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The access of nutrients, microbiota metabolites and medicines to the circulation is controlled by the gut-blood barrier (GBB). We describe a direct method for measuring the GBB permeability in vivo, which, in contrast to commonly used indirect methods, is virtually not affected by liver and kidney functions.
The gut-blood barrier (GBB) controls the passage of nutrients, bacterial metabolites and drugs from intestinal lumen to the bloodstream. The GBB integrity is disturbed in gastrointestinal, cardiovascular and metabolic diseases, which may result in easier access of biologically active compounds, such as gut bacterial metabolites, to the bloodstream. Thus, the permeability of the GBB may be a marker of both intestinal and extraintestinal diseases. Furthermore, the increased penetration of bacterial metabolites may affect the functioning of the entire organism.
Commonly used methods for studying the GBB permeability are performed ex vivo. The accuracy of those methods is limited, because the functioning of the GBB depends on intestinal blood flow. On the other hand, commonly used in vivo methods may be biased by liver and kidney performance, as those methods are based on evaluation of urine or/and peripheral blood concentrations of exogenous markers. Here, we present a direct measurement of GBB permeability in rats using an in vivo method based on portal blood sampling, which preserves intestinal blood flow and is virtually not affected by the liver and kidney function.
Polyurethane catheters are inserted into the portal vein and inferior vena cava just above the hepatic veins confluence. Blood is sampled at baseline and after administration of a selected marker into a desired part of the gastrointestinal tract. Here, we present several applications of the method including (1) evaluation of the colon permeability to TMA, a gut bacterial metabolite, (2) evaluation of liver clearance of TMA, and (3) evaluation of a gut-portal blood-liver-peripheral blood pathway of gut bacteria-derived short-chain fatty acids. Furthermore, the protocol may also be used for tracking intestinal absorption and liver metabolism of drugs or for measurements of portal blood pressure.
The gut-blood barrier (GBB), also known as the intestinal barrier, is a complex multilayer system that separates the gut lumen from the bloodstream in order to limit the passage of harmful compounds while allowing the absorption of nutrients1. It consists of the three main layers: the mucus layer, epithelium and lamina propria.
Numerous factors may affect the GBB integrity and function2. It has been shown that GBB is disturbed in both gastrointestinal and extraintestinal diseases, including cardiovascular and metabolic diseases3, which may lead to an increased passage of gut bacterial metabolites to the bloodstream4. An increased penetration of gut bacterial metabolites may affect the functioning of the entire organism. For example, recent studies show a significant impact of bacterial metabolites, such as indoles, H2S, short-chain fatty acids (SCFA), and trimethylamine N-oxide, on the circulatory system functions5,6,7,8,9. Finally, it has been proposed that an increased GBB permeability may serve as a marker of cardiovascular and metabolic diseases which are associated with morphological and functional alterations in the intestines10. Therefore, tracking the gut-portal blood-liver-systemic blood pathway of bacterial metabolites may be of interest for both basic and clinical sciences.
Commonly utilized experimental methods for the evaluation of GBB permeability are performed in vitro using resected intestinal segments, fragments of mucosa, or artificial membranes11,12. The accuracy of those methods is compromised by the fact that proper functioning of the GBB requires constant intestinal blood flow. On the other hand, the available in vivo methods are based on the evaluation of urine or peripheral blood concentrations of exogenous markers13. However, peripheral blood and urine concentration of exogenous compounds is influenced by kidney function, i.e., glomerular filtration rate and tubular excretion, as well as by liver metabolism, i.e., first pass metabolism. Both parameters may differ significantly between study subjects independently of the GBB function.
This paper describes a direct measurement of the GBB permeability in rats using portal blood sampling. This in vivo method preserves the intestinal blood flow and is virtually not influenced by liver and kidney function. The described approach is not commonly used, possibly because of some methodological difficulties. We describe in detail the catheterization of the portal vein and inferior vena cava just above the hepatic vein confluence. Blood sampling from the portal vein and inferior vena cava allows evaluation of the GBB permeability and liver clearance as well as tracking of gut-portal blood-liver-systemic blood pathway of molecules of interest, such as gut bacterial metabolites or medicines. We also present several applications of the method that were tested in our laboratory. These include the evaluation of the colon permeability to TMA, a gut bacterial metabolite, evaluation of liver clearance of TMA, and evaluation of a gut-portal blood-liver-systemic blood pathway of SCFA.
To evaluate gut-blood barrier permeability, the following protocol steps should be followed, in order: 1 (insertion of the line for intraintestinal administrations), 3 (portal vein catheterization), 4 (portal vein blood sampling), 6 (administration of a gut permeability marker), 4.
To evaluate liver clearance and a gut-portal blood-liver-systemic blood pathway, the following protocol steps should be followed, in order: 1 (insertion of the line for intraintestinal administrations), 2 (inferior vena cava catheterization), 3 (portal vein catheterization), 4 (portal vein blood sampling), 5 (inferior vena cava blood sampling), 6 (administration of a gut permeability marker), 4, 5, 7 (calculation of liver clearance).
The experiments were performed on male Wistar Kyoto rats according to Directive 2010/63 EU on the protection of animals used for scientific purposes and were approved by the I Local Bioethical Committee in Warsaw.
1. Insertion of the Line for Intraintestinal Administration
NOTE: Here we propose intracolonic administration of a marker using a catheter. It may be modified by oral administration or gavage at various levels of the digestive tract e.g. stomach or duodenum. Remember to use disposable surgical clothing, including surgical gown, hood and gloves, and ensure to follow the safety precautions related to the sharp tools used in surgery (needles, etc.) during procedures 1-6.
2. Inferior Vena Cava Catheterization
3. Portal Vein Catheterization
Figure 1: Portal catheter. The portal catheter consists of a needle OD: 0.9 mm with a length of about 25.0 mm [A], a flexible polyurethane catheter OD: 0.025", length about 100.0 mm [B], a flexible polyethylene tip of the catheter OD: 0.040", approximately 15.0 mm long [C], a plug [D], and a ligature 3/0 with a length of 100.0 mm [E]. Please click here to view a larger version of this figure.
4. Portal Vein Blood Sampling
Short protocol | Long protocol |
t0 – baseline (before intracolonic administration) | t0 – baseline (before intracolonic administration) |
t1 – 5 min after intracolonic administration | t1 – 30 min after intracolonic administration |
t2 – 30 min after intracolonic administration | t2 – 60 min after intracolonic administration |
Table 1: Portal blood sampling protocols for gut permeability assessment.
NOTE: The time between consecutive blood sampling depends mainly on the bioavailability of the tested substances and the site of administration (colon, stomach, etc.).
5. Inferior Vena Cava Blood Sampling
Portal vein | Inferior vena cava |
t0 – baseline (before intracolonic administration) | t0 – baseline (before intracolonic administration) |
t1 – 30 min after intracolonic administration | t1 – 30 min after intracolonic administration |
Table 2: Protocol of blood sampling for liver clearance measurement and tracking the gut-portal blood-liver-systemic blood pathway.
6. Administration of a Gut Permeability Marker
7. Calculation of Liver Clearance
8. Evaluation of the Test Substance Concentration n Blood Samples
We have successfully measured the GBB permeability and liver clearance of TMA in rats. We have demonstrated that hypertensive rats have an increased colon permeability to TMA in comparison to normotensive rats (Figure 2)4. In another study we found that high salt intake does not affect the GBB permeability and liver clearance of TMA (Figure 3)14.
The described direct, in vivo, method of measuring the GBB permeability maintains closetophysiological conditions in the gastrointestinal system (preserves the intestinal blood flow), and is virtually not influenced by liver and kidney function.
The critical step of this technique is the insertion of the portal catheter. This must be done gently and decisively at the same time. A mild, short bleeding may occur from the correctly performed puncture of the portal vein; however, it stops...
The authors have nothing to disclose.
The work is supported by the Ministry of Science and Higher Education Republic of Poland, Diamond grant no: DI2017 009247.
Name | Company | Catalog Number | Comments |
Needle OD: 9 mm | Becton Dickinson S.A. | 301300 | |
Polyethylene catheter ID: 0.025", OD: 0.040" | Scientific Commodities, Inc. | #BB520-40 | |
Polyethylene catheter ID: 0.012", OD: 0.025" | Scientific Commodities, Inc. | #BB520-25 | |
C-Flex Tubing,Opaque White 1/50"ID x 1/12 " OD | Cole-Parmer Instrument Co. | 06424-59 | |
Pediatric Foley catheter (size 10F or 8F) | Sigmed | 0000 80305 | |
Surgical ligatures 3/0 | Yavo Sp. Z o.o. | P48JE | |
Absorbable surgical sutures - Polyglactine 910 4/0 | KRUUSE Polska Sp. Zo.o. | 152336 | |
Tissue glue - Loctite 454Cyanoacrylate Adhesive | Loctite | 1370127 | |
Povidone iodine | EGIS Pharmaceuticals PLC | 4449 11 | |
Heparin - Heparinium WZF | WZF Polfa S.A. | 02BK0417 | Dilute 10 times with physiological saline |
Glycerin 86% | Laboratorium Farmaceutyczne Avena | 5.90999E+12 | Serves as a lubricant in colon catheterization |
Xylocaine 2% | AstraZenca | 9941342 | |
Urethane | Sigma-Aldrich (Merck) | U2500-500G | |
Trimethylamine solution 45% | Sigma-Aldrich (Merck) | 92262-1L | |
Syringes 2 mL | B.Braun Melsungen AG | 4606027V | |
Saline 250 mL | Fraesenius Kabi Polska Sp. Z o.o. | 15LL707WL | |
Surgical scissors, straight, length 115 mm, 4 1/2 "blunt ends | Braun | NS-010-115-PKM | |
Artery forceps type Micro-Adson bent, length 140 mm 5 1/2 " | Braun | KN-008-140-ZMK | |
Anatomic forceps, lenght 95 mm, 3 3/4" sharp 0.7x0.55 | Braun | PO-001-007-ZMK | |
Micro Scissors type Vannas, straight, lenght 85 mm, 3 3/8 " the length of the blades 6 mm | Braun | NO-010-085-PMK | |
Towel clamps type Backhouse, lenght 130 mm, 5 1/8" | Braun | HO-128-130-PMK | |
Needle holders, lenght 150 mm, 6" t=0.4 1/2 | Braun | IM-927-150-PZMK | |
Delicate Scissors, lenght 110 mm , straight, 4 3/8” sharp | Braun | NO-052-110-PMK | |
Anatomic forceps, lenght 95 mm, 3 3/4" sharp | Braun | PO-022-001-PMK |
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