Abstract
The accumulation, distribution and luminal secretion of hyaluronan (hyaluronic acid; HA) was demonstrated at different times after small bowel transplantation experimentally, and in one clinical case. Semiallogenic or semisyngenic rat models were used to elicit either unidirectional graft rejection or graft-versus-host disease. During graft rejection a cellular infiltrate and edema appeared in the lamina propria in the crypt are where an accumulation of HA was also demonstrated. There was progressive accumulation of HA in the small bowel during rejection and on day 6 there was a three-fold increase compared to the values in syngenic grafts. The increase in tissue HA was paralleled by an increase in the total water content of the rejecting graft. Measurements of the luminal secretion of HA in rejection grafts at day 6 revealed a five fold increase at this time. In specimens from animals suffering from GVHD, no significant changes in water of HA content and distribution were observed until day 12. In a clinical case of small bowel transplantation in a 14 months oldchild, luminal secretion of HA was measured in the graft by using a segmental intestinal perfusion technique. A more than 30 fold increase of secreted HA was noted, which was directly paralleled by clinical and histological signs of graft rejection. The data suggest that accumulation of HA might contribute to the pathophysiology of the transplantation edema and that HA might be of potential diagnostic value for monitoring purposes after small bowel transplantation.
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Wallander, J., Johnson, C., Meurling, S. et al. INTESTINAL DISTRIBUTION AND LEAKAGE OF HYALURONAN AFTER SMALL BOWEL TRANSPLANTATION. Pediatr Res 32, 632 (1992). https://doi.org/10.1203/00006450-199211000-00165
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DOI: https://doi.org/10.1203/00006450-199211000-00165