Indomethacin accelerates clearance of labeled cells and increases DNA synthesis in gastrointestinal mucosa of the rat

Sprague-Dawley rats treated with placebo, parenteral indomethacin, or oral prostaglandin E₂ for six days were given an intraperitoneal injection of [³H]methyl-thymidine and killed at 45 min and 96 hr after labeling. Treatments were continued, until death. The dpm/DNA index was determined in mucosal scrapings of the stomach, duodenum, and jejunum and used to estimate DNA synthesis (45 min) and the clearance of labeled cells (96 hr). Indomethacin increased the DNA synthesis in both the duodenal and jejunal mucosa (P<0.05). In comparison to the controls, the clearance of labeled cells from the antral, duodenal, and jejunal mucosa was accelerated by indomethacin treatment, whereas the elimination of labeled cells from the antral and jejunal mucosa was slowed by PGE₂ treatment (P<0.05). DNA synthesis of the antral mucosa was significantly reduced by PGE₂ (P<0.05). The cyclooxygenase blocker did not affect the cell kinetic parameters of the oxyntic mucosa. The plasma levels of somatostatin were significantly higher both in PGE₂- and indomethacin-treated rats than in controls (P<0.05). It is concluded that indomethacin treatment increases the cell losses from the epithelial surface, which in turn trigger a compensatory trophic reaction. It is suggested that an important physiological action of endogenous prostaglandins is to regulate the outflow of cells from the superficial zones of the epithelium. Finally, this study disclosed the presence of hitherto unknown regulatory mechanism that promote cell proliferation in the gastrointestinal, mucosa despite inhibition of the synthesis of endogenous prostaglandins.     

Cell proliferation of the rat gastrointestinal mucosa after treatment with E2 prostaglandins and indomethacin

The frequency of arrested mitoses after vincristine injection was studied in the gastrointestinal mucosa of rats treated with either natural prostaglandin E2 (0.2-5.0 mg X kg-1, b.d.), 15-R-15 methyl prostaglandin E2 (2 mg X kg-1, b.d.) or indomethacin (1.0-3.0 mg X kg-1, b.d.). In addition to the mitotic index, morphometric measurements including the mucosal thickness and the thickness of the proliferative and functional zones of the gastric corpus, antrum and jejunum were performed. Natural prostaglandin E2, at the highest dose range, reduced significantly the mitotic index in the gastric antrum. Normal values were found in the gastric corpus and jejunum and in the antrum with the lower doses. The mitotic index was unaffected by treatment with 15-R-15 methyl prostaglandin E2. Natural prostaglandin E2 produced trophic changes (i.e. increased thickness and/or hyperplasia) in the antrum, functional epithelial zone of the gastric corpus and in the jejunum. More pronounced trophic changes were observed in the mucosa of rats treated with the analogue. Indomethacin reduced the mucosal thickness in all examined epithelia and lowered the mitotic index in the jejunum. It is concluded that the trophic effects of E2 prostaglandins on gastrointestinal epithelia are not caused by increased production of new cells. The reduced mitotic index observed in the antral mucosa of prostaglandin-treated rats could be secondary to a negative feedback from the hyperplastic epithelium. The antitrophic effects of the prostaglandin-synthesis blocker (indomethacin) indicates that endogenous prostaglandins may participate in the epithelial cell regulation of the gastrointestinal tract.     

Reversibility of the cell kinetic changes induced by omeprazole in the rat oxyntic mucosa. An autoradiographic study using tritiated thymidine.

Both oxyntic mucosal progenitor cells and enterochromaffin-like (ECL) cells are under the trophic control of gastrin. We studied the effect of discontinuing omeprazole-induced hypergastrinemia on cell proliferation and ECL cell function in the rat oxyntic mucosa. All rats had hypergastrinemia after 16 days' omeprazole administration, and the proliferation rate of both progenitor and ECL cells was increased, whereas it was decreased 5 days after withdrawal of omeprazole. Circulating gastrin had normalized by then. The proliferative activity of the progenitor cells returned to normal within 10 days, whereas that of the ECL cells remained suppressed for at least 20 days. The histidine decarboxylase activity of the ECL cells changed in parallel with their proliferative activity. These data suggest either a down-regulation of membrane receptors or the involvement of still unknown inhibitors of mitotic activity and ECL cell function in the oxyntic mucosa.     

Effect of acute and chronic glucocorticoid treatments on epithelial cell proliferation in the esophagus and small intestine of rats

Data about glucocorticoid influence on proliferation in the esophagus and small intestine are very contradictory and need to be reexamined. Moreover, only the effects of acute or short-term treatments with glucocorticoids have been demonstrated, whereas nothing is known about their effects under chronic exposure. This work was therefore carried out to examine proliferative activity in the esophagus and small intestine under conditions of acute and chronic glucocorticoid exposure. Rats were treated with either glucocorticoid triamcinolone acetonide or vehicle for 3, 33, or 63 days. Proliferation was assessed in the basal layer of esophageal epithelium and in the epithelium of jejunal crypts, using three criteria, as the number of mitotic, bromodeoxyuridine-labelled, and proliferating cell nuclear antigen-labelled cells. Treatment with glucocorticoid for 3 days led to a slight decrease in all parameters in the esophageal epithelium and had almost no effect on proliferation in the epithelium of jejunal crypts. Long-term treatment with glucocorticoid for either 33 or 63 days resulted in an increase in all parameters tested in both esophageal and jejunal crypt epithelia. Sixty-three-day treatment had a more prominent and significant (P < 0.05) effect. These results suggest that acute glucocorticoid treatment nonsignificantly reduces the number of cells in the cell cycle in the esophageal epithelium, whereas chronic treatment increases the number of proliferating cells in both esophageal and jejunal crypt epithelia. Received: February 22, 1999 / Accepted: June 25, 1999     

The effects of glutamine on intestinal epithelial cell proliferation in parenterally fed rats

BACKGROUND: Several papers have indicated that glutamine is a preferred fuel for the enterocyte and that it can increase intestinal epithelial cell proliferation. AIMS: To investigate the effects of glutamine on intestinal epithelial cell proliferation in the parenterally fed rat. METHODS: Five groups of six rats were fed parenterally; a group of orally fed rats was also studied. Crypt cell proliferation was studied after six days using native mitoses in microdissected crypts and bromodeoxyuridine labelling. RESULTS: No effect of treatment was seen on intestinal weight; however, the weights of the small intestine, caecum, and colon were all significantly heavier in the orally fed group than in the total parenteral nutrition groups (p<0.001). There was no effect of any of the glutamine treatments on mitotic activity in the small intestine. In the colon there was a small increase in native mitoses with glutamine (p=0.03). There was also an indication of increased proliferative activity in the first fifth of the small intestine and colon with glutamine. Little effect of glutamine on bromodeoxyuridine labelling in either site was observed, but there was a small but significant reduction in growth fraction of the colon of the glutamine treated group. The labelling distribution curve from sections and the mitotic distribution curve obtained from crypt squashes showed a good correlation. CONCLUSION: Glutamine has a small, but significant effect on mitotic activity but only in the colon. Modest effects on the distribution of labelled cells were also seen.     

Two-month glucocorticoid treatment increases proliferation in the stomach and large intestine of rats

BACKGROUND/AIMS: It has been shown that acute or short-term treatments with glucocorticoids lead to a marked decrease in proliferation in the stomach and large intestine. The effects of more prolonged glucocorticoid treatment on cell renewal in these organs are not known. The present work was therefore undertaken to examine the proliferative activity in the stomach and colon during 2 months of glucocorticoid treatment in comparison with shorter treatments. METHODS: Rats were treated with either the glucocorticoid triamcinolone acetonide or vehicle for 63, 33 or 3 days. Proliferation was assessed in the glandular epithelium of the fundal part of the stomach and in the epithelium of the colonic crypts using three criteria: the mitotic index; the bromodeoxyuridine labelling index, and the proliferating cell nuclear antigen-labelling index (percentage of mitotic or labelled cells). RESULTS: Treatment with glucocorticoid for 63 days resulted in a very significant increase in all proliferative parameters tested in the gastric mucosa and the colonic crypts. On the contrary, treatments with glucocorticoid for 3 or 33 days had a marked inhibitory influence on proliferation in these tissues. CONCLUSION: As opposed to treatments for 3 or 33 days, glucocorticoid treatment for 2 months leads to an increase in the number of cycling cells in the gastric and colonic mucosae.     

Nimesulide inhibits crypt epithelial cell proliferation at 6 hours in the small intestine in CD-1 mice

To determine whether the gut-sparing selectivity of cyclooxygenase-2 inhibitors is related to early crypt kinetic mechanisms, this study compared the primary effects on small intestinal mucosal epithelial cell proliferation and morphometry of a nonselective dual cyclooxygenase inhibitor, indomethacin, with a cyclooxygenase-2 selective inhibitor, nimesulide. Indomethacin downregulated the crypt cell production rate in the proximal small intestine, and nimesulide reduced cell proliferation in the proximal and distal small intestine. Compared to controls, there were smaller proliferating compartments in the crypts in midintestinal segments in both indomethacin- and nimesulide-treated groups, but more dividing cells in the distal intestine in indomethacin-treated group. Crypt cellularity, numbers, and width were unchanged from control values in both treated groups, suggesting a reduction in crypt cell emigration. Despite its selectivity for inhibiting cyclooxygenase-2, nimesulide induces similar but widespread initial effects on intestinal cell kinetics when compared to indomethacin.     

Medium-chain triglycerides enhance mucous secretion and cell proliferation in the rat

Background  The specific purpose of this study was to investigate the effects of medium-chain triglycerides (MCTs) on intestinal cell proliferation and mucous secretion of the small intestine in the rat. Methods  Rats were fed chow diet and given MCTs or the same weight of corn oil (5 g/kg per day) by gavage daily for 2 weeks, and then tissue samples of the small intestines were harvested. Leptin concentration in the small intestine was measured. Cell proliferation and apoptosis in the small intestine was determined by immunohistochemistry. Diamine oxidase (DAO) activity was measured by colorimetric assay. Results  In rats fed only chow diet (normal rats), the number of goblet cells per villi was 14.2 ± 0.75 in the jejunum and 15.2 ± 1.12 in the ileum. The number of goblet cells increased significantly in rats given MCTs compared with rats given corn oil or normal rats. Ki-67-positive cells were detected on the entire villi and the crypts in the small intestine. Furthermore, the proliferative index and the apoptotic index were also significantly greater in rats given MCTs than rats given corn oil or normal rats. Moreover, DAO activity and leptin concentration in the small intestine were significantly greater in rats given MCTs than rats given corn oil or normal rats. Conclusions  MCTs enhance cell proliferation of the intestinal epithelium and mucous secretion from goblet cells in the small intestine. These effects may protect the gut in patients suffering from inflammatory bowel disease or enterogenous infection.     

Does dietary fibre stimulate intestinal epithelial cell proliferation in germ free rats?

The aim of the present experiment was to investigate the role of hind gut fermentation in the proliferative response of the intestinal epithelium to dietary fibre. We have previously shown that refeeding starved rats with an elemental diet supplemented with fermentable dietary fibre (but not inert bulk) is capable of stimulating intestinal epithelial cell proliferation throughout the gastrointestinal tract. Three groups of 10 germ free (GF) rats and three groups of 10 conventional (CV) rats, were used. All groups were starved for three days and then refed for two days with either an elemental diet (Flexical); Flexical plus 30% kaolin; or Flexical plus 30% of a fibre mixture. Cell production was determined by the accumulation of vincristine arrested metaphases in microdissected crypts. There was no significant difference between refeeding the rats with an elemental diet alone or with kaolin supplementation, however, the addition of fibre in CV rats was associated with a significant increase in intestinal crypt cell production rate in both the small intestine (p less than 0.01) and the colon (p less than 0.001). This marked proliferative effects of fibre was abolished in the GF rats. It can be concluded that it is the products of hind gut fermentation, not fibre per se that stimulate intestinal epithelial cell proliferation in the colon and small intestine.     

Initial kinetic changes of prostaglandin E2-induced hyperplasia of the rat small intestinal epithelium occur in the villous compartments

This study was performed to further identify the sequence of cell kinetics that occurs in the development of gastric and intestinal epithelial hyperplasia after orally administered prostaglandins of the E series. A high-dose, short-treatment schedule was used to examine the initial effects on kinetic parameters in the rat small intestinal epithelium. Groups of rats were killed after a single dose of oral prostaglandin E2 at 1 h after in vivo labeling with [methyl-3H]thymidine and during continued treatment at 6, 12, 24, 48, 72, and 96 h. As evidenced by autoradiography, the earliest change produced by prostaglandin E2 was an increased cellularity of the villous compartment (p less than 0.05 after 24 h). There was no change of labeling index of the villous compartment or of the leading edge of labeled cells within 24 h. At 48 h, the increased cellularity was accompanied by a significantly elevated labeling index of the villi. Throughout the study period no significant differences were observed between groups in the number of cells or labeling indices in the jejunal crypts, or in cellular input from the crypts to the villi. Epithelial turnover time in the placebo and treatment groups was 69 and 71 h, respectively. To exclude the possibility that prostaglandin E2 initially affects cell birth rate and mean cell cycle time, a metaphase blocker was given after 4 days of treatment in a second study. Animals were killed after 0, 0.5, 1.0, 1.5, and 2.5 h. The rate of entry into mitoses was 8.1% cells/h in controls compared with 8.2% cells/h in treated rats. The distribution of mitoses within crypts was identical in the two groups and the mean cell cycle time was 13.6 and 13.2 h, respectively. Also in this study there were trophic changes of the villi. It is concluded that the hyperplasia produced by oral prostaglandin E2 starts in the villi of the small intestine and is initiated by reduced cell exfoliation from the villous tips. Previously recorded retention of cellular elements in villi and crypts, increased cellularity of the proliferative compartments, and reduced mitotic index are secondary events.     

Diffusible factors regulate hair cell regeneration in the avian inner ear.

Damage to the avian inner ear results inup-regulation of mitotic activity resulting in regeneration of hair cells. Theobjective of this investigation was to determine whether the damaged inner earepithelium releases a soluble mitogen that is responsible for the up-regulationof proliferation. The sensory epithelium from normal and drug-damaged avianinner ears was cultured alone or in the presence of other cultures. Aspreviously shown in vivo and in vitro, damaged organs displayed increasedsupporting cell proliferation compared with undamaged organs, leading toeventual morphologic and functional recovery. When damaged organs werecocultured with an undamaged organ, proliferation was increased in the undamagedtissue. When undamaged organs were cultured together, proliferation wasdecreased. These results indicate that a soluble factor released from thedamaged inner ear epithelium stimulates proliferation and suggest the release ofa factor from normal tissue that suppressed mitotic activity. Thus, reparativehair cell regeneration in the inner ear appears to be regulated by a balancebetween proliferative and antiproliferative paracrine factors.     

Effects of amidated gastrin and glycine-extended gastrin on cell proliferation and crypt fission in parenterally and orally fed rats

BACKGROUND/AIMS: It has been suggested that processing variants of gastrin, such as glycine-extended gastrin (G17-Gly), are enterotrophic to the colon. METHODS: Cell proliferation and crypt branching were studied in total parenteral nutrition (TPN) and orally fed rats after infusion of G17-Gly or gastrin-17. RESULTS: Gastrin produced an increase in the weight of the stomach and small intestine and a marked proliferative action on the proximal small intestine, which diminished distally. No proliferative effects of gastrin were seen in the colon. G17-Gly was associated with a small, but significant, increase in colonic weight but had little effect on cell proliferation, except in the gastric fundus. In the distal colon, G17-Gly was associated with a significant decrease in proliferation. Neither agent affected crypt branching in the small intestine or colon, but both proliferation and branching were significantly decreased by TPN. CONCLUSION: Gastrin was trophic to the stomach and the proximal small intestine but not the colon. G17-Gly had only modest proliferative actions on the intestinal epithelium in this study.     

Prolactin-producing cells differentiate from G0/G1-arrested somatotrophs in vitro: an analysis of cell cycle phases and mammotroph differentiation.

In order to analyze the relationship between cell proliferation and mammotroph differentiation, we studied a somatotrophic cell line, MtT/S. MtT/S cell is known to differentiate into PRL-producing cells in response to stimulation with insulin or insulin-like growth factor-1 (IGF-1). Double immunostaining for bromodeoxyuridine (BrdU), which labels proliferating cells, and for GH or PRL showed that most BrdU-labeled cells were GH-immunopositive, whereas considerably few PRL-positive cells were labeled with BrdU. This was confirmed by immunostaining of proliferating cells with antibody to proliferating cell nuclear antigen (PCNA). Furthermore, flow-cytometry analysis indicated that most of the PRL-producing cells were in the G0/G1 phase of the cell cycle. In order to determine whether cell cycle changes are required for transdifferentiation of PRL-producing cells, MtT/S cells were cultivated in serum restricted medium for 7 days to reduce their mitotic activity and then treated with insulin and epidermal growth factor (EGF). Under these conditions, the cell cycle of MtT/S cells was significantly delayed, but the percentage of PRL-producing cells induced was almost identical to that under control conditions, showing that mitosis is not required for PRL- producing cell differentiation. We also labeled MtT/S cells with BrdU for 24 h during PRL-producing cell induction by insulin and EGF, and as a result BrdU-labeled proliferative cells were specifically absent from PRL-producing cell populations. These data, taken as whole, suggest that PRL cells differentiated from G0/G1 arrested somatotrophs and the PRL cells which appeared had their cell proliferation activity significantly declined. In conclusion, this is the first report showing the relationship cell between proliferation and differentiation of PRL cells.     

Ciliated cell differentiation in regenerating rat tracheal epithelium

We studied the differentiation of progeny of mitotic cells in regenerating tracheal epithelium using a model of minimal mechanical injury in which the mitotic cells cycle only once and synchronously. Ultrastructural features of cells which incorporated tritiated thymidine were assessed at a series of times after DNA synthetic phases. Cells arising from G₁ arrested populations and G₂ arrested population were followed separately. The G₁ blocked cells were labelled at 22 hours after injury, divided at 32 hours and then differentiated. G₂ blocked cells were labelled at 39 hours after injury and differentiated without an intervening mitosis. Both populations exhibit initial differentiation of most superficial cells as secretory cells with a subsequent increase in ciliated cells and a reciprocal decrease in secretory cells. Transitional forms in which there are both secretory granules and developing cilia are seen among the labelled cells during the period of increasing ciliated cells. While it is probable that ciliated cells also arise from basal cells or directly from cycling cells, this study demonstrates that post mitotic redifferentiation of secretory cells is one source of ciliated cells in regenerating tracheal epithelium.     

Mucosal cell proliferation of the rectal stump in ulcerative colitis patients after ileorectal anastomosis

The proliferative activity and polyamine levels of the rectal epithelium in unoperated ulcerative colitis patients and in ulcerative colitis patients after total colectomy and ileorectal anastomosis were determined and compared with control subjects. Cell proliferation was evaluated in rectal biopsies by in vitro 3H thymidine incorporation by measuring the labeling index and the position of labeled cells along the crypt; polyamines were determined with a chromatographic method. In ulcerative colitis patients the labeling index was significantly increased, and labeled cells were shifted toward the upper part of the crypt when compared with controls. Ileorectal anastomosis patients showed a normalization of the labeling index and a distribution of labeled cells similar to controls. Polyamine levels were also increased in ulcerative colitis patients; in ileorectal anastomosis patients, the level of polyamines was decreased in respect to unoperated patients and return to normal values except for spermine. Because the increased proliferation and higher polyamine levels are related to increased colon cancer risk, our results confirm that ulcerative colitis is a risk factor for the development of carcinoma. Ileorectal anastomosis may reduce this risk through a normalization of mucosal cell proliferative activity and of some polyamine levels.     

Effects of prostaglandins on ornithine decarboxylase activity in rat small intestine

Role of prostaglandins on feeding-associated induction of ornithine decarboxylase in small intestine was studied. Rats received intraperitoneal injection of either saline, or 16,16-dimethyl prostaglandin E₂, or TRY-200 (a stable prostaglandin I₂ analog), or refeeding, after a 44 hr-fast. Four hours later, mucosae from duodenum, jejunum, and ileum were scraped for subsequent measurements of enzyme activity of ornithine decarboxylase by a radiometric technique. Refeeding resulted in a profound induction of enzyme activity throughout the small intestine. Parenteral administration of prostaglandin I₂ also led to a significant induction with the level similar to refeeding. The stimulatory effect of prostaglandin I₂ was completely abolished by a specific and irreversible enzyme inhibitor, difluoromethylornithine. Prostaglandin E₂ had a similar but lesser effect than prostaglandin I₂ on the induction of the enzyme activity. Pretreatment with indomethacin, a cyclooxygenase inhibitor had no effect on feeding-associated enzyme induction. These results indicate that although exogenous prostaglandin I₂ appears to be a potent stimulant for ornithine decarboxylase activity in rat small intestine, endogenous prostaglandins seem to play little or no role in feeding-associated induction of ornithine decarboxylase.     

Depressed T cell reactivity to recall antigens in Crohn's disease before and after surgical resection.

Earlier studies regarding possible primary immune disturbances participating in the pathogenesis of Crohn's disease yielded conflicting results. Peripheral blood lymphocyte subsets and lymphocyte proliferative responses to five soluble recall antigens and to the polyclonal stimulator phythaemagglutinin were therefore measured in 17 patients with active Crohn's disease, before and six months after surgical resection of the inflamed intestine and in 16 healthy controls. Lymphocyte proliferation in response to all five recall antigens was significantly lower in patients than in controls. No significant differences with controls were detected after surgery. Addition of indomethacin to phythaemagglutinin stimulated lymphocyte cultures had a stronger proliferation enhancing effect in patients than in controls, resulting in comparable proliferative responses in both groups. When both indomethacin and prostaglandin E2 were added, inhibition of reactivity by prostaglandin E2 was stronger in patients' cultures. This suggests a higher sensitivity to inflammatory prostaglandins in Crohn's disease. The degree of lymphocyte stimulation by antigens correlated positively with the percentage of circulating memory T cells (CD 45 RA-). The percentage of activated (HLA-DR+) CD8 cells was higher in patients than in controls. The CD4/CD8 ratio, which was not significantly different between patients and controls, correlated significantly with disease activity and characteristics, even in the postoperative phase. These findings suggest that immune abnormalities in Crohn's disease fluctuate with and are probably secondary to inflammatory activity.     

Nimesulide Alters Cell Recruitment into Mitosis in Murine Intestinal Crypts Without Influencing the Cell Production Rate

The use of nonsteroidal anti-inflammatory drugs (NSAIDs) that exhibit COX-2 selectivity is associated with fewer gastrointestinal side effects than seen with more traditional NSAIDs. To determine whether the early effects on cell kinetics in the intestinal mucosal epithelium described after COX-2 selective inhibition are sustained following continuous therapy with these inhibitors, assessments of morphometry and cryptal cell proliferation in the murine small intestinal mucosa were made at 24 hr after treatment with indomethacin, a dual COX inhibitor (10 mg/kg body weight intraperitoneally), nimesulide, a selective COX-2 inhibitor (15 mg/kg body weight intraperitoneally), or vehicle. Nimesulide-treated intestine was elongated beyond control values, in contrast to the shorter indomethacin-treated intestine, but anomalous villous forms were present in both treated groups. Both treatments induced expansion and contraction of proliferating compartments in the crypts in different regions of the intestine but nimesulide did not alter crypt cell production rates, in contrast to the down-regulation induced by indomethacin. These findings may provide some of the fundamental basis for the gut-sparing properties seen in patients treated with COX-2 selective inhibitors.     

Altered controls of proliferation in proximal small intestine of the senescent rat.

The proximal small intestine responds to starvation by rapidly reducing crypt cell proliferation rate and villus cellularity and to resumption of food intake (refeeding) by abruptly increasing proliferation and the number of villus epithelial cells. We show that villus cellularity responds to starvation and refeeding similarly in young and aging animals. However, as compared to young animals, senescent rats showed increased basal DNA synthetic activity, starvation resulted in a smaller decrease in DNA labeling of crypt cells, and refeeding produced an abrupt broadening of the proliferative zone in older animals without concomitant increased numbers of villus cells. Such altered crypt proliferative responses resemble precancerous changes seen in the colon and the aberrant proliferation found in both small and large intestine after administration of the carcinogen dimethylhydrazine.