Alteration in human defensin-5 expression following gastric bypass surgery

• Published in: Journal of clinical pathology 2007-09, Vol.60 (9), p.1029-1034
• Main Authors: Sundbom, M, Elphick, D A, Mahida, Y R, Cunliffe, R N, Midtvedt, T, Engstrand, L, Rubio, C, Axelsson, L Göran
• Format: Article
• Language: English
• Subjects: Adult; alpha-Defensins - metabolism; antimicrobial peptide; Bacteria; Bacteria - growth & development; Bacteria - isolation & purification; Biological and medical sciences; Biopsy; Cell Count; Cytoplasm; Female; Food; Gastric Bypass; Gastrointestinal surgery; Heart surgery; Histology; human defensin; Humans; Immunoenzyme Techniques; innate immunity; intermediate cells; Intestinal Mucosa - metabolism; Intestinal Mucosa - microbiology; Investigative techniques, diagnostic techniques (general aspects); Jejunum - metabolism; Jejunum - microbiology; Medical sciences; MEDICIN; Medicin och hälsovetenskap; MEDICINE; Microorganisms; Microscopy; Microscopy, Immunoelectron; Middle Aged; Muramidase - metabolism; Obesity; Original; Paneth cells; Paneth Cells - pathology; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Peptides; Pharynx - microbiology; Postoperative Period; Rodents; Small intestine; Stem cells; Studies; Weight control
• ISSN: 0021-9746; 1472-4146; 1472-4146
• DOI: 10.1136/jcp.2006.041871

Background: Roux-en-Y gastric bypass surgery provides a novel human model to investigate small bowel mucosal innate immunity, in which there is loss of gastric acid-mediated protection against orally-acquired microorganisms. Aim: To study changes in jejunal mucosal immunoreactivity of human defensin (HD)-5, an antimicrobial peptide normally produced by Paneth cells. Methods: Mucosal samples were obtained from 18 female patients (24–54 years), from the same segment of jejunum during and after gastric bypass surgery. Samples were used for bacterial culture and immunohistochemistry using anti-HD-5 antibody. The number of immunoreactive cells per crypt and villus were determined and expressed as mean (SD). Results: No bacteria were cultured from any of the perioperative jejunal samples but colonies of bacteria normally present in the pharynx were identified during culture of all postoperative jejunal biopsy specimens (1–>100 colonies). Paneth cell numbers per crypt were unchanged after gastric bypass (4.16 (0.71) vs 4.24 (0.78)). However, following surgery, there was an increase in HD-5-positive intermediate cells per crypt (0.25 (0.41) vs 1.12 (0.66), p