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Type: Journal article
Title: Chemotherapy for cancer causes apoptosis that precedes hypoplasia in crypts of the small intestine in humans
Author: Keefe, D.
Brealey, J.
Goland, G.
Cummins, A.
Citation: Gut, 2000; 47(5):632-637
Publisher: British Med Journal Publ Group
Issue Date: 2000
ISSN: 0017-5749
Statement of
D M K Keefe, J Brealey, G J Goland, A G Cummins
Abstract: <h4>Background and aims</h4>The mechanism of gastrointestinal damage (mucositis) induced by cancer chemotherapy remains uncertain. The aims of this study were to define the time course and mechanism of small intestinal damage following chemotherapy in humans.<h4>Methods</h4>Patients receiving chemotherapy underwent upper gastrointestinal endoscopy (a maximum of two per patient) with duodenal biopsy prior to chemotherapy and again at 1, 3, 5, and 16 days after chemotherapy. Tissue was taken for morphometry, disaccharidase assays, electron microscopy, and for assessment of apoptosis using the Tdt mediated dUTP-biotin nick end labelling (TUNEL) method. Villus area, crypt length, and mitotic index were measured by a microdissection technique.<h4>Results</h4>Apoptosis increased sevenfold in intestinal crypts at one day, and villus area, crypt length, mitotic count per crypt, and enterocyte height decreased at three days after chemotherapy. Disaccharidase activities remained unchanged. Electron microscopy showed increased open tight junctions of enterocytes at day 3, consistent with more immature cells. All indices improved by 16 days.<h4>Conclusion</h4>Small intestinal mucositis is associated with apoptosis in crypts that precedes hypoplastic villous atrophy and loss of enterocyte height.
Keywords: Enterocytes
Tight Junctions
Antineoplastic Agents
Microscopy, Electron
Endoscopy, Gastrointestinal
Mitotic Index
In Situ Nick-End Labeling
Remission, Spontaneous
Middle Aged
Rights: Copyright © 2000 BMJ Publishing Group Ltd & British Society of Gastroenterology
DOI: 10.1136/gut.47.5.632
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Appears in Collections:Aurora harvest 4
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