Abstract: Intestinal epithelial stem cells (ISC) are responsible for epithelial regeneration and are critical to the intestine's ability to regain barrier function following injury. Evaluating ISC biomarker expression in cases of small intestinal strangulation (SIS) may provide insight into clinical progression. Objective: Intestinal resection margins from cases of SIS were evaluated to determine if (1) evidence of injury could be identified using histomorphometry, (2) ISC biomarker expression was decreased in the proximal resection margin compared to control and distal resection margin, and (3) the ISC biomarker expression was associated with the number of preoperative risk factors negatively related to outcome, post-operative complications, or case outcome. Methods: Retrospective cohort study. Methods: Intestinal samples were obtained intraoperatively from resection margins of adult horses with SIS and horses euthanised for reasons unrelated to colic. Preoperative risk factors negatively related to outcome, post-operative complications, and case outcome were obtained from medical records. Horses were grouped as euthanised intraoperatively, postoperatively, or survived to discharge. Histomorphometry and immunofluorescence were performed to evaluate tissue architecture and ISC and progenitor cell number. Groups were compared using one-way ANOVA. Associations between biomarker expression and the number of preoperative risk factors and post-operative complications negatively related to outcome were determined using linear regression modelling. Results: Thirty-six cases of SIS were evaluated. Ki67 cell counts were decreased in the proximal (mean = 15.45 cells; 95% CI = 10.27-20.63; SD = 4.17; p = 0.02) and distal resection margins (mean = 15.05; 95% CI = 8.46-21.64; SD = 4.141; p = 0.03) in horses euthanised postoperatively compared to control (mean = 23.62 cells; 95% CI = 19.42-27.83; SD = 5.883). In the distal resection margin, an increase in SOX9 Ki67 cells were associated with a decrease in the total number of preoperative risk factors negatively related to outcome (95% CI = 0.236-1.123; p = 0.008, SE = 0.1393). Conclusions: Small population size. Conclusions: Proliferating cell and ISC numbers may be associated with case outcome. Unassigned: Intestinale epitheliale Stammzellen (ISC) sind verantwortlich für epitheliale Regeneration und ausschlaggebend für die intestinale Fähigkeit der Wiedererlangung einer Barrierefunktion nach Verletzung. Evaluation von ISC Biomarkerexpression in Fällen von Dünndarmstrangulationen (SIS) könnte Einsicht in klinische Entwicklungen geben. Unassigned: Intestinale Resektionsränder von Fällen mit SIS wurden evaluiert um zu bestimmen, ob (1) ein Hinweis auf Schädigung mithilfe Histomorphometrie identifiziert werden kann, (2) ISC Biomarkerexpression im proximalen Resektionsrand im Vergleich zu einer Kontrolle oder dem distalen Resektionsrand vermindert war, (3) die ISC Biomarkerexpression mit der Anzahl präoperativer Risikofaktoren, welche negativ mit dem klinischen Ausgang zusammenhängen, post-operativen Komplikationen, oder Resultaten der Fälle assoziiert ist. Methods: Retrospektive Kohortenstudie. Methods: Intestinalproben wurden von intraoperativen Resektionsrändern adulter Pferde mit SIS entnommen, sowie Pferden, welche aus nicht mit Kolik zusammenhängenden Gründen euthanasiert wurden. Präoperative Risikofaktoren, welche mit Ausgang, postoperativen Komplikationen, und Fallresultaten negativ assoziiert waren, wurden aus Patientenberichten ermittelt. Pferde wurden kategorisiert als intraoperativ oder postoperativ euthanasiert, oder als entlassen. Histomorphometrie und Immunfluoreszenz wurden für die Ermittlung von Gewebearchitektur, ISC und Progenitorzellzahl durchgeführt. Die Gruppen wurden mithilfe einer einfachen ANOVA verglichen. Assoziationen zwischen Biomarkerexpression und Anzahl präoperativer Risikofaktoren und postoperativer Komplikationen, welche negativ mit dem Ausgang verbunden waren, wurden mithilfe eines linearen Regressionsmodells ermittelt. Unassigned: Sechsunddreißig Fälle von SIS wurden evaluiert. Ki67 Zellzahlen waren im proximalen (Mittel = 15.45 Zellen; 95% CI = 10.27-20.63; SD = 4.17; p = 0.02) und distalen (Mittel = 15.05 Zellen; 95% CI = 8.46-21.64; SD = 4.141; p = 0.03) Resektionsrand von postoperativ euthanasierten Pferden heruntergesetzt im Vergleich zur Kontrollgruppe (Mittel = 23.62 Zellen; 95% CI = 19.42-27.83; SD = 5.883). Im distalen Resektionsrand war ein Anstieg von SOX9 Ki67 Zellen mit einer Abnahme der Gesamtzahl präoperativer Risikofaktoren, welchen negativ mit dem Ausgang (95% CI = 0.236-1.123; p = 0.008, SE = 0.1393) in Verbindung standen, assoziiert. HAUPTEINSCHRÄNKUNGEN: Geringe Populationsgröße. Unassigned: Proliferierende Zellen und ISC Zahlen könnten mit Fallresultaten assoziiert sein.
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The research article investigates whether changes in equine intestinal stem cells (ISC) have a direct impact on recovery from small intestinal strangulation (SIS) in horses. After analyzing intestinal resection margins, they found that the reduction in ISC may be linked with decreased chances of successful outcomes post-surgery in SIS cases.
Objective of the Study
The study aims to understand the behavior of intestinal stem cells (ISC) in horses suffering from small intestinal strangulation (SIS), specifically within the zones of resection margins. The main research questions include:
Is injury identifiable at the resection margins using histomorphometry (a method to study the structure of biologic tissue)?
Does ISC biomarker expression decrease at the proximal resection margin compared to controls and distal resection margin?
Is ISC biomarker expression connected to number of preoperative risk factors, post-operative complications, or case outcome?
Methods Employed in the Study
The study adopts a retrospective cohort study approach.
Intestinal samples were collected from resection margins of adult horses with SIS and horses euthanized for reasons unrelated to colic.
Medical records provided data on preoperative risk factors negatively impacting outcome, and post-operative complications.
Histo-morphometry and immunofluorescence were used to examine tissue architecture and number of ISC and progenitor cells.
One-way ANOVA was used for group comparisons, and linear regression modelling for identifying associations between biomarker expression and risk factors impacting outcome.
Findings of the Study
The study evaluated 36 instances of SIS. The results indicated that:
Ki67 cell counts, which indicate cell proliferation, reduced in both proximal and distal resection margins in postoperatively euthanized horses compared to controls.
An increase in SOX9 Ki67 cells, a specific type of ISC, at the distal resection margin was linked with a decrease in preoperative risk factors negatively related to outcome.
Conclusions of the Study
Even though the study had a small sample size, it concluded that the number of proliferating cells and ISC can potentially influence the outcome of SIS cases.
Cite This Article
APA
Veerasammy B, Gonzalez G, Báez-Ramos P, Schaaf CR, Stewart AS, Ludwig EK, McKinney-Aguirre C, Freund J, Robertson J, Gonzalez LM.
(2023).
Changes in equine intestinal stem/progenitor cell number at resection margins in cases of small intestinal strangulation.
Equine Vet J.
https://doi.org/10.1111/evj.13927
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