The authors thank Dr. Sven Flemming of the University of Wuerzburg for his contributions to the establishment of the proximal colon loop model, Sean Watson for the management of the mouse colonies and Chithra K. Muraleedharan for helping with the acquisition of the pictures of the iLoop model. This work was supported by the German Research Foundation/DFG (BO 5776/2-1) to KB, R01DK079392, R01DK072564, and R01DK061379 to C.A.P.

All animal experiments were conducted in accordance with the guidelines and policies of the National Institutes of Health and approved by the Institutional Animal Care &#38; Use Committee at the University of Michigan.
1. Preoperative preparation
NOTE: This method was generated employing adult mice from C57BL/6 genetic background, aged 8 - 12 weeks. All mice were kept under strict specific pathogen free conditions with ad libitum access to normal chow and water. Resul...

The mechanisms responsible for dysregulation of intestinal barrier function and immune cell recruitment under pathologic conditions such as IBD are incompletely understood. Here, we detail a robust in vivo murine model that employs a well-vascularized exteriorized intestinal segment of either ileum or proximal colon and allows for assessment of intestinal permeability, neutrophil migration studies as well as other applications.
The iLoop is a non-recovery surgery that is performed on live anim...

The intestinal mucosa encompasses a single layer of columnar intestinal epithelial cells (IECs), underlying lamina propria immune cells and the muscularis mucosae. Besides its role in the absorption of nutrients, the intestinal epithelium is a physical barrier that protects the body interior from luminal commensal bacteria, pathogens, and dietary antigens. In addition, IECs and lamina propria immune cells coordinate the immune response inducing either tolerance or response depending on the context and stimuli. It has been reported that the disruption of the epithelial barrier can precede the onset of pathologic mucosal inflammation and contribute to inflammatory bowel disease (IBD) encompassing both ulcerative colitis and Crohn&#39;s disease1,2,3,4,5,6,7. Individuals with ulcerative colitis present excessive transepithelial migration (TEpM) of polymorphonuclear neutrophils (PMN) forming crypt abscesses, a finding that has been associated with severity of disease8,9. Although compromised epithelial barrier function and excessive immune responses are hallmarks of IBD, there is a lack of experimental in vivo assays to perform quantitative assessments of intestinal permeability and immune cell recruitment into the intestinal mucosa.
The most common methods used to study intestinal epithelial permeability and PMN TEpM employ ex vivo chamber-based approaches using IEC monolayers cultured on semi-permeable porous membrane inserts10,11,12. The epithelial barrier integrity is monitored either by measurements of transepithelial electrical resistance (TEER) or the paracellular flux of the Fluorescein isothiocyanate (FITC)-labeled dextran from apical to basal compartment13,14,15. Similarly, PMN TEpM is typically studied in response to a chemoattractant that is added in the lower chamber16. PMN are placed in the upper chamber and after an incubation period, PMN that have migrated into the basal compartment are collected and quantified. While these methods are useful, easy to perform and very reproducible, they are obviously reductionist approaches and do not necessarily represent an accurate reflection of in vivo conditions.
In mice, a common assay to study intestinal paracellular permeability is by oral gavage of FITC-dextran and subsequent measurement of FITC-dextran appearance in the blood serum13,17. The disadvantage of this assay is that it represents an assessment of overall barrier integrity of the gastrointestinal tract rather than that of regional intestinal contributions. In addition, Evans blue is commonly used to evaluate vascular leakage in vivo18 and has also been employed to evaluate intestinal mucosal permeability in mouse and rat19,20,21. The quantification of Evans blue in the intestinal mucosa requires extraction from tissue employing incubation in formamide overnight. Therefore, the same tissue cannot be used to study intestinal epithelial permeability and neutrophil infiltration.
Here we highlight a simple protocol that reduces the number of animals needed to collect reproducible data on colonic mucosal permeability and leukocyte transepithelial migration in vivo. We, therefore, recommend the use of FITC-dextrans that are easily detectable in blood serum without compromising the integrity of intestinal loops which can be harvested for further analysis. Of note, the intestinal ligated loops have been used in various species (including mouse, rat, rabbit, calf) to study bacterial infection (such as Salmonella, Listeria monocytogenes and Escherichia coli)22,23,24,25 as well as intestinal permeability26; however, to the best of our knowledge there are no studies investigating mechanisms of PMN TEpM in specific regions in the intestine such as ileum or colon that are commonly involved in IBD.
Here we describe the mouse intestinal loop (iLoop) model that is a robust and reliable microsurgical in vivo method that employs a well-vascularized and exteriorized intestinal segment of either the ileum or proximal colon. The iLoop model is physiologically relevant and allows the assessment of intestinal barrier integrity and PMN TEpM on living mice under anesthesia. We demonstrate two applications: 1) quantification of serum levels of 4 kDa FITC-dextran after intraluminal administration in the iLoop 2) quantification of transmigrated PMN in the iLoop lumen after intraluminal injection of&#160;the potent chemottractant Leukotriene B4 (LTB4)27. Moreover, utilizing the iLoop model with Jam-a-null mice or mice harboring selective loss of JAM-A on IECs (Villin-cre;Jam-a fl/fl) compared to control mice, we are able to corroborate previous studies that have reported a major contribution for tight junction-associated protein JAM-A to intestinal permeability and neutrophil transmigration15,28,29,30,31.
The iLoop model is a highly functional and physiological method that can be used to corroborate in vitro assays. Furthermore, this is a versatile experimental model that allows the study of various reagents that can be injected into the loop lumen, including chemokines, cytokines, bacterial pathogens, toxins, antibodies and therapeutics.

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			<td>Equipment and Material</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>BD Alcohol Swabs</td>
			<td>BD</td>
			<td>326895</td>
			<td></td>
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		<tr>
			<td>BD PrecisionGlide Needle, 25G X 5/8&#34;</td>
			<td>BD</td>
			<td>305122</td>
			<td></td>
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		<tr>
			<td>BD PrecisionGlide Needle, 30G X 1/2&#34;</td>
			<td>BD</td>
			<td>305106</td>
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			<td>BD 1ml Tuberculin Syringe Without Needle</td>
			<td>BD</td>
			<td>309659</td>
			<td></td>
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		<tr>
			<td>15ml Centrifuge Tube</td>
			<td>Corning</td>
			<td>14-959-53A</td>
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			<td>Corning 96-Well Solid Black Polystyrene Microplate</td>
			<td>FisherScientific</td>
			<td>07-200-592</td>
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			<td>Corning Non-treated Culture Dish, 10cm</td>
			<td>MilliporeSigma</td>
			<td>CLS430588</td>
			<td></td>
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		<tr>
			<td>Cotton Tip Applicator (cotton swab), 6&#34;, sterile</td>
			<td>FisherScientific</td>
			<td>25806 2WC</td>
			<td></td>
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		<tr>
			<td>Dynarex Cotton Filled Gauze Sponges, Non-Sterile, 2&#34; x 2&#34;</td>
			<td>Medex</td>
			<td>3249-1</td>
			<td></td>
		</tr>
		<tr>
			<td>EZ-7000 anesthesia vaporizer (Classic System, including heating units)</td>
			<td>E-Z Systems</td>
			<td>EZ-7000</td>
			<td></td>
		</tr>
		<tr>
			<td>Falcon Centrifuge Tube 50ml&#160;</td>
			<td>VWR</td>
			<td>21008-940</td>
			<td></td>
		</tr>
		<tr>
			<td>Fisherbrand Colored Labeling Tape</td>
			<td>FisherScientific</td>
			<td>15-901-10R</td>
			<td></td>
		</tr>
		<tr>
			<td>Halsey Needle Holder (needle holder)&#160;</td>
			<td>FST</td>
			<td>12001-13</td>
			<td></td>
		</tr>
		<tr>
			<td>Kimwipes, small (tissue wipe)</td>
			<td>FisherScientific</td>
			<td>06-666</td>
			<td></td>
		</tr>
		<tr>
			<td>1.7ml Microcentrifuge Tubes&#160;</td>
			<td>Thomas Scientific&#160;</td>
			<td>c2170</td>
			<td></td>
		</tr>
		<tr>
			<td>Micro Tube 1.3ml Z (serum clot activator tube)</td>
			<td>Sarstedt&#160;</td>
			<td>41.1501.105</td>
			<td></td>
		</tr>
		<tr>
			<td>Moria Fine Scissors</td>
			<td>FST</td>
			<td>14370-22</td>
			<td></td>
		</tr>
		<tr>
			<td>5ml Polystyrene Round-Bottom Tube with Cell-Strainer Cap (35 &#181;m nylon mesh)</td>
			<td>Falcon</td>
			<td>352235</td>
			<td></td>
		</tr>
		<tr>
			<td>Puralube Vet Ointment, Sterile Ocular Lubricant</td>
			<td>Dechra</td>
			<td>12920060</td>
			<td></td>
		</tr>
		<tr>
			<td>Ring Forceps (blunt tissue forceps)</td>
			<td>FST</td>
			<td>11103-09</td>
			<td></td>
		</tr>
		<tr>
			<td>Roboz Surgical 4-0 Silk Black Braided, 100 YD</td>
			<td>FisherScientific</td>
			<td>NC9452680</td>
			<td></td>
		</tr>
		<tr>
			<td>Semken Forceps (anatomical forceps)</td>
			<td>FST</td>
			<td>1108-13</td>
			<td></td>
		</tr>
		<tr>
			<td>Sofsilk Nonabsorbable Coated Black Suture Braided Silk Size 3-0, 18&#34;, Needle 19mm length 3/8 circle reverse cutting&#160;</td>
			<td>HenrySchein</td>
			<td>SS694</td>
			<td></td>
		</tr>
		<tr>
			<td>Student Fine Forceps, Angled</td>
			<td>FST</td>
			<td>91110-10</td>
			<td></td>
		</tr>
		<tr>
			<td>10ml Syringe PP/PE without needle</td>
			<td>Millipore Sigma&#160;</td>
			<td>Z248029</td>
			<td></td>
		</tr>
		<tr>
			<td>96 Well Cell Culture Plate</td>
			<td>Corning</td>
			<td>3799</td>
			<td></td>
		</tr>
		<tr>
			<td>Yellow Feeding Tubes for Rodents 20G x 30 mm</td>
			<td>Instech</td>
			<td>FTP-20-30</td>
			<td></td>
		</tr>
		<tr>
			<td>Solutions and Buffers</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Accugene 0.5M EDTA</td>
			<td>Lonza</td>
			<td>51201</td>
			<td></td>
		</tr>
		<tr>
			<td>Ammonium-Chloride-Potassium (ACK) Lysing Buffer</td>
			<td>BioWhittaker</td>
			<td>10-548E</td>
			<td></td>
		</tr>
		<tr>
			<td>Hanks&#39; Balanced Salt Solution</td>
			<td>Corning</td>
			<td>21-023-CV</td>
			<td></td>
		</tr>
		<tr>
			<td>Phosphate-Buffered Saline without Calcium and Magnesium</td>
			<td>Corning</td>
			<td>21-040-CV</td>
			<td></td>
		</tr>
		<tr>
			<td>Reagents</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Alexa Fluor 647 Anti-Mouse Ly-6G Antibody (1A8)</td>
			<td>BioLegend</td>
			<td>127610</td>
			<td></td>
		</tr>
		<tr>
			<td>CD11b Monoclonal Antibody, PE, eBioscience (M1/70)</td>
			<td>ThermoFisher</td>
			<td>12-0112-81</td>
			<td></td>
		</tr>
		<tr>
			<td>CountBright Absolute Counting Beads</td>
			<td>Invitrogen</td>
			<td>C36950</td>
			<td></td>
		</tr>
		<tr>
			<td>Dithiotreitol</td>
			<td>FisherScientific</td>
			<td>BP172-5</td>
			<td></td>
		</tr>
		<tr>
			<td>Fetal Bovine Serum, heat inactivated</td>
			<td>R&#38;D Systems</td>
			<td>511550</td>
			<td></td>
		</tr>
		<tr>
			<td>Fluorescein Isothiocyanate-Dextran, average molecular weight 4.000</td>
			<td>Sigma</td>
			<td>60842-46-8</td>
			<td></td>
		</tr>
		<tr>
			<td>Isoflurane</td>
			<td>Halocarbon</td>
			<td>12164-002-25</td>
			<td></td>
		</tr>
		<tr>
			<td>Leukotriene B4</td>
			<td>Millipore Sigma</td>
			<td>71160-24-2</td>
			<td></td>
		</tr>
		<tr>
			<td>PerCP Rat Anti-Mouse CD45 (30-F11)</td>
			<td>BD Pharmingen</td>
			<td>557235</td>
			<td></td>
		</tr>
		<tr>
			<td>Purified Rat Anti-Mouse CD16/CD32 (Mouse BD FC Block)</td>
			<td>BD Bioscience</td>
			<td>553142</td>
			<td></td>
		</tr>
		<tr>
			<td>Recombinant Murine IFN-&#947;</td>
			<td>Peprotech</td>
			<td>315-05</td>
			<td></td>
		</tr>
		<tr>
			<td>Recombinant Murine TNF-&#945;</td>
			<td>Peprotech</td>
			<td>315-01A</td>
			<td></td>
		</tr>
	</tbody>
</table>

functional assessment of intestinal permeability and neutrophil transepithelial migration in mice using a standardized intestinal loop model

The intestinal mucosa is lined by a single layer of epithelial cells that forms a dynamic barrier allowing paracellular transport of nutrients and water while preventing passage of luminal bacteria and exogenous substances. A breach of this layer results in increased permeability to luminal contents and recruitment of immune cells, both of which are hallmarks of pathologic states in the gut including inflammatory bowel disease (IBD). 
Mechanisms regulating epithelial barrier function and transepithelial migration (TEpM) of polymorphonuclear neutrophils (PMN) are incompletely understood due to the lack of experimental in vivo methods allowing quantitative analyses. Here, we describe a robust murine experimental model that employs an exteriorized intestinal segment of either ileum or proximal colon. The exteriorized intestinal loop (iLoop) is fully vascularized and offers physiological advantages over ex vivo chamber-based approaches commonly used to study permeability and PMN migration across epithelial cell monolayers.
We demonstrate two applications of this model in detail: (1) quantitative measurement of intestinal permeability through detection of fluorescence-labeled dextrans in serum after intraluminal injection, (2) quantitative assessment of migrated PMN across the intestinal epithelium into the gut lumen after intraluminal introduction of chemoattractants. We demonstrate feasibility of this model and provide results utilizing the iLoop in mice lacking the epithelial tight junction-associated protein JAM-A compared to controls. JAM-A has been shown to regulate epithelial barrier function as well as PMN TEpM during inflammatory responses. Our results using the iLoop confirm previous studies and highlight the importance of JAM-A in regulation of intestinal permeability and PMN TEpM in vivo during homeostasis and disease. 
The iLoop model provides a highly standardized method for reproducible in vivo studies of intestinal homeostasis and inflammation and will significantly enhance understanding of intestinal barrier function and mucosal inflammation in diseases such as IBD.

A schematic representation of the ileal loop and pcLoop models is depicted in Figure 1 and Figure 2, respectively. The anatomical pictures display the critical steps of the procedure including exteriorization of the intestinal segment (Figure 1B and Figure 2B), identification of an appropriate location for ligations that allows minimal disturbance of blood supply (<strong class=...

Watch this Scientific Journal Video about Functional Assessment of Intestinal Permeability and Neutrophil Transepithelial Migration in Mice using a Standardized Intestinal Loop Model at JoVE.com

Functional Assessment of Intestinal Permeability and Neutrophil Transepithelial Migration in Mice using a Standardized Intestinal Loop Model

Dysregulated intestinal epithelial barrier function and immune responses are hallmarks of inflammatory bowel disease that remain poorly investigated due to a lack of physiological models. Here, we describe a mouse intestinal loop model that employs a well-vascularized and exteriorized bowel segment to study mucosal permeability and leukocyte recruitment in vivo.

The intestinal mucosa is lined by a single layer of epithelial cells that forms a dynamic barrier allowing paracellular transport of nutrients and water ...