20 control subjects. Human ER had a 48-hour lag before induction of regenerative epithelial cells (WAE and TA cells) along with increase of fibroblast derived stem cell growth factor Gremlin 1 mRNA (GREM1). However, in UC deconvolution data showed aby rapid induction of inflammatory fibroblasts, and upregulation of major structural ECM collagen mRNAs and along with tissue inhibitor of metalloproteinase 1 (TIMP1) suggesting increased profibrotic ECM deposition. No change was seen in transforming growth factor β (TGFβ) mRNA whereas and the profibrotic cytokines interleukin 13 (IL13) and IL11 were upregulated in UC suggesting that human post injury responses could be TGFβ-independent. In conclusion, we found distinct regulatory layers of regeneration in the normal human colon and a potential targetable profibrotic dysregulation in UC that could lead to long-term end organ failure - i.e., intestinal damage.

Hellen, Dominick J.; Fay, Meredith E.; Lee, David H.; Klindt-Morgan, Caroline; Bennett, Ashley; Pachura, Kimberly J.; Grakoui, Arash; Huppert, Stacey S.; Dawson, Paul A.; Lam, Wilbur A.; Karpen, Saul J.

doi: 10.1152/ajpgi.00058.2024pmid: 38651949

The progress of research focused on cholangiocytes and the biliary tree during development and following injury is hindered by limited available quantitative methodologies. Current techniques include two-dimensional standard histological cell-counting approaches, which are rapidly performed error-prone and lack architectural context; or three-dimensional analysis of the biliary tree in opacified livers, which introduce technical issues along with minimal quantitation. The present study aims to fill these quantitative gaps with a supervised machine learning model (BiliQML) able to quantify biliary forms in the liver of anti-Keratin 19 antibody-stained whole slide images. Training utilized 5,019 researcher-labeled biliary forms, which following feature selection, and algorithm optimization, generated an F-score of 0.87. Application of BiliQML on seven separate cholangiopathy models; genetic (Afp-CRE;Pkd1l1null/Fl, Alb-CRE;Rbp-jkfl/fl, Albumin-CRE; ROSANICD), surgical (bile duct ligation), toxicological (3,5-diethoxycarbonyl-1,4-dihydrocollidine), and therapeutic (Cyp2c70-/- with ileal bile acid transporter inhibition), allowed for a means to validate the capabilities, and utility of this platform. The results from BiliQML quantification revealed biological and pathological differences across these seven diverse models indicate a highly sensitive, robust, and scalable methodology for the quantification of distinct biliary forms. BiliQML is the first comprehensive machine-learning platform for biliary form analysis, adding much needed morphologic context to standard immunofluorescence - based histology, and provides clinical and basic-science researchers a novel tool for the characterization of cholangiopathies.

Sabui, Subrata; Anthonymuthu, Selvaraj; Ramamoorthy, Kalidas; Skupsky, Jonathan; Jennings, Tara Sinta Kartika; Rahmatpanah, Farah; Fleckenstein, James M.; Said, Hamid M.

doi: 10.1152/ajpgi.00065.2024pmid: 38713615

Humans/mammals obtain vitamin B1 from dietary and gut microbiota sources. Considerable amount of the microbiota generated vitamin exists in the form of thiamine pyrophosphate (TPP), and colonocytes are capable of absorbing TPP via a specific carrier-mediated process that involves the colonic TPP transporter (cTPPT; encoded by SLC44A4). Little is known about the relative contribution of SLC44A4 toward total colonic carrier-mediated TPP uptake, and its role in colon physiology. To address these issues, we generated an Slc44a4 knockout (KO) mouse model (by Cre-Lox recombination) and found a near complete inhibition in colonic carrier-mediated 3H-TPP uptake in the Slc44a4 KO compared to Wild-type-littermates (WT). We also observed a significant reduction in KO mice body weight and a shortening of their colon compared to WT. Using RNAseq and Ingenuity Pathway Analysis (IPA) approaches, we found that knocking out the colonic Slc44a4 to lead to changes in level of expression of many genes, including up-regulation in those associated with intestinal inflammation/colitis. Finally, we found that the Slc44a4 KO mice to be more susceptible to the effect of the colitogenic dextran sodium sulfate (DSS) compared to WT animals, a finding that lends support to the recent prediction by multiple genome-wide association studies (GWAS) that the SLC44A4 is a possible colitis susceptibility gene. In summary, results of these investigations show that the Slc44a4 is the predominant/only transporter involved in colonic uptake of TPP, that the transporter is important for colon physiology, and that its deletion increases susceptibility to inflammation.

Lim, Alexandria H.; Varghese, Chris; Sebaratnam, Gabrielle H.; Schamberg, Gabriel; Calder, Stefan; Gharibans, Armen A.; Andrews, Christopher N.; Foong, Daphne; Ho, Vincent; Ishida, Shunichi; Imai, Yohsuke; Wise, Michelle R.; O’Grady, Greg

doi: 10.1152/ajpgi.00216.2023pmid: 38713629

Chronic gastroduodenal symptoms disproportionately affect females of childbearing age; however, the effect of menstrual cycling on gastric electrophysiology is poorly defined. To establish the effect of the menstrual cycle on gastric electrophysiology, healthy subjects underwent non-invasive Body Surface Gastric Mapping (BSGM; 8x8 array), with validated symptom logging App (Gastric AlimetryⓇ, New Zealand). Participants were premenopausal females in follicular (n=26) and luteal phases (n=18). Postmenopausal females (n=30) and males (n=51) were controls. Principal gastric frequency (PGF), BMI-adjusted amplitude, Gastric Alimetry Rhythm Index (GA-RI), fasted-fed amplitude ratio (ff-AR), meal response curves, and symptom burden were analysed. Menstrual cycle-related electrophysiological changes were then transferred to an established anatomically-accurate computational gastric fluid dynamics model (meal viscosity 0.1 Pas), to predict the impact on gastric mixing and emptying. PGF was significantly higher in the luteal vs. follicular phase (mean 3.21 cpm, SD (0.17) vs. 2.94 cpm, SD (0.17), p<0.001) and vs. males (3.01 cpm, SD (0.2), p<0.001). In the computational model, this translated to 8.1% higher gastric mixing strength and 5.3% faster gastric emptying for luteal versus follicular phases. Postmenopausal females also exhibited higher PGF than females in the follicular phase (3.10 cpm, SD (0.24) vs. 2.94 cpm, SD (0.17), p=0.01), and higher BMI-adjusted amplitude (40.7 µV (33.02-52.58) vs. 29.6 µV (26.15-39.65), p<0.001), GA-RI (0.60 (0.48-0.73) vs. 0.43 (0.30-0.60), p=0.005), and ff-AR (2.51 (1.79-3.47) vs. 1.48 (1.21-2.17), p=0.001) than males. There were no differences in symptoms. These results define variations in gastric electrophysiology with regard to human menstrual cycling and menopause.