The impact of intestinal resection on the immune function of short bowel syndrome patients

Abstract

Short bowel syndrome (SBS) is characterized by a massive intestinal loss after surgery resection. Likewise, disturbances involving the intestine, which represents a complex immune environment, may result in breakdown of homeostasis and altered responses, thus leading to unpredictable clinical outcomes. However, the consequences of bowel resection were poorly investigated until now. Therefore, this study aimed to evaluate the immunological status of SBS-patients. For this purpose, ten subjects and nine healthy controls were evaluated. Along with some metabolic disturbances, the main results showed higher levels of the inflammatory cytokine IL-6 in plasma among SBS-patients. However, there were no differences in the frequency of CD3⁺, CD3⁺CD4⁺ or CD3⁺CD8⁺ T lymphocytes. An augmented frequency in CD4⁺ and CD8⁺ cells producing IFN-γ was also observed in peripheral blood mononuclear cells (PBMC), together with elevated percentage of CD4⁺ cells producing IL-10. No differences were observed in the frequency of total CD4⁺CD25^-, CD4⁺CD25⁺ lymphocytes nor in the expression of FoxP3 or GITR. Nevertheless, SBS-patients showed higher frequency of the regulatory T cell population CD4⁺CD25⁺CD39⁺ cells in PBMC. In conclusion, these data pointed to SBS as an important disturbance that compromises not only the intestinal environment but also negatively influences systemic immune components.

Keywords: Immune response; Intestinal resection; Regulation; Short bowel syndrome.