Name: a ligated intestinal loop model in anesthetized specific pathogen free chickens to study clostridium perfringens virulence
Uploaded: 2018-10-11T12:30:00
Description: Watch this Scientific Journal Video about A Ligated Intestinal Loop Model in Anesthetized Specific Pathogen Free Chickens to Study Clostridium Perfringens Virulence at JoVE.com

This work was supported by the Chair in Poultry Research (M. Boulianne) from the Faculty of Veterinary Medicine of the Universit&#233; de Montr&#233;al. Drs. Boulianne and Parent developed the model. Drs. Boulianne and Parent performed the surgeries. Dr. Burns assisted in developing the anesthesia protocol. Dr. Parent edited the video and wrote the manuscript. Drs Burns, Desrochers and Boulianne edited the manuscript.

All procedures with live animal use were authorized by the Ethical Committee of the Faculty of Veterinary Medicine, Universit&#233; de Montr&#233;al (C&#201;UA, &#39;Comit&#233; d&#39;&#233;thique de l&#39;utilisation des Animaux&#39;).
1. Considerations Before Surgery
<ol>
	<li>Select 10 weeks old specific pathogen free (SPF) leghorn chickens for the surgery. 
	NOTE: Their weight must be between 1.0 and 1.2 kg.</li>
	<li>Withdraw the feed 12 h prior to the procedures to empty the intes...

<ol>
	<li>Vitale, A., Chiarotti, F., Alleva, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+use+of+animal+models+in+disease+research.">The use of animal models in disease research.</a> Rare diseases and orphan drugs. 2 (1), 1-4 (2015).</li><li>Uzal, F. A., 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=Animal+models+to+study+the+pathogenesis+of+human+and+animal+Clostridium+perfringens+infections.">Animal models to study the pathogenesis of human and animal Clostridium perfringens infections.</a> Veterinary Microbiology. , (2015).</li><li>Bernier, G., Phaneuf, J. B., Filion, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Necrotic+enteritis+in+broiler+chickens.+III.+Study+of+the+factors+favoring+the+multiplication+of+Clostridium+perfringens+and+the+experimental+transmission+of+the+disease.">Necrotic enteritis in broiler chickens. III. Study of the factors favoring the multiplication of Clostridium perfringens and the experimental transmission of the disease.</a> Canadian Journal of Comparative Medicine. 41 (1), 112-116 (1977).</li><li>Al-Sheikhly, F., Truscott, R. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+pathology+of+necrotic+enteritis+of+chickens+following+infusion+of+broth+cultures+of+Clostridium+perfringens+into+the+duodenum.">The pathology of necrotic enteritis of chickens following infusion of broth cultures of Clostridium perfringens into the duodenum.</a> Avian Diseases. 21 (2), 230-240 (1977).</li><li>Wicker, D. L., Iscrigg, W. N., Trammell, J. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+control+and+prevention+of+necrotic+enteritis+in+broilers+with+zinc+bacitracin.">The control and prevention of necrotic enteritis in broilers with zinc bacitracin.</a> Poultry Science. 56 (4), 1229-1231 (1977).</li><li>Keyburn, A. L., 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=NetB,+a+new+toxin+that+is+associated+with+avian+necrotic+enteritis+caused+by+Clostridium+perfringens.">NetB, a new toxin that is associated with avian necrotic enteritis caused by Clostridium perfringens.</a> PLoS Pathog. 4 (2), e26 (2008).</li><li>Timbermont, L., 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=Origin+of+Clostridium+perfringens+isolates+determines+the+ability+to+induce+necrotic+enteritis+in+broilers.">Origin of Clostridium perfringens isolates determines the ability to induce necrotic enteritis in broilers.</a> Comp Immunol Microbiol Infect Dis. 32 (6), 503-512 (2009).</li><li>Paradis, M. A., 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=Efficacy+of+avilamycin+for+the+prevention+of+necrotic+enteritis+caused+by+a+pathogenic+strain+of+Clostridium+perfringens+in+broiler+chickens.">Efficacy of avilamycin for the prevention of necrotic enteritis caused by a pathogenic strain of Clostridium perfringens in broiler chickens.</a> Avian Pathol. 45 (3), 365-369 (2016).</li><li>Valgaeren, B., 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=Lesion+development+in+a+new+intestinal+loop+model+indicates+the+involvement+of+a+shared+Clostridium+perfringens+virulence+factor+in+haemorrhagic+enteritis+in+calves.">Lesion development in a new intestinal loop model indicates the involvement of a shared Clostridium perfringens virulence factor in haemorrhagic enteritis in calves.</a> Journal of Comparative Pathology. 149 (1), 103-112 (2013).</li><li>Goossens, E., 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+C-terminal+domain+of+Clostridium+perfringens+alpha+toxin+as+a+vaccine+candidate+against+bovine+necrohemorrhagic+enteritis.">The C-terminal domain of Clostridium perfringens alpha toxin as a vaccine candidate against bovine necrohemorrhagic enteritis.</a> Vet Res. 47 (1), 52 (2016).</li><li>Goossens, E., 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=Toxin-neutralizing+antibodies+protect+against+Clostridium+perfringens-induced+necrosis+in+an+intestinal+loop+model+for+bovine+necrohemorrhagic+enteritis.">Toxin-neutralizing antibodies protect against Clostridium perfringens-induced necrosis in an intestinal loop model for bovine necrohemorrhagic enteritis.</a> BMC Vet Res. 12 (1), 101 (2016).</li><li>Parent, E., Archambault, M., Charlebois, A., Bernier-Lachance, J., Boulianne, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+chicken+intestinal+ligated+loop+model+to+study+the+virulence+of+Clostridium+perfringens+isolates+recovered+from+antibiotic-free+chicken+flocks.">A chicken intestinal ligated loop model to study the virulence of Clostridium perfringens isolates recovered from antibiotic-free chicken flocks.</a> Avian Pathol. 46 (2), 138-149 (2017).</li><li>Janvilisri, T., 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=Temporal+differential+proteomes+of+Clostridium+difficile+in+the+pig+ileal-ligated+loop+model.">Temporal differential proteomes of Clostridium difficile in the pig ileal-ligated loop model.</a> PLoS One. 7 (9), e45608 (2012).</li><li>Aabo, S., 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=Development+of+an+in+vivo+model+for+study+of+intestinal+invasion+by+Salmonella+enterica+in+chickens.">Development of an in vivo model for study of intestinal invasion by Salmonella enterica in chickens.</a> Infection and Immunity. 68 (12), 7122-7125 (2000).</li><li>Meurens, F., 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=Early+immune+response+following+Salmonella+enterica+subspecies+enterica+serovar+Typhimurium+infection+in+porcine+jejunal+gut+loops.">Early immune response following Salmonella enterica subspecies enterica serovar Typhimurium infection in porcine jejunal gut loops.</a> Vet Res. 40 (1), 5 (2009).</li><li>Gerdts, V., 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=Multiple+intestinal+'loops'+provide+an+in+vivo+model+to+analyse+multiple+mucosal+immune+responses.">Multiple intestinal 'loops' provide an in vivo model to analyse multiple mucosal immune responses.</a> J Immunol Methods. 256 (1-2), 19-33 (2001).</li><li>Wade, B., 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+adherent+abilities+of+Clostridium+perfringens+strains+are+critical+for+the+pathogenesis+of+avian+necrotic+enteritis.">The adherent abilities of Clostridium perfringens strains are critical for the pathogenesis of avian necrotic enteritis.</a> Vet Microbiol. 197, 53-61 (2016).</li><li>Cooper, K. K., 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=Virulence+for+chickens+of+Clostridium+perfringens+isolated+from+poultry+and+other+sources.">Virulence for chickens of Clostridium perfringens isolated from poultry and other sources.</a> Anaerobe. 16 (3), 289-292 (2010).</li><li>Cooper, K. K., Songer, J. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Virulence+of+Clostridium+perfringens+in+an+experimental+model+of+poultry+necrotic+enteritis.">Virulence of Clostridium perfringens in an experimental model of poultry necrotic enteritis.</a> Veterinary Microbiology. 142 (3-4), 323-328 (2010).</li><li>Chalmers, G., Bruce, H. L., Toole, D. L., Barnum, D. A., Boerlin, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Necrotic+enteritis+potential+in+a+model+system+using+Clostridium+perfringens+isolated+from+field+outbreaks.">Necrotic enteritis potential in a model system using Clostridium perfringens isolated from field outbreaks.</a> Avian Diseases. 51 (4), 834-839 (2007).</li></ol>

Intestinal loops models have been described in numerous species to study host-pathogen interaction and pathogenesis of diseases caused by various intestinal pathogens, such as Clostridium perfringens, Clostridium difficile and Salmonella enterica7,9,13,14,15. It has also been used to analyze the mucosal immune response<sup class="xre...

The use of animal models to study infectious diseases affecting humans and animals is a central tool in assessing virulence factors regulating the pathogenesis of a specific condition as well as to elaborate strategies to prevent or cure diseases1. Despite numerous advantages of using animal models to study various diseases, ethical concerns regarding this practice are arising. Researchers need to minimize animal use while obtaining significant and valid results. The concept of the 3 Rs principles (Replace, Reduce and Refine) was elaborated to ensure that welfare issues were addressed in such trials. In chicken necrotic enteritis studies, in vivo chicken models are used to investigate the etiology, prevention, and treatments of this condition2,3,4,5. Pathogenic strains of C. perfringens carrying specific virulence factors, such as the NetB toxin6, are administered to cause necrotic enteritis in chickens7. The replacement principle is, therefore, difficult to achieve in such case as these virulence factors may not be as critical in other animal species. Most models for necrotic enteritis in chickens use a combination of risk factors, such as coccidiosis and altered diet to induce necrotic enteritis followed by gavage of broth culture containing large numbers of C. perfringens2. These models will induce the disease in a large number of chickens, and mortality can be important in such trials8, thus raising concerns about the reduction and refinement principles in animal research.
Intestinal ligated loops models are a desirable alternative for the study of diseases induced by intestinal pathogens with respect to the principle reduction, and refinement. In these models, intestinal segments called &#39;loops&#39; are created by placing ligatures along the intestinal tract to form independent and hermetic compartments where pathogens can be injected alone9 or with other molecules, such as vaccine candidates10,11. The pathogens of interest are placed in close contact with the intestinal cells and after a few hours of infection time, intestinal samples can be recovered for further analysis. This allows the use of multiple treatment and control groups in the same animal. Statistical analysis can be performed with repeated measures models, which increases the power of discrimination between groups and reduces the number of necessary chickens compared to oral gavage trials. Also, surgical procedures and subsequent infection times are performed under continuous general anesthesia and analgesia, hence minimizing the animal pain. Closed loop ligations are an ideal template for reducing host numbers and creating a more humane system in animal research.
Intestinal ligated loops models are well described in various species, such as calves, rabbits and mice2,9, but poorly described in chickens7. For an optimal use of this surgical model, proper technique and execution are essential for the creation of ligated intestinal loops to avoid damages to the intestinal integrity. The goal of this manuscript is to describe a step by step method in the creation of multiple intestinal loops in a chicken model. This technique is limited by the surgeon&#39;s skill and experience, as accurate procedures are essential for the success of the project.

<table>
	<tbody>
		<tr>
			<td>EZ-Scrub 747</td>
			<td>Becton Dickinson and Company</td>
			<td></td>
			<td>4% chlorhexidine gluconate detergent impregnated sterile brush. No catalog number available. Web address: https://www.bd.com/en-us/offerings/capabilities/infection-prevention/surgical-hand-scrubs/ez-scrub-preoperative-surgical-scrub-brushes&#160;</td>
		</tr>
		<tr>
			<td>Isopropyl alcohol 70% USP 4 L</td>
			<td>Commercial isopropyl alcohol</td>
			<td>P016IP70</td>
			<td>Web address: http://www.comalc.com/products/</td>
		</tr>
		<tr>
			<td>Chlorexidine</td>
			<td>Sigma-Aldrich</td>
			<td>282227-1G</td>
			<td>Chlorhexidine gluconate solution, must be diluted to 4%. Web address: http://www.sigmaaldrich.com/catalog/product/aldrich/282227?lang=fr&#38;region=CA&#38;gclid=EAIaIQobChMI8vHr4_OY1wIV3rrACh2ZWQKuEAAYAiAAEgLKx_D_BwE</td>
		</tr>
		<tr>
			<td>Surgical Drape Small (27 inch x 24 inch) with 3 x 6 inch Fenestration</td>
			<td>Veterinary Specialty Products</td>
			<td>32724</td>
			<td>Web address: http://www.vetspecialtyproducts.com/index.cfm?fuseaction=ecommercecatalog.detail&#38;productgroup_id=15</td>
		</tr>
		<tr>
			<td>Scalpel blades #3</td>
			<td>Swann-Morton</td>
			<td>301</td>
			<td>Web address: https://www.swann-morton.com/product/16.php</td>
		</tr>
		<tr>
			<td>Sterile saline NaCl 0.9%</td>
			<td>Sigma-Aldrich</td>
			<td>S8776-100ML</td>
			<td>Web address: http://www.sigmaaldrich.com/catalog/product/sigma/s8776?lang=fr&#38;region=CA</td>
		</tr>
		<tr>
			<td>Vicryl 3-0</td>
			<td>Ethicon</td>
			<td>D9003</td>
			<td>Polyglactin multifilament absorbable suture material. Web address: http://www.ethicon.com/healthcare-professionals/products/wound-closure/absorbable-sutures/coated-vicryl-polyglactin-910-suture</td>
		</tr>
		<tr>
			<td>Syringe 1 ml with 26G needle</td>
			<td>Becton Dickinson and Company</td>
			<td>329652</td>
			<td>Web address: https://www.bd.com/en-us/offerings/capabilities/diabetes-care/insulin-syringes/bd-1-ml-conventional-insulin-syringes</td>
		</tr>
		<tr>
			<td>Brain Heart Infusion</td>
			<td>Sigma-Aldrich</td>
			<td>1104930500</td>
			<td>Web address: http://www.sigmaaldrich.com/catalog/product/mm/110493?lang=fr&#38;region=CA&#38;cm_sp=Insite-_-prodRecCold_xorders-_-prodRecCold2-1</td>
		</tr>
		<tr>
			<td>Eppendorf tube</td>
			<td>Sigma-Aldrich</td>
			<td>T9661-500EA</td>
			<td>Microcentrifuge tube. Web address: http://www.sigmaaldrich.com/catalog/product/sigma/t9661?lang=fr&#38;region=CA&#38;gclid=EAIaIQobChMI-YizzfiY1wIVRkCGCh30SQjuEAAYAiAAEgLK5fD_BwE</td>
		</tr>
		<tr>
			<td>Formalin solution, buffered neutral, 10%</td>
			<td>Sigma-Aldrich</td>
			<td>HT501128-4L</td>
			<td>Ratio tissue : formalin of 1: 10 for adequate fixation. Web address: http://www.sigmaaldrich.com/catalog/product/sigma/ht501128?lang=fr&#38;region=CA</td>
		</tr>
		<tr>
			<td>Clostridium perfringens strains</td>
			<td>Universit&#233; de Montr&#233;al, Chaire en recherche avicole</td>
			<td>N/A</td>
			<td>Specific to each laboratory, available upon request to correspondant author</td>
		</tr>
	</tbody>
</table>

a ligated intestinal loop model in anesthetized specific pathogen free chickens to study clostridium perfringens virulence

Necrotic enteritis was studied in chickens using various in vivo infection models. Most of these use a combination of predisposing factors, such as coccidiosis and diet, with gavage or administration via the feed using Clostridium perfringens. In these models, the comparison of multiple C. perfringens strains for virulence studies requires a large number of hosts to obtain significant results. Mortality during the course of the study can be high depending on the experimental model, hence raising ethical concerns regarding animal welfare in research. The development of new infection models requiring fewer animals to study pathogenesis, yet providing statistically significant and valid results, is important in reducing animal use in research. Intestinal ligated loop models have been used to study clostridial infections in various species such as mice, rabbits and calves. Following surgical procedures to create ligated loop segments, C. perfringens strains are injected directly into the loops to establish a close contact between the bacteria and the intestinal mucosa. Samples of the small intestine and luminal contents are taken at the termination of the procedures after a few hours. Multiple bacterial strains can be inoculated in each animal, hence reducing the number of required subjects in the experiments. Also, procedures are performed under general anesthesia to reduce animal pain. In chickens, this model would be more appropriate than oral administration to compare C. perfringens strain pathogenicity because fewer animals are needed, no predisposing factors are required to induce the disease, and pain is controlled by analgesics. The intestinal ligated loop model is poorly described in chickens and standardization is essential for its optimal use. This manuscript provides all the necessary steps to create numerous intestinal ligated loops in chickens and brings information on the critical points to obtain valid results.

A schematic of the 9 intestinal loops and 8 interloops is shown in Figure 1. In this model, a total of 9 loops and 8 interloops are created with simple ligatures. A loop consists of proximal and distal ligatures spaced by 2 cm measured from the proximal ligature. Two adjacent loops are separated by an interloop of 1 cm. To decrease the possible risk of cross-contamination between loops by leakage from a ligature, an interloop ligature is placed mid-way from t...

Watch this Scientific Journal Video about A Ligated Intestinal Loop Model in Anesthetized Specific Pathogen Free Chickens to Study Clostridium Perfringens Virulence at JoVE.com

A Ligated Intestinal Loop Model in Anesthetized Specific Pathogen Free Chickens to Study Clostridium Perfringens Virulence

Here we present a protocol to surgically create &#39;intestinal ligated loops&#39; in chicken small intestines. This procedure allows for the comparison of multiple Clostridium perfringens strains&#39; virulence in situ in a single host. This method markedly decreases the number of chickens usually necessary for similar in vivo experiments.

A Ligated Intestinal Loop Model in Anesthetized Specific Pathogen Free Chickens to Study Clostridium Perfringens Virulence

Necrotic enteritis was studied in chickens using various in vivo infection models. Most of these use a combination of predisposing factors, such as ...

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