Work

Chemotherapy for cancer causes apoptosis that precedes hypoplasia in crypts of the small intestine in humans

Year: 2000

Type: article

Abstract: BACKGROUND AND AIMS: 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. METHODS: 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. RESULTS: 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. CONCLUSION: Small intestinal mucositis is associated with apoptosis in crypts that precedes hypoplastic villous atrophy and loss of enterocyte height.

Source: Gut

DOI: 10.1136/gut.47.5.632

Authors: D M K Keefe, J Brealey, G J Goland, A G Cummins

Institution: Royal Adelaide Hospital

Language: English

Topic: Oral health in cancer treatment

Subfield: General Dentistry

Field: Dentistry

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: bronze

Funder: University of Adelaide