Roux­en­Y gastric bypass surgery triggers rapid DNA fragmentation in vagal afferent neurons in rats.

Previous studies have shown that Roux­en­Y gastric bypass (RYGB), one of the most effective weight loss treatments for obesity, results in neurodegenerative responses in vagal afferent gut­brain connection reflected by microglia activation and reduced sensory input to the nucleus tractus solitarius (NTS). However, it is not known whether RYGB­induced microglia activation is the cause or an effect of the reported neuronal damage. Therefore, the aim of this study was to establish the order of neurodegenerative responses in vagal afferents after RYGB in the nodose ganglia (NG) and NTS in male and female rats. Sprague­Dawley rats were fed regular chow or an energy­dense diet for two weeks followed by RYGB or sham surgery. Twenty­four hours later, animals were sacrificed and NG and NTS were collected. Neuronal cell damage was determined by TUNEL assay. Microglia activation was determined by quantifying the fluorescent staining against the ionizing calcium adapter­binding molecule 1. Reorganization of vagal afferents was evaluated by fluorescent staining against isolectin 4. Results of the study revealed significantly increased DNA fragmentation in vagal neurons in the NG when observed at 24 h after RYGB. The surgery did not produce rapid changes in the density of vagal afferents and microglia activation in the NTS. These data indicate that decreased density of vagal afferents and increased microglia activation in the NTS likely ensue as a res ult of RYGB­induced neuronal damage.

Precious cargo: Modulation of the mesenteric lymph exosome payload after hemorrhagic shock.

BACKGROUND: Trauma/hemorrhagic shock (T/HS) causes a release of proinflammatory mediators into the mesenteric lymph (ML) that may trigger a systemic inflammatory response and subsequent organ failure. Recently, we showed that exosomes in postshock ML are biologically active mediators of this inflammation. Because the specific inflammatory mediators in postshock ML exosomes have yet to be characterized, we hypothesized that T/HS would lead to a distinct ML proinflammatory exosome phenotype that could be identified by proteomic analysis. We further hypothesized that their regulation by the neuroenteric axis via the vagus nerve would modify this proinflammatory profile. METHODS: Male rats underwent an established T/HS model including 60 minutes of HS followed by resuscitation. Mesenteric lymph was collected before HS (preshock) and after resuscitation (postshock). A subset of animals underwent cervical vagus nerve electrical stimulation (VNS) after the HS phase. Liquid chromatography with tandem mass spectroscopy (LC-MS/MS) followed by protein identification, label free quantification, and bioinformatic analysis was performed on exosomes from the pre-shock and post-shock phases in the T/HS and T/HS + vagus nerve electrical stimulation groups. Biological activity of exosomes was evaluated using a monocyte nuclear factor kappa B (NF-κB) activity assay. RESULTS: ML exosomes express a distinct protein profile after T/HS with enrichment in pathways associated with cell signaling, cell death and survival, and the inflammatory response. Stimulation of the vagus nerve following injury attenuated the transition of ML exosomes to this T/HS-induced inflammatory phenotype with protein expression remaining similar to pre-shock. Monocyte NF-κB activity was increased after exposure to ML exosomes harvested after T/HS, while ML exosomes from preshock had no effect on monocyte NF-κB expression. CONCLUSION: Postshock ML exosomes carry a distinct, proinflammatory protein cargo. Stimulating the vagus nerve prevents the T/HS-induced changes in ML exosome protein payload and suggests a novel mechanism by which the neuroenteric axis may limit the systemic inflammatory response after injury.

Down-regulation of ghrelin receptors in the small intestine delays small intestinal transit in vagotomized rats.

Vagal nerve injury may occur in esophageal and gastric surgeries. The aim of this study was to observe the effects of ghrelin on small intestinal motility upon vagal nerve injury and the possible co-relationship between changes in ghrelin receptor expression in the small intestine and delayed small intestinal transit after vagotomy. The effects of intraperitoneal administration of ghrelin (20, 40 and 80 µg/kg) and the ghrelin receptor antagonist [D-Lys3]-GHRP-6 (1.5 µmol/kg) on small intestinal transit were studied in control and vagotomized rats in vivo. The effects of ghrelin (0.01, 0.1, 0.5, 1.0 and 2.0 µmol/l) on the contraction force of smooth muscle strips from the jejunum were studied in the presence or absence of carbachol (50 nmol/l) and [D-Lys3]-GHRP-6 (10 µmol/l) in vitro. Ghrelin receptor expression was assessed in intestinal muscle layers by means of Western blotting. The results indicated that ghrelin dose-dependently increased small intestinal transit in the control and model rats. In addition, ghrelin enhanced smooth muscle strip contraction induced by carbachol. Ghrelin receptor antagonist [D-Lys3]-GHRP-6 blocked the effect of ghrelin. Ghrelin receptor expression in the small intestinal muscle layers was down-regulated in the vagotomized rats. Down-regulation of growth hormone secretagogue receptor 1a in small intestinal muscle layers, which affected the function of ghrelin, may be one of the mechanisms behind delayed small intestinal transit after vagotomy.