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Biomedical subjects

Eric D Strauch

Publications and source records attributed to Eric D Strauch.

10 recordsLinked to original sources

The use of Alloderm in the closure of a giant omphalocele.

Giant omphaloceles are associated with a considerable loss of abdominal domain. Early primary repair of the fascia is either not possible or poorly tolerated by the infant. Current surgical options result in a ventral hernia requiring future surgery or involve the chronic use of prosthetic patches with or without tissue expanders. This case presentation describes an alternative surgical approach that results in early fascial closure using an interposition graft of Alloderm.

Abdominal Wall↗

Surgical necrotizing enterocolitis and intraventricular hemorrhage in premature infants below 1000 g.

BACKGROUND/PURPOSE: Infants with very low birth weight are at increased risk for both intraventricular hemorrhage (IVH) and necrotizing enterocolitis (NEC). IVH often progresses in severity after initial diagnosis and causes severe neurological morbidity and mortality. The authors examined the role of NEC in the progression of IVH in these infants. METHODS: The authors conducted a retrospective case-control study using data from the University of Maryland neonatal intensive care unit database between 1991 and 2003. From a cohort of 957 infants with very low birth weight, 53 pairs of infants labeled as IVH progression versus controls were selected and closely matched in respect to their gestational age and birth weight. Charts from these infants were reviewed to identify risk factors contributing to IVH progression. RESULTS: Infants with IVH progression were significantly more likely to suffer from NEC (odds ratio, 3.6), whereas infants with surgical NEC showed a greater association with IVH progression (odds ratio, 5.33). Association with thrombocytopenia was also seen (odds ratio, 3.33). Sepsis showed trend toward significance (odds ratio, 1.9; P = .095) for progression of IVH. CONCLUSION: Surgical NEC showed the greatest risk for IVH progression. NEC and thrombocytopenia also appear to be risk factors for IVH progression.

Case-Control Studies↗

Induced focal adhesion kinase expression suppresses apoptosis by activating NF-kappaB signaling in intestinal epithelial cells.

Focal adhesion kinase (FAK) integrates various extracellular and intracellular signals and is implicated in a variety of biological functions, but its exact role and downstream targeting signals in the regulation of apoptosis in intestinal epithelial cells (IECs) remains unclear. The current study tested the hypothesis that FAK has an antiapoptotic role in the IEC-6 cell line by altering NF-kappaB signaling. Induced FAK expression by stable transfection with the wild-type (WT)-FAK gene increased FAK phosphorylation, which was associated with an increase in NF-kappaB activity. These stable WT-FAK-transfected IECs also exhibited increased resistance to apoptosis when they were exposed to TNF-alpha plus cycloheximide (TNF-alpha/CHX). Specific inhibition of NF-kappaB by the recombinant adenoviral vector containing the IkappaBalpha superrepressor prevented increased resistance to apoptosis in WT-FAK-transfected cells. In contrast, inactivation of FAK by ectopic expression of dominant-negative mutant of FAK (DNM-FAK) inhibited NF-kappaB activity and increased the sensitivity to TNF-alpha/CHX-induced apoptosis. Furthermore, induced expression of endogenous FAK by depletion of cellular polyamines increased NF-kappaB activity and resulted in increased resistance to TNF-alpha/CHX-induced apoptosis, both of which were prevented by overexpression of DNM-FAK. These results indicate that increased expression of FAK suppresses TNF-alpha/CHX-induced apoptosis, at least partially, through the activation of NF-kappaB signaling in IECs.

Animals↗

Taurodeoxycholate increases intestinal epithelial cell proliferation through c-myc expression.

BACKGROUND: Bile salts have been shown to modulate gastrointestinal epithelial restitution, differentiation, and other functions. Prior studies have shown that the bile salt taurodeoxycholate increases cell migration after injury. The purpose of this experiment was to determine the effect that taurodeoxycholate has on intestinal epithelial cell growth, c-myc expression and function. METHODS: IEC-6 or Caco-2 cells were treated with varying concentrations of taurodeoxycholate (.05 to 1 mmol/L) and proliferation determined. Apoptosis was measured by use of DNA fragmentation assay and nuclear staining. Cell phase was determined with propidium iodide flow cytometry. C-myc expression was determined by Northern and Western blot analysis, and c-myc function was inhibited by specific c-myc antisense. RESULTS: There was no change in cell structure. Apoptosis was not induced. Six days after exposure to taurodeoxycholate, IEC-6 cell proliferation was significantly increased. Flow cytometry showed a significant increase in S-phase concentration and a significant decrease in G1-phase concentration of the cell cycle. Taurodeoxycholate also increased c-myc protein and mRNA expression, and inhibition of c-myc function prevented taurodeoxycholate-induced cell proliferation. CONCLUSIONS: Exposure to physiological concentrations of the bile salt taurodeoxycholate increases intestinal epithelial cell proliferation. This effect is at least partially mediated through a c-myc-dependent mechanism. Bile salts can have a beneficial effect on the intestinal mucosa.

Animals↗

Taurodeoxycholate stimulates intestinal cell proliferation and protects against apoptotic cell death through activation of NF-kappaB.

We hypothesized that the NF-kappaB pathway would be operative in the proliferative effect of bile salts on enterocytes. To determine this, we studied the effect of the bile salt taurodeoxycholate on cultured rat enterocyte proliferation and apoptosis and examined the role of NF-kappaB activation in these growth regulatory processes. Intestinal epithelial cells were grown for 6 days with or without taurodeoxycholate. Proliferation was measured. The cells were exposed to a known apoptotic stimulus, TNF-alpha and cyclohexamide. Apoptosis was quantified using cell number and the TUNEL stain. NF-kappaB activation was determined by an electrophoretic mobility shift assay. NF-kappaB activation was inhibited by an IkappaB superrepressor. Taurodeoxycholate stimulated cell proliferation (P < 0.01) and induced resistance to TNF-alpha induced apoptosis (P < 0.01). Taurodeoxycholate induced NF-kappaB activation. Inhibition of NF-kappaB prevented taurodeoxycholate-induced IEC-6 cell proliferation and rendered cells sensitive to TNF-alpha-induced apoptosis. Taurodeoxycholate stimulates intestinal epithelial cell proliferation and protects intestinal epithelial cells from TNF-alpha-induced apoptosis through NF-kappaB. These data support an important beneficial role of bile salts in regulation of mucosal growth and repair. Decreased enterocyte exposure to luminal bile salts, as occurs during starvation and parenteral nutrition, may have a detrimental effect on mucosal integrity.

Apoptosis↗

NF-kappaB-mediated IAP expression induces resistance of intestinal epithelial cells to apoptosis after polyamine depletion.

Apoptosis plays a crucial role in maintenance of intestinal epithelial integrity and is highly regulated by numerous factors, including cellular polyamines. We recently showed that polyamines regulate nuclear factor (NF)-kappaB activity in normal intestinal epithelial (IEC-6) cells and that polyamine depletion activates NF-kappaB and promotes resistance to apoptosis. The current study went further to determine whether the inhibitors of apoptosis (IAP) family of proteins, c-IAP2 and XIAP, are downstream targets of activated NF-kappaB and play a role in antiapoptotic activity of polyamine depletion in IEC-6 cells. Depletion of cellular polyamines by alpha-difluoromethylornithine not only activated NF-kappaB activity but also increased expression of c-IAP2 and XIAP. Specific inhibition of NF-kappaB by the recombinant adenoviral vector containing IkappaBalpha superrepressor (AdIkappaBSR) prevented the induction of c-IAP2 and XIAP in polyamine-deficient cells. Decreased levels of c-IAP2 and XIAP proteins by inactivation of NF-kappaB through AdIkappaBSR infection or treatment with the specific inhibitor Smac also overcame the resistance of polyamine-depleted cells to apoptosis induced by the combination of tumor necrosis factor (TNF)-alpha and cycloheximide (CHX). Although polyamine depletion did not alter levels of procaspase-3 protein, it inhibited formation of the active caspase-3. Decreased levels of c-IAP2 and XIAP by Smac prevented the inhibitory effect of polyamine depletion on the cleavage of procaspase-3 to the active caspase-3. These results indicate that polyamine depletion increases expression of c-IAP2 and XIAP by activating NF-kappaB in intestinal epithelial cells. Increased c-IAP2 and XIAP after polyamine depletion induce the resistance to TNF-alpha/CHX-induced apoptosis, at least partially, through inhibition of the caspase-3 activity.

Animals↗

Bile salts regulate intestinal epithelial cell migration by nuclear factor-kappa B-induced expression of transforming growth factor-beta.

BACKGROUND: Mucosal restitution is an important repair modality in the gastrointestinal tract. We have shown that taurodeoxycholate increases intestinal epithelial cell migration by increasing TGF-beta expression, and that the transcription factor NF-kappa B regulates TDCA induced cell migration after injury. The objectives of this study were to determine if this is a property shared by other bile salts or an effect specific to TDCA, and to determine if NF-kappa B regulates TGF-beta expression. STUDY DESIGN: Studies were conducted in IEC-6 cells. Cell migration was examined using an in vitro model. TGF-beta protein and mRNA expression was determined by ELISA and Northern blot analysis. Sequence-specific NF-kappa B binding activity was measured by gel shift assays. RESULTS: Taurocholate and deoxycholate at physiologic concentrations significantly increased intestinal epithelial cell migration 6 hours after wounding (p < 0.01), and was associated with a significant increase in specific NF-kappa B binding activity. Inhibition of NF-kappa B activity significantly inhibited cell migration during restitution and resulted in a significant decrease in TGF-beta mRNA expression and protein expression. CONCLUSIONS: We conclude that bile salts at physiologic conditions increase cell migration after injury, an effect regulated by NF-kappa B. Further, NF-kappa B elicits TGF-beta gene transcription during cell migration. These data support a physiologic role of bile salts in the maintenance of intestinal mucosal integrity.

Animals↗

NF-kappaB regulates intestinal epithelial cell and bile salt-induced migration after injury.

OBJECTIVE: To determine if NF-kappa B regulates intestinal epithelial cell migration and if it has a role during bile salt-induced migration. SUMMARY BACKGROUND DATA: Mucosal restitution is an important repair modality in the gastrointestinal tract. The authors have shown that taurodeoxycholate (TDCA) increases intestinal epithelial cell migration. NF-kappa B regulates activation of a number of genes involved in inflammatory responses. METHODS: Studies were conducted in IEC-6 cells. I kappa B protein expression was determined by Western blot analysis. Sequence-specific NF-kappa B binding activity was measured by EMSA shift assays and nuclear localization by immunohistochemistry. Cell migration was examined by using an in vitro model that mimics the early cell division-independent stages of epithelial restitution. RESULTS: The process of cell migration over the wounded area was associated with a significant increase in NF-kappa B binding activity in IEC-6 cells. Immunohistochemistry revealed translocation of NF-kappa B into the nucleus. Western blot analysis showed that injury decreased I kappa B protein expression. Inhibition of the binding activity by treatment with a specific NF-kappa B inhibitor, MG-132, inhibited cell migration during restitution. Further, exposure to TDCA at the physiologic concentration that induces intestinal epithelial cell migration increased NF-kappa B binding activity, induced NF-kappa B translocation into the nucleus, and decreased I kappa B protein expression. MG-132 also inhibits bile salt-induced cell migration. CONCLUSIONS: NF-kappa B regulates intestinal epithelial cell migration. Bile salts at physiologic concentrations increase cell migration by activation of NF-kappa B. These data show that bile salts may have a role in the maintenance of intestinal mucosal integrity.

Animals↗

JunD stabilization results in inhibition of normal intestinal epithelial cell growth through P21 after polyamine depletion.

BACKGROUND & AIMS: Normal intestinal mucosal growth requires cellular polyamines that regulate expression of various genes involved in cell proliferation, growth arrest, and apoptosis. We have recently shown that growth inhibition after polyamine depletion is associated with an increase in JunD/AP-1 activity in normal intestinal epithelial cells (IEC-6 line). The current study tests the hypothesis that polyamine depletion-induced JunD/activator protein 1 (AP-1) activity results from the activation of junD gene expression and plays a critical role in regulation of intestinal epithelial cell growth. METHODS: The junD gene transcription was examined by nuclear run-on assays, and messenger RNA (mRNA) stability was measured by determination of JunD mRNA half-life. Functions of JunD were investigated by using JunD antisense oligodeoxyribonucleotides and transient transfection with the junD-expressing vector. RESULTS: Depletion of cellular polyamines by DL-alpha-difluoromethylornithine (DFMO) induced levels of JunD mRNA and protein, which was associated with an increase in G(1) phase growth arrest. Polyamine depletion did not increase the rate of junD gene transcription but significantly increased the stability of JunD mRNA. Decreasing JunD protein by using JunD antisense oligomers promoted cell growth in polyamine-deficient cells. Growth arrest following polyamine depletion also was accompanied by increases in both p21 expression and its promoter activity. Treatment with JunD antisense oligomers inhibited the p21 promoter and prevented the increase in p21 expression in the presence of DFMO. Ectopic expression of the wild-type junD increased p21-promoter activity and inhibited epithelial cell growth. CONCLUSIONS: Polyamines negatively regulate junD gene expression posttranscriptionally, and increased JunD/AP-1 inhibits intestinal epithelial cell proliferation at least partially through the activation of p21 promoter.

Animals↗

Gangrenous intestine in a hernia can be reduced.

A 3-month-old former 31-week premature triplet presented with a perforated terminal ileum 36 hours after complete reduction of an incarcerated inguinal hernia. Classic pediatric surgery teaching asserts that gangrenous bowel in an inguinal hernia will not reduce. In this case, gangrenous bowel was reduced and proceeded to perforate after reduction. Though extremely rare, it is possible to reduce gangrenous bowel, and disposition requires reliable observation at home or hospitalization, if circumstances warrant.

Drainage↗