Name: murine distal colostomy, a novel model of diversion colitis in c57bl/6 mice
Uploaded: 2018-07-12T13:30:00
Description: Watch this Scientific Journal Video about Murine Distal Colostomy, A Novel Model of Diversion Colitis in C57BL/6 Mice at JoVE.com

All methods described here have been approved by the veterinary government authority (Landesamt f&#252;r Landwirtschaft, Lebensmittelsicherheit und Fischerei Mecklenburg-Vorpommern, (LALLF M-V)).
1. Preoperative Care and Preparation of the Animal
<ol>
	<li>Upon arrival in the animal facility, divide animals (C57Bl/6) into groups of similar size, cage each group together, and keep groups constant throughout the experiments. 
	NOTE: Use animals of the same sex. The results described were obtained with male mi...

<ol>
	<li>Glotzer, D. J., Glick, M. E., Goldman, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Proctitis+and+colitis+following+diversion+of+the+fecal+stream.">Proctitis and colitis following diversion of the fecal stream.</a> Gastroenterology. 80, 438-441 (1981).</li><li>Morson, B., Dawson, I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Gastrointestinal Pathology. , (1972).</li><li>Whelan, R. L., Abramson, D., Kim, D. S., Hashmi, H. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Diversion+colitis.+A+prospective+study.">Diversion colitis. A prospective study.</a> Surg Endosc. 8, 19-24 (1994).</li><li>Haas, P. A., Fox, T. A., Szilagy, E. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Endoscopic+examination+of+the+colon+and+rectum+distal+to+a+colostomy.">Endoscopic examination of the colon and rectum distal to a colostomy.</a> Am J Gastroenterol. 85, 850-854 (1990).</li><li>Valatas, V., Bamias, G., Kolios, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Experimental+colitis+models:+Insights+into+the+pathogenesis+of+inflammatory+bowel+disease+and+translational+issues.">Experimental colitis models: Insights into the pathogenesis of inflammatory bowel disease and translational issues.</a> Eur J Pharmacol. 759, 253-264 (2015).</li><li>Kleinwort, A., D&#246;ring, P., Hackbarth, C., Heidecke, C. D., Schulze, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Deviation+of+the+Fecal+Stream+in+Colonic+Bowel+Segments+Results+in+Increased+Numbers+of+Isolated+Lymphoid+Follicles+in+the+Submucosal+Compartment+in+a+Novel+Murine+Model+of+Diversion+Colitis.">Deviation of the Fecal Stream in Colonic Bowel Segments Results in Increased Numbers of Isolated Lymphoid Follicles in the Submucosal Compartment in a Novel Murine Model of Diversion Colitis.</a> Biomed Res Int. 2017, 13 (2017).</li><li>Tangjarukij, C., Navasumrit, P., Zelikoff, J. T., Ruchirawat, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+effects+of+pyridoxine+deficiency+and+supplementation+on+hematological+profiles,+lymphocyte+function,+and+hepatic+cytochrome+P450+in+B6C3F1+mice.">The effects of pyridoxine deficiency and supplementation on hematological profiles, lymphocyte function, and hepatic cytochrome P450 in B6C3F1 mice.</a> J Immunotoxicol. 6, 147-160 (2009).</li><li>Soave, O., Brand, C. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Coprophagy+in+animals:+a+review.">Coprophagy in animals: a review.</a> Cornell Vet. 81, 357-364 (1991).</li><li>Ebino, K. Y., Yoshinaga, K., Suwa, T., Kuwabara, Y., Takahashi, K. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+prevention+of+coprophagy+on+pregnant+mice--is+coprophagy+beneficial+on+a+balanced+diet.">Effects of prevention of coprophagy on pregnant mice--is coprophagy beneficial on a balanced diet.</a> Jikken Dobutsu. 38, 245-252 (1989).</li><li>Babickova, J., Tothova, L., Lengyelova, E., Bartonova, A., Hodosy, J., Gardlik, R., Celec, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Sex+Differences+in+Experimentally+Induced+Colitis+in+Mice:+a+Role+for+Estrogens.">Sex Differences in Experimentally Induced Colitis in Mice: a Role for Estrogens.</a> Inflammation. 38, 1996-2006 (2015).</li><li>Lee, S. M., Kim, N., Son, H. J., Park, J. H., Nam, R. H., Ham, M. H., Choi, D., Sohn, S. H., Shin, E., Hwang, Y. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Effect+of+Sex+on+the+Azoxymethane/Dextran+Sulfate+Sodium-treated+Mice+Model+of+Colon+Cancer.">The Effect of Sex on the Azoxymethane/Dextran Sulfate Sodium-treated Mice Model of Colon Cancer.</a> J Cancer Prev. 21, 271-278 (2016).</li><li>Angele, M. K., Pratschke, S., Hubbard, W. J., Chaudry, I. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Gender+differences+in+sepsis:+cardiovascular+and+immunological+aspects.">Gender differences in sepsis: cardiovascular and immunological aspects.</a> Virulence. 5, 12-19 (2013).</li><li>Brown, R. Z. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Social+Behaviour,+reproduction,+and+population+changes+in+the+house+mouse+(Mus+musculus+L).">Social Behaviour, reproduction, and population changes in the house mouse (Mus musculus L).</a> Eccological Monographs. 23, 788-795 (1953).</li><li>Poole, T. B., Morgan, H. D. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Differences+in+aggressive+behaviour+betweeen+male+mice+(Mus+musculus+L.)+in+colonies+of+different+sizes.">Differences in aggressive behaviour betweeen male mice (Mus musculus L.) in colonies of different sizes.</a> Animal Behaviour. 21, 788-795 (1973).</li><li>Pasquarelli, N., Voehringer, P., Henke, J., Ferger, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effect+of+a+change+in+housing+conditions+on+body+weight,+behavior+and+brain+neurotransmitters+in+male+C57BL/6J+mice.">Effect of a change in housing conditions on body weight, behavior and brain neurotransmitters in male C57BL/6J mice.</a> Behav Brain Res. 333, 35-42 (2017).</li><li>Langgartner, D., Foertsch, S., Fuchsl, A. M., Reber, S. O. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Light+and+water+are+not+simple+conditions:+fine+tuning+of+animal+housing+in+male+C57BL/6+mice.">Light and water are not simple conditions: fine tuning of animal housing in male C57BL/6 mice.</a> Stress. 20, 10-18 (2017).</li><li>Nicholson, A., Malcolm, R. D., Russ, P. L., Cough, K., Touma, C., Palme, R., Wiles, M. V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+response+of+C57BL/6J+and+BALB/cJ+mice+to+increased+housing+density.">The response of C57BL/6J and BALB/cJ mice to increased housing density.</a> J Am Assoc Lab Anim Sci. 48, 740-753 (2009).</li><li>Buchler, G., Wos-Oxley, M. L., Smoczek, A., Zschemisch, N. H., Neumann, D., Pieper, D. H., Hedrich, H. J., Bleich, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Strain-specific+colitis+susceptibility+in+IL10-deficient+mice+depends+on+complex+gut+microbiota-host+interactions.">Strain-specific colitis susceptibility in IL10-deficient mice depends on complex gut microbiota-host interactions.</a> Inflamm Bowel Dis. 18, 943-954 (2012).</li><li>Nakanishi, M., Tazawa, H., Tsuchiya, N., Sugimura, T., Tanaka, T., Nakagama, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mouse+strain+differences+in+inflammatory+responses+of+colonic+mucosa+induced+by+dextran+sulfate+sodium+cause+differential+susceptibility+to+PhIP-induced+large+bowel+carcinogenesis.">Mouse strain differences in inflammatory responses of colonic mucosa induced by dextran sulfate sodium cause differential susceptibility to PhIP-induced large bowel carcinogenesis.</a> Cancer Sci. 98, 1157-1163 (2007).</li><li>Mahler, M., Bristol, I. J., Leiter, E. H., Workman, A. E., Birkenmeier, E. H., Elson, C. O., Sundberg, J. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Differential+susceptibility+of+inbred+mouse+strains+to+dextran+sulfate+sodium-induced+colitis.">Differential susceptibility of inbred mouse strains to dextran sulfate sodium-induced colitis.</a> Am J Physiol. 274, 544-551 (1998).</li><li>Mekada, K., Abe, K., Murakami, A., Nakamura, S., Nakata, H., Moriwaki, K., Obata, Y., Yoshiki, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Genetic+differences+among+C57BL/6+substrains.">Genetic differences among C57BL/6 substrains.</a> Exp Anim. 58, 141-149 (2009).</li><li>Sellers, R. S., Clifford, C. B., Treuting, P. 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The murine model of DC presented in this protocol reliably reproduces the histopathological features of human DC (e.g., de novo development of lymphoid follicles in the submucosa of inflamed bowel segments, crypt shortening, and reductions in goblet cell numbers). Aside from this advantage, this model is induced by a very similar triggering factor and presents with a clinical course of moderate to mild severity as is the case in most affected humans.
To obtain reproducible re...

In recent years, a substantial number of non-infectious colitis entities different from classical inflammatory bowel diseases (IBDs; i.e., Crohn&#39;s disease or colitis ulcerosa) have been clinically and histopathologically characterized in humans. The pathophysiological mechanisms leading to the development of these colitis forms are not completely understood partially because appropriate animal models are scarce. Diversion colitis is one of these recently described entities. Although the term was coined in 1980 by Glotzer1, the initial description of a similar phenotype was given in 1972 by Morson2. The disease develops in 50% to 91% of patients with diverting enterostomy, and its clinical intensity varies3,4. Given the annual incidence of around 120,000 colostomy patients in the United States of America, this disease entity constitutes an important health problem.
The overall goal of developing this protocol was to provide a murine DC model that relies on a colitis trigger similar to that seen in human DC and that reproduces the primary histopathological features of the human disease. In contrast to other murine colitis models, colitis induction in our model does not require genetically modified animals (e.g., IL-7 transgenic mice, N-cadherin dominant negative mice, or TGF&#946;-/- mice), the application of chemically irritating substances (e.g., dextran sulfate sodium (DSS)-induced colitis, or trinitrobenzene sulfonic acid (TNBS)-induced colitis), or the transfer of specific cell populations in immune deficient mice (as in the CD45RBhigh transfer model of colitis) (for a review, see5). In contrast to other models, the intact immune system of our DC model allows assessment of the immunological mechanism involved in DC development. The limitation of mucosal inflammation to the excluded bowel segment allows assessment of its repercussion on mucosal immunity in other parts of the gastrointestinal tract, on the immune homeostasis in other immune compartments of the intestinal tract (e.g., Peyer&#39;s patches and mesenteriale lymph nodes), and on the immune homeostasis of the entire organism. Finally, our model constitutes an appropriate tool for investigating the mechanisms controlling local inflammatory stimuli originating from changes in the normal local environment for both the local microbiome as well as alimentary antigens.

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			<td height="21" style="height:21px;width:216px;">Operation material</td>
			<td style="width:136px;"></td>
			<td style="width:119px;"></td>
			<td style="width:167px;"></td>
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			<td height="42" style="height:42px;width:216px;">heat underlay, 6 watt</td>
			<td style="width:136px;">ThermoLux, Witte + Sutor GmbH</td>
			<td style="width:119px;">461265</td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="63">
			<td height="63" style="height:63px;width:216px;">Ethanol 70% (with methylethylketon)</td>
			<td style="width:136px;">Pharmacie of the University Hospital Greifswald</td>
			<td style="width:119px;"></td>
			<td style="width:167px;"></td>
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		<tr height="63">
			<td height="63" style="height:63px;width:216px;">Wooden applicators, small cotton head onesided, wooden stick, 150 mm length</td>
			<td style="width:136px;">Centramed GmbH, Germany</td>
			<td style="width:119px;">8308370</td>
			<td style="width:167px;">for disinfection of operation field</td>
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		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Scissor</td>
			<td style="width:136px;">Aesculap (BRAUN)</td>
			<td style="width:119px;">BC064R</td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Atraumatic DeBakey forceps</td>
			<td style="width:136px;">Aesculap (BRAUN)</td>
			<td style="width:119px;">OC021R</td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Needle holder</td>
			<td style="width:136px;">Aesculap (BRAUN)</td>
			<td style="width:119px;">BM012R</td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:216px;">Vasofix Safety i.v. cannula 22G</td>
			<td style="width:136px;">Braun Melsungen AG, Germany</td>
			<td style="width:119px;">4268091S-01</td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:216px;">VICRYL Plus 4-0 violet braided; V-5 17 m 1/2c; 70 cm</td>
			<td style="width:136px;">ETHICON, Inc.</td>
			<td style="width:119px;">VCP994H</td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:216px;">PDS II 6-0 monofil; V-18 13 mm 3/8c; 70 cm</td>
			<td style="width:136px;">ETHICON, Inc.</td>
			<td style="width:119px;">Z991H</td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="63">
			<td height="63" style="height:63px;width:216px;">BD Plastipak 1 mL (Syringes with needle with sterile interior)</td>
			<td style="width:136px;">BD Medical</td>
			<td style="width:119px;">305501</td>
			<td style="width:167px;"></td>
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			<td height="63" style="height:63px;width:216px;">Triacid-N (N-Dodecylpropan-1,3-diamin)</td>
			<td style="width:136px;">ANTISEPTICA, Germany</td>
			<td style="width:119px;">18824-01</td>
			<td style="width:167px;">disinfection of surgical instruments in ultrasonic bath</td>
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		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Medications</td>
			<td style="width:136px;"></td>
			<td style="width:119px;"></td>
			<td style="width:167px;"></td>
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		<tr height="42">
			<td height="42" style="height:42px;width:216px;">ketamine 10%, 100 mg/mL (ketamine hydrochloride)</td>
			<td style="width:136px;">selectavet, Dr. Otto Fischer GmbH</td>
			<td style="width:119px;">9089.01.00</td>
			<td style="width:167px;">87 mg/kg i.p.</td>
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		<tr height="42">
			<td height="42" style="height:42px;width:216px;">Xylasel, 20 mg/mL (xylazine hydrochloride)</td>
			<td style="width:136px;">selectavet, Dr. Otto Fischer GmbH</td>
			<td style="width:119px;">400300.00.00</td>
			<td style="width:167px;">13 mg/kg i.p.</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:216px;">NaCl 0.9%</td>
			<td style="width:136px;">Braun Melsungen AG, Germany</td>
			<td style="width:119px;">6697366.00.00</td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:216px;">Buprenovet 0.3 mg/mL (buprenorphine)</td>
			<td style="width:136px;">Bayer, Germany</td>
			<td style="width:119px;">PZN: 01498870</td>
			<td style="width:167px;">0.1 mg/kg s.c.</td>
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		<tr height="42">
			<td height="42" style="height:42px;width:216px;">Tramal Drops, 100 mg/mL (tramadol hydrochloride)</td>
			<td style="width:136px;">Gr&#252;nenthal GmbH, Germany</td>
			<td style="width:119px;">10116838</td>
			<td style="width:167px;">1 mg/mL drinking water</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:216px;">Ceftriaxon-saar 2 g (ceftriaxone)&#160;</td>
			<td style="width:136px;">Cephasaar GmbH, Germany</td>
			<td style="width:119px;">PZN: 08844252</td>
			<td style="width:167px;">25 mg/kg body weight i.p.</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:216px;">metronidazole 5 mg/mL</td>
			<td style="width:136px;">Braun Melsungen AG, Germany</td>
			<td style="width:119px;">PZN: 05543515</td>
			<td style="width:167px;">12.5 mg/kg body weight i.p.</td>
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		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Food</td>
			<td style="width:136px;"></td>
			<td style="width:119px;"></td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">ssniff M-Z Ereich</td>
			<td style="width:136px;">ssniff, Germany</td>
			<td style="width:119px;">&#160;V1184-3</td>
			<td style="width:167px;"></td>
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			<td height="42" style="height:42px;width:216px;">Solid Drink Dehyprev Vit BIO, pouches</td>
			<td style="width:136px;">TripleATrading, the Netherlands</td>
			<td style="width:119px;">SDSHPV-75</td>
			<td style="width:167px;"></td>
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			<td height="21" style="height:21px;width:216px;">Equipment</td>
			<td style="width:136px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="63">
			<td height="63" style="height:63px;width:216px;">Nikon Eclipse Ci-L</td>
			<td style="width:136px;">Nikon Instruments Europe BV, Germany</td>
			<td style="width:119px;"></td>
			<td>light microscopy</td>
		</tr>
		<tr height="63">
			<td height="63" style="height:63px;width:216px;">VetScan HM 5&#160;</td>
			<td style="width:136px;">Abaxis, USA</td>
			<td style="width:119px;">770-9000</td>
			<td style="width:167px;">Veterinary hematology analyzer of 50 &#181;l venous EDTA-blood</td>
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		<tr height="63">
			<td height="63" style="height:63px;width:216px;">Bandelin SONOREX (Ultrasonic bath)</td>
			<td style="width:136px;">Bandelin electronics, Germany</td>
			<td style="width:119px;">RK 100 H</td>
			<td style="width:167px;">disinfection of surgical instruments</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Software</td>
			<td style="width:136px;"></td>
			<td style="width:119px;"></td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="63">
			<td height="63" style="height:63px;">NIS-Element BR4 software</td>
			<td style="width:136px;">Nikon Instruments Europe BV, Germany</td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:216px;">GraphPad Prism Version 6</td>
			<td style="width:136px;">GraphPad Software, Inc.</td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
	</tbody>
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murine distal colostomy, a novel model of diversion colitis in c57bl/6 mice

Diversion colitis (DC) is a frequent clinical condition occurring in patients with bowel segments excluded from the fecal stream as a result of a diverting enterostomy. The etiology of this disease remains ill-defined but appears to differ from that of classical inflammatory bowel diseases such as Crohn's disease and ulcerative colitis. Research aimed to decipher the pathophysiological mechanisms leading to the development of this disease has been severely hampered by the lack of an appropriate murine model. This protocol generates a murine model of DC that facilitates the study of the immune system's role and its interaction with the microbiome in the development of DC. In this model using C57BL/6 animals, distal parts of the colon are excluded from the fecal stream by creating a distal colostomy, triggering the development of mild to moderate inflammation in the excluded bowel segments and reproducing the hallmark lesions of human DC with a moderate systemic inflammatory response. In contrast to the rat model, a large number of genetically-modified murine models on the C57BL/6 background are available. The combination of these animals with our model allows the potential roles of individual cytokines, chemokines, or receptors of bioactive molecules (e.g., interleukin (IL)-17; IL-10, chemokine CXCL13, chemokine receptors CXCR5 and CCR7, and the sphingosine-1-phosphate receptor 4) to be assessed in the pathogenesis of DC. The availability of congenic mouse strains on the C57BL/6 background largely facilitates transfer experiments to establish the roles of distinct cell types involved in the etiology of DC. Finally, the model offers the opportunity to assess the influences of local interventions (e.g., modification of the local microbiome or local anti-inflammatory therapy) on mucosal immunity in affected and non-affected bowel segments and the on systemic immune homeostasis.

Surgery is well tolerated both in the experimental (colostomy) and sham (colotomy) groups. Perioperative mortality should not exceed 10% when surgery and perioperative management is correctly performed. In the first postoperative week, significant weight loss is seen in both the experimental and sham groups. Animals of the sham group attain their weight nadir usually toward the fourth postoperative day, but it occurs one day later in the experimental group. Weight loss is more pronounced ...

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Murine Distal Colostomy, A Novel Model of Diversion Colitis in C57BL/6 Mice

Murine distal colostomy provides a murine model for human diversion colitis, a predominantly lymphocytic colitis in colon segment excluded from the fecal stream.

Diversion colitis (DC) is a frequent clinical condition occurring in patients with bowel segments excluded from the fecal stream as a result of a ...

The overall goal of this protocol is to facilitate the study of the immune system's role and its interaction with the microbiome in the development of Diversion Colitis. This method can help answer key questions regarding Diversion Colitis which occurs in both segments excluded from the fecal stream and affects up to 90%of patients with Diverting Enterostomy. The main advantage of this technique is that it does not require genetically modified animals, the use of chemically irritating substances or the transfer of specific cell populations to immune deficient mice to induce colitis.Upon arrival at the animal facility, divide mice into groups of similar size. Cage each group together and keep the groups constant throughout the experiments. At least one week before surgery, switch to a high energy and high protein feed containing all the essential trace elements and vitamins.To prepare for surgery after anesthetizing the animal according to the text protocol, use tape to stabilize the animal in a supine position on a heating pad to prevent loss of body heat. Then, check that the mouse tolerates mechanical stimulation e.g. toe pinch without a motor response.Before starting surgery, disinfect the operation field three times using alcohol 70%and an iota 4. Drape the operation field to guarantee for aseptic conditions. Perform a 15 mm medium laparotomy by incising the abdominal muscles and the peritoneum along the linea alba thus minimizing blood loss.Then, using two debakey atraumatic forceps, carefully pull the cecum, terminal ileum and descending and transverse colon from the peritoneal cavity. Be careful to limit the mechanical manipulation of the intestine in order to avoid injury to mesenteric structures and to maintain the optimal profusion of the intestine. Next, identify the cecal pole, the ascending colon and the small intestine.If the anatomy of the ileocecal region is ambiguous, the presence of Peyer's patches identifies the small intestine and the presence of forms ature characterizes the colon. Use a ruler to determine the position of the future colostomy. It should be placed 20 mm distal to the ileocecal valve for a distal colostomy.Make a second 3 mm incision in the abdominal wall in the upper right quadrant. Then, pull the previously identified colon segment through this incision to form a loop, taking care not to distort the loop. Carefully pass a 22 gauge, flexible IV canula through the mesocolon, taking care not to damage the mesenteric vascular structures.Then, return the intestine to the peritoneal cavity. Using simple stitches and a resorbable suture, fix both ends of the flexible tube to the skin. Before closing the laparotomy, perform fluid resuscitation using an intra peritoneal injection of 0.5 mL of 0.9%saline.Close the peritoneum and the muscle layer with a continuous resorbable suture. Then, close the skin in a similar manner. Using a fine scissor, open the exteriorized colon loop by performing a subtotal transection.Avoid all injury to the mesentery and do not completely transect the colon. With a monofil absorbable suture, fix each colostomy opening using three single full thickness stitches to the peritoneum and skin. The afferent loop, which is a functional end colostomy and the efferent loop, which is a mucus fistula are clearly separated at this point.To carry out a colotomy, after identifying the cecal pole, ascending colon and small intestine as demonstrated for the distal colostomy, use a ruler to determine the future colotomy position which should be positioned the same distance from the ileocecal valve as the colostomy. Using fine scissors, open the colon at least two-thirds its circumference. Using a monofil absorbable suture, close the colotomy with a full thickness interrupted suture before carrying out fluid resuscitation and closing of the peritoneum and skin as before.Following the procedure, return animals to their cages and place them under an infrared lamp at 37 degrees celsius until they are fully awake before returning them to a temperature and humidity controlled environment. When animals show response to mechanical stimulation, start postoperative analgesia, by injecting 0.1 mg per kg body weight, buprenorphine SC.Carefully check for signs of respiratory depression. Supplement drinking water with 1 mg per mL of tramadol for continued analgesia during the first postoperative week.To compensate for decrease fluid intake due to reduced mobility, supply a solid drink pad in the cage during the first postoperative week. Finally, weigh the animals and score animal behavior daily during the first week, every second day during the remainder of the first month, and every third day during the second month. Surgery is well tolerated both in the experimental and the sham groups.Weight loss is more pronounced in the experimental group reaching 21.7%of initial body weight. In contrast, sham animals lose 10.8%of their initial body weight. Total mortality during the first 60 days postoperatively is around 40%in the colostomy group and about 10%in the sham group.Most deaths occurred during the first postoperative week, with the causes of death shown in this figure. Distal colostomy in mice results in the development of predominantly lymphocytic colitis, reproducing the hallmark histological features of human DC.Crypt length is significantly shortened in excluded bowel segments and reaches statistical significance after 14 days of fecal diversion. The goblet cell-bearing crypt length is reduced after 30 days in excluded bowel segments.Absolute goblet cell numbers are also significantly reduced in crypts in the excluded bowel segment after 14 postoperative days. The hallmark lesion of DC, the development of lymphoid follicles in the mucosa requires a longer duration of stool deviation. Although, an increased number of the lymphoid follicles can be observed as early as two weeks, differences become significant after two months.After watching this video, you should have a good understanding of how to perform a Murine Distal Colostomy. Once mastered, this technique can be done in less than 20 minutes if performed properly. This model can be combined with other genetically modified models or transfer experiments in congenic mouse strains, in order to address the role of inflammatory mediators of specific cell populations, and the pathogenesis of Diversion Colitis.

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