Response of the intestinal mucosa to ischaemia.
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Progress reportResponse of the intestinal mucosa to ischaemiaThe small intestinal mucosa is particularly sensitive to ischaemia, but it also possesses a tremendous regenerative potential.The mucosa of the colon is less easily destroyed by a reduction in the blood supply, but, once damaged, it recovers imore slowly.In these pages we shall review the various structural and functional studies, performed in experi- mental animals, that have contributed to our understanding of the response of these epithelia to dfifferent degrees of ischaemia.Disruption of small intestinal mucosa during ischaemia Structural damage to the small intestinal mucosa is observed remark- ably rapidly after the onset of an ischaemic accident.Ultrastructural investigations have revealed alterations in the microvilli of the cells at the villus tips three to five minutes after the onset of total circulatory arrest affecting a loop of rat or dog small intestine.1-3At the light microscope level, the first visible lesions consist of a detachment of the cells, particularly in the apical regions of the villi, from the basement membrane, with the formation of subepithelial blebs.4-6Numerous authors have described the development of the morphological changes in the small intestinal mucosa on prolongation of the ischaemic trauma, both with the aid of the light microscope4 7-9 and with the electron microscope.' 2 610 After a total ischaemia of 30 minutes in the rat or of 60 minutes in the dog (Figure ), the upper two-thirds of the villi are completely denuded of epithelial cells, whereas the lower reaches of the villi and the crypts remain relatively intact.9" 1 Certain investiga- tors have claimed that rat crypt cells are already damaged after an ischaemia of 30 minutes,5 whereas others have reported lesions in these structures only after a circulatory arrest of one hour'2 or even two hours.'3With this single exception, there has been good agreement between the different groups of investigators on the course of mucosal destruction; only those authors who left the collateral circulation in- tact'4 have described a markedly slower rate of tissue disruption.The structural alterations that occur in the intestinal mucosa during shock are similar to those observed in acute ischaemia, as the splanchnic cir- culation is greatly reduced in such circumstances.Fewer investigations have been devoted to functional studies of the mucosa during ischaemia, but those which exist have emphasised the good correlation between structural and functional characteristics after thiis trauma.Guthrie and Quastel"5 published the first study of the function in vitro of an intestine excised from a guinea-pig suffering from shock or of an intestinal loop that had been rendered ischaemic for 512on August 19, 2023 by guest.
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The small bowel mucosa is more sensitive to ischemia as compared to colonic mucosa but it has tremendous regenerative potential.
“The small bowel mucosa is more sensitive to ischemia as compared to colonic mucosa but it has tremendous regenerative potential.”
From Ischemic bowel disease in 2021. (2021) · cites this paper as [15]
Colonic mucosa is less easily damaged by ischemia but once destroyed, slow recovery occurs.
“On the other hand, colonic mucosa is less easily damaged by ischemia but once destroyed, slow recovery occurs[15].”
From Ischemic bowel disease in 2021. (2021) · cites this paper as [15]
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- Authors
- Robinson, J. W., Mirkovitch, V, Winistörfer, B., & Saegesser, F.
- Venue
- Gut
- Publisher
- BMJ
- Published
- 1981-06
- Volume
- 22
- Issue
- 6
- Pages
- 512-527
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- PMC
- PMC1419258
- OpenAlex
- W1971505965
- Cited by
- 92
- References
- 68
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 1 · 2020: 1 · 2019: 2 · 2018: 3 · 2017: 4 · 2016: 3 · 2015: 2 · 2014: 3 · 2013: 5 · 2012: 1
- FWCI
- 0.35
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gut (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
- Health Sciences › Medicine › Pathology and Forensic Medicine › Cardiac Ischemia and Reperfusion
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Digestive system and related health
- Keywords
- intestinal mucosa, intestinal ischemia, small intestine, colon, mucosal regeneration, crypt cells, circulatory arrest, splanchnic circulation, intestinal blood flow, intestinal permeability, intestinal secretion, intestinal motility, shock, ischemic injury
- MeSH terms
- Animals, Colon, Dogs, Glucose, Intestinal Mucosa, Intestine, Small, Ischemia, Oxygen, Regeneration, Sodium, Time Factors, Water, Rats
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