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Previous issue date: 2011-09-05 / Diversion colitis is a chronic inflammatory process affecting the dysfunctional
colon, after a colostomy. It is postulated that nutritional deficiency of the colonic
epithelium by the absence of short-chain fatty acids (SCFA) is one of the factors
responsible for the appearance of DC and that their employment could reverse
the morphological changes of the mucosa. The treatment of choice for fecal
diversion colitis (DC) is the reconstruction of the intestinal tract, although they
suggested therapeutic options using enemas. This study evaluates the effect of
SCFA in atrophy and inflammation in excluded colonic segments before and
after the installation DC. Forty Wistar rats were divided into four groups (n = 10
for each group), submitted colostomy with distal colon exclusion. Two control
groups (A1 and B1) received rectally administered physiological saline, whereas
two experimental groups (A2 and B2) received rectally administered short-chain
fatty-acids. The A groups were prophylactically treated (5th to 40th days
postoperatively), whereas the B groups were therapeutically treated (after postoperative
day 40), for 07 days. Histological sections stained with HE were used
for histological analysis of the thickness of the colonic mucosa excluded (t-
Student p ≤0.05). Inflammatory reaction of the lamina propria and mucosa were
measured with scores previously established (Mann Whitney p ≤ 0.05). There
was a significant thickness recovery of the colonic mucosa in group B2 animals
(p = 0.0001), which also exhibited a significant reduction in the number of
eosinophilic polymorphonuclear cells in the lamina propria (p = 0.0126) and in
the intestinal lumen (p = 0.0256). Group A2 did not prevent the mucosal atrophy
and significant increases in the numbers of lymphocytes (p=0.0006) and
50
eosinophilic polymorphonuclear cells in the lamina propria of the mucosa (p =
0.0022). Therapeutic use of short-chain fatty-acids significantly reduced
eosinophilic polymorphonuclear cell numbers in the intestinal wall and in the
colonic lumen; it also reversed the atrophy of the colonic mucosa. Prophylactic
use did not impede the development of mucosal atrophy / Colite de deriva??o fecal (CD) ? um processo inflamat?rio cr?nico que acomete
o segmento intestinal desfuncionalizado, ap?s a confec??o de colostomia.
Postula-se que a defici?ncia nutricional do epit?lio col?nico pela aus?ncia de
?cidos graxos de cadeia curta (AGCC) seja um dos fatores respons?veis pelo
surgimento da CD e que o emprego deles poderia reverter as altera??es
morfol?gicas da mucosa. O tratamento de elei??o para a colite por deriva??o
fecal (CD) ? a reconstru??o do tr?nsito intestinal, embora sejam sugeridas
terap?uticas opcionais empregando enemas. O presente estudo visou estudar
o efeito dos AGCC na atrofia e inflama??o de segmentos col?nicos exclu?dos,
antes e depois da instala??o da CD. Quarenta ratos Wistar foram divididos em
quatro grupos (n=10 para cada grupo), todos submetidos a colostomia com
exclus?o do c?lon distal. Nos dois grupos controle instilou-se solu??o salina
0,9% por via retal (grupos A1 e B1) e nos dois grupos teste (grupos A2 e B2)
AGCC foram instilados por via retal. O grupo A foi submetido a interven??o
profil?tica, entre o 5? e o 40? dia de p?s-operat?rio (DPO), enquanto o grupo B
foi submetido a interven??o terap?utica a partir o 40? DPO, durante 07 dias.
Sec??es histol?gicas coradas com HE foram usadas para an?lise histol?gica
da espessura da mucosa do c?lon exclu?do (t de Student com p≤0,05). Rea??o
inflamat?ria da l?mina pr?pria e mucosa foi quantificada com escores
previamente estabelecidos (teste de Mann Whitney p≤0,05). Houve significante
recupera??o da espessura da mucosa col?nica dos animais do grupo B2
(p=0,0001), que, tamb?m, apresentou significativa redu??o da presen?a de
xii
polimorfonucleares eosin?filos (PNE) na l?mina pr?pria (p=0,0126) e na luz
intestinal (p=0,0256). O Grupo A2 n?o preveniu a atrofia da mucosa e mostrou
significativo aumento do n?mero de linf?citos (p = 0.0006) e da quantidade de
PNE na l?mina pr?pria da mucosa (p = 0.0022). Concluiu-se que o emprego
terap?utico de AGCC reduz significativamente o n?mero de polimorfonucleares
eosin?filos na parede intestinal e na luz do c?lon, e tamb?m reverte a atrofia da
mucosa col?nica. Entretanto, o emprego profil?tico dos AGCC n?o impede o
desenvolvimento da atrofia da mucosa
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/13233 |
| Date | 05 September 2011 |
| Creators | Oliveira, Ariano Jose Freitas de |
| Contributors | CPF:04045599487, http://lattes.cnpq.br/2365612055067945, Maranhao, H?lcio de Sousa, CPF:44435762404, http://lattes.cnpq.br/3263555213414154, Ara?jo Filho, Irami, CPF:91619300400, http://lattes.cnpq.br/3975706297235540, Carvalho, Maria Goretti Freire de, CPF:05601592420, http://lattes.cnpq.br/8934375314306198, Paiva, Daurita Darci de, CPF:04619331449, http://lattes.cnpq.br/9828765471259692, Ramos, Ana Maria de Oliveira |
| Publisher | Universidade Federal do Rio Grande do Norte, Programa de P?s-Gradua??o em Ci?ncias da Sa?de, UFRN, BR, Ci?ncias da Sa?de |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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