Ру-ан-Y желудка обходного операции у крыс
Summary
Многочисленные исследования с использованием моделей желудка крыс обхода были недавно проведены, чтобы раскрыть основные физиологические механизмы Ру-ан-Y желудка операции шунтирования. Эта статья призвана продемонстрировать и обсудить технические и экспериментальные детали нашего опубликованы желудка модель крысы обход, чтобы понять преимущества и недостатки этого экспериментального инструмента.
Abstract
Currently, the most effective therapy for the treatment of morbid obesity to induce significant and maintained body weight loss with a proven mortality benefit is bariatric surgery1,2. Consequently, there has been a steady rise in the number of bariatric operations done worldwide in recent years with the Roux-en-Y gastric bypass (gastric bypass) being the most commonly performed operation3. Against this background, it is important to understand the physiological mechanisms by which gastric bypass induces and maintains body weight loss. These mechanisms are yet not fully understood, but may include reduced hunger and increased satiation4,5, increased energy expenditure6,7, altered preference for food high in fat and sugar8,9, altered salt and water handling of the kidney10 as well as alterations in gut microbiota11. Such changes seen after gastric bypass may at least partly stem from how the surgery alters the hormonal milieu because gastric bypass increases the postprandial release of peptide-YY (PYY) and glucagon-like-peptide-1 (GLP-1), hormones that are released by the gut in the presence of nutrients and that reduce eating12.
During the last two decades numerous studies using rats have been carried out to further investigate physiological changes after gastric bypass. The gastric bypass rat model has proven to be a valuable experimental tool not least as it closely mimics the time profile and magnitude of human weight loss, but also allows researchers to control and manipulate critical anatomic and physiologic factors including the use of appropriate controls. Consequently, there is a wide array of rat gastric bypass models available in the literature reviewed elsewhere in more detail 13-15. The description of the exact surgical technique of these models varies widely and differs e.g. in terms of pouch size, limb lengths, and the preservation of the vagal nerve. If reported, mortality rates seem to range from 0 to 35%15. Furthermore, surgery has been carried out almost exclusively in male rats of different strains and ages. Pre- and postoperative diets also varied significantly.
Technical and experimental variations in published gastric bypass rat models complicate the comparison and identification of potential physiological mechanisms involved in gastric bypass. There is no clear evidence that any of these models is superior, but there is an emerging need for standardization of the procedure to achieve consistent and comparable data. This article therefore aims to summarize and discuss technical and experimental details of our previously validated and published gastric bypass rat model.
Protocol
Discussion
Ру-ан-Y желудка обойти процедуры у человека был впервые описан в 1967 году Мейсон и изменение в его нынешнем виде на Торреса в 1983 году 19. В настоящее время процедура состоит из небольшой мешочек желудка и обход проксимальных отделах тонкого кишечника. Схематическое изображение пред-…
Disclosures
The authors have nothing to disclose.
Acknowledgements
Марко Bueter и Флориан Сейфрид были поддержаны Deutsche Forschungsgemeinschaft (DFG). Томас Лутц при поддержке Швейцарского Национального исследовательского фонда (ОЯТ). Марко Bueter и Томас Лутц дальнейшем получать финансирование от Национального института здоровья (NIH) и от центра Цюриха интегративной физиологии человека (ЗКМП). Карел W Ле Ру была поддержана Министерством здравоохранения Клинические награды ученым. Имперского колледжа в Лондоне получает поддержку от исследований NIHR биомедицинских схема финансирования центра.
Materials
| Generic name | Brand name | Company | Catalogue number |
| Enrofloxacin | Baytril 2.5% | Provet AG | 1036 |
| Flunixin | Finadyne | Graeub | 908040 |
| Buprenorphin | Temgesic | Reckitt Benckiser | 138976 |
| Isoflurane | IsoFlo | Graeub | 902035 |
| Vitamin A | Vitagel | Bausch & Lomb | 690 |
| Iodine solution | Betadine | Mundipharma | 111141 |
| NaCl 0.9% | NaCl 0.9% | B. Braun | 534534 |
Table 1. Drugs.
| Name | Size | Company | Catalogue number |
| PDS II | 4-0 | Ethicon | Z924H |
| PDS II | 5-0 | Ethicon | Z925H |
| PDS II | 6-0 | Ethicon | PUU2971E |
| PDS II | 7-0 | Ethicon | Z1370E |
| Vicryl | 4-0 | Ethicon | V451H |
Table 2. Sutures.
| Name | Company | Catalogue number |
| Scalpel handle No. 3 | Aesculap | BB073R |
| Scalpel blades No. 10 | Swann-Morton | 0301 |
| Needle holder | Aesculap | BM124R |
| Tissue forceps | Aesculap | BD555R |
| Metzenbaum scissors, straight | Aesculap | BC022R |
| Metzenbaum scissors, curved | Aesculap | BC023R |
| Delicate scissors, curved | Aesculap | BC061R |
| Artery forceps, curved | Aesculap | BH109R |
| Artery forceps, curved, 1×2 teeth | Aesculap | BH121R |
| Probe, double-ended | Aesculap | BN113R |
| Micro needle holder | Aesculap | FM 541R |
| Micro forceps | Aesculap | FM571R |
| Micro scissors | Aesculap | FM470R |
| Disposable eye cautery | John Weiss International | 0111122 |
| Cotton buds | Hartmann AG | 9679369 |
Table 3. Surgical equipment.
References
- Adams, T. D., Gress, R. E., Smith, S. C. Long-term mortality after gastric bypass surgery. N. Engl. J. Med. 357, 753-761 (2007).
- Sjostrom, L., Lindroos, A. K., Peltonen, M. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N. Engl. J. Med. 351, 2683-2693 (2004).
- Buchwald, H., Oien, D. M. Metabolic/bariatric surgery Worldwide. Obes. Surg. 19, 1605-1611 (2008).
- Welbourn, R., Werling, M. Gut hormones as mediators of appetite and weight loss after Roux-en-Y gastric bypass. Ann. Surg. 246, 780-785 (2007).
- le Roux, C. W., Aylwin, S. J., Batterham, R. L. Gut hormone profiles following bariatric surgery favor an anorectic state, facilitate weight loss, and improve metabolic parameters. Ann. Surg. 243, 108-114 (2006).
- Bueter, M., Lowenstein, C., Olbers, T. Gastric bypass increases energy expenditure in rats. Gastroenterology. 138, 1845-1853 (2010).
- Stylopoulos, N., Hoppin, A. G., Kaplan, L. M. Roux-en-Y Gastric Bypass Enhances Energy Expenditure and Extends Lifespan in Diet-induced Obese Rats. Obesity (Silver Spring). 17, 1839-1847 (2009).
- Bueter, M., Miras, A. D., Chichger, H. Alterations of sucrose preference after Roux-en-Y gastric bypass. Physiol. Behav. 104, 709-721 (2011).
- le Roux, C. W., Bueter, M., Theis, N. Gastric bypass reduces fat intake and preference. Am. J. Physiol. Regul. Integr. Comp. Physiol. 301, 1057-1066 (2011).
- Bueter, M., Ashrafian, H., Frankel, A. H. Sodium and water handling after gastric bypass surgery in a rat model. Surg. Obes. Relat. Dis. 7, 68-73 (2011).
- Li, J. V., Ashrafian, H., Bueter, M. Metabolic surgery profoundly influences gut microbial-host metabolic cross-talk. Gut. 60, 1214-1223 (2011).
- Ashrafian, H., le Roux, C. W. Metabolic surgery and gut hormones – a review of bariatric entero-humoral modulation. Physiol. Behav. 97, 620-631 (2009).
- Ashrafian, H., Bueter, M., Ahmed, K. Metabolic surgery: an evolution through bariatric animal models. Obes. Rev. 11, 907-920 (2010).
- Rao, R. S., Rao, V., Kini, S. Animal models in bariatric surgery–a review of the surgical techniques and postsurgical physiology. Obes. Surg. 20, 1293-1305 (2010).
- Seyfried, F., le Roux, C. W., Bueter, M. Lessons learned from gastric bypass operations in rats. Obes. Facts. 4, 3-12 (2011).
- Fenske, W. K., Bueter, M., Miras, A. D. Exogenous peptide YY3-36 and Exendin-4 further decrease food intake, whereas octreotide increases food intake in rats after Roux-en-Y gastric bypass. Int. J. Obes. (Lond). , (2011).
- Kreymann, B., Williams, G., Ghatei, M. A. Glucagon-like peptide-1 7-36: a physiological incretin in man. Lancet. 2, 1300-1304 (1987).
- le Roux, C. W., Batterham, R. L., Aylwin, S. J. Attenuated peptide YY release in obese subjects is associated with reduced satiety. Endocrinology. 147, 3-8 (2006).
- Torres, J. C., Oca, C. F., Garrison, R. N. Gastric bypass: Roux-en-Y gastrojejunostomy from the lesser curvature. South Med. J. 76, 1217-1221 (1983).
- Guijarro, A., Suzuki, S., Chen, C. Characterization of weight loss and weight regain mechanisms after Roux-en-Y gastric bypass in rats. Am. J. Physiol. Regul. Integr. Comp. Physiol. 293, R1474-R1489 (2007).
- Roberts, K., Duffy, A., Kaufman, J. Size matters: gastric pouch size correlates with weight loss after laparoscopic Roux-en-Y gastric bypass. Surg. Endosc. 21, 1397-1402 (2007).
- Hajnal, A., Kovacs, P., Ahmed, T. Gastric bypass surgery alters behavioral and neural taste functions for sweet taste in obese rats. Am. J. Physiol. Gastrointest. Liver Physiol. 299, G967-G979 (2010).
- Shin, A. C., Zheng, H., Pistell, P. J. Roux-en-Y gastric bypass surgery changes food reward in rats. Int. J. Obes. (Lond). 35, 642-651 (2011).
- Tichansky, D. S., Rebecca, G. A., Madan, A. K. Decrease in sweet taste in rats after gastric bypass surgery. Surg. Endosc. 25, 1176-1181 (2011).
- Olbers, T., Lonroth, H., Fagevik-Olsen, M. Laparoscopic gastric bypass: development of technique, respiratory function, and long-term outcome. Obes. Surg. 13, 364-370 (2003).
- Madan, A. K., Harper, J. L., Tichansky, D. S. Techniques of laparoscopic gastric bypass: on-line survey of American Society for Bariatric Surgery practicing surgeons. Surg. Obes. Relat. Dis. 4, 166-172 (2008).
- Bueter, M., Lowenstein, C., Ashrafian, H. Vagal sparing surgical technique but not stoma size affects body weight loss in rodent model of gastric bypass. Obes. Surg. 20, 616-622 (2010).
- Korner, J., Bessler, M., Cirilo, L. J. Effects of Roux-en-Y gastric bypass surgery on fasting and postprandial concentrations of plasma ghrelin, peptide YY, and insulin. J. Clin. Endocrinol. Metab. 90, 359-365 (2005).
- Schwartz, M. W., Woods, S. C., Porte, D. Central nervous system control of food intake. Nature. 404, 661-671 (2000).
- Abbott, C. R., Monteiro, M., Small, C. J. The inhibitory effects of peripheral administration of peptide YY(3-36) and glucagon-like peptide-1 on food intake are attenuated by ablation of the vagal-brainstem-hypothalamic pathway. Brain Res. 1044, 127-131 (2005).
- Adrian, T. E., Ballantyne, G. H., Longo, W. E. Deoxycholate is an important releaser of peptide YY and enteroglucagon from the human colon. Gut. 34, 1219-1224 (1993).
- Nakatani, H., Kasama, K., Oshiro, T. Serum bile acid along with plasma incretins and serum high-molecular weight adiponectin levels are increased after bariatric surgery. Metabolism. 58, 1400-1407 (2009).
- Ashrafian, H., le Roux, C. W. Metabolic surgery and gut hormones – a review of bariatric entero-humoral modulation. Physiol. Behav. 97, 620-631 (2009).
- Choban, P. S., Flancbaum, L. The effect of Roux limb lengths on outcome after Roux-en-Y gastric bypass: a prospective, randomized clinical trial. Obes. Surg. 12, 540-545 (2002).
- Gleysteen, J. J. Five-year outcome with gastric bypass: Roux limb length makes a difference. Surg. Obes. Relat. Dis. 5, 242-247 (2009).
- Lee, S., Sahagian, K. G., Schriver, J. P. Relationship between varying Roux limb lengths and weight loss in gastric bypass. Curr. Surg. 63, 259-263 (2006).
- Hayes, M. R., Kanoski, S. E., De Jonghe, B. C. The common hepatic branch of the vagus is not required to mediate the glycemic and food intake suppressive effects of glucagon-like-peptide-1. Am. J. Physiol. Regul. Integr. Comp. Physiol. 301, R1479-R1485 (2011).
