Intestinal adaptation in pediatric short bowel syndrome - controlled assessment of duodenal mucosa after extensive bowel resection

Galina Sanaksenaho

Research output: ThesisDoctoral ThesisCollection of Articles


Background. Although extensively studied in experimental models, human data on intestinal adaptation in short bowel syndrome (SBS) is very limited. Aim of the study. We studied mucosal homeostasis of the duodenum in children with intestinal failure (IF) both during parenteral nutrition (PN) and after achieving intestinal autonomy by weaning off PN in relation to controls. Patients and methods. In total, 58 patients with IF aged from 0.5 to 23 years and 43 controls matched for age and gender without intestinal pathology were included. Duodenal biopsies obtained during clinically indicated gastroscopies were collected. We evaluated duodenal disaccharidase activities, inflammation, structural mucosal hyperplasia, proliferation, apoptosis, epithelial barrier function and nutrient transport by using the glucose oxidase method, histology, immunohistochemistry, and quantitative real-time polymerase chain reaction (qPCR) for 52 genes. Dilatation of the small bowel was assessed from a contrast small bowel series. Results. Activities of maltase and sucrase were 1.6 times lower and mucosal inflammation more frequent (22% vs 3%) in patients on current PN in comparison with controls (P˂0.05 for both). Disaccharidase activities in patients who had weaned off PN were comparable with controls. In the evaluation of mucosal morphology, proliferation, and apoptosis, PN-dependent and weaned off patients showed similar results to controls. Compared to controls, SBS patients showed a statistically significant (P
Original languageEnglish
  • Pakarinen, Mikko Petteri, Supervisor
Place of PublicationHelsinki
Print ISBNs978-951-51-6409-4
Publication statusPublished - 2020
MoE publication typeG5 Doctoral dissertation (article)

Bibliographical note

M1 - 88 s. + liitteet

Fields of Science

  • Duodenum
  • +pathology
  • Short Bowel Syndrome
  • Intestinal Mucosa
  • +metabolism
  • Adolescent
  • alpha-Glucosidases
  • Apoptosis
  • Biomarkers
  • Cell Proliferation
  • Child
  • Dilatation
  • Disaccharidases
  • Hyperplasia
  • Ileocecal Valve
  • Inflammation
  • Intestine, Small
  • +surgery
  • Intestines
  • Lactase
  • Nutrients
  • Parenteral Nutrition
  • RNA, Messenger
  • Young Adult
  • 3123 Gynaecology and paediatrics

Cite this