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Am J Physiol Gastrointest Liver Physiol (July 5, 2007). doi:10.1152/ajpgi.00195.2007
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Submitted on May 2, 2007
Accepted on June 29, 2007

Effects of laxative and N-acetylcysteine on mucus accumulation, bacterial load, transit, and inflammation in the cystic fibrosis mouse small intestine

Robert C De Lisle1*, Eileen Roach2, and Kyle Jansson1

1 Anatomy and Cell Biology, University of Kansas School of Medicine, Kansas City, Kansas, United States
2 Anatomy and Cell Biology, University of Kansas School of Medicine, Kansas City, Kansas, United States; Anatomy and Cell Biology, University of Kansas School of Medicine, Kansas City, Kansas, United States

* To whom correspondence should be addressed. E-mail: rdelisle{at}kumc.edu.

Accumulation of mucus in affected organs is characteristic of cystic fibrosis (CF). The CF mouse small intestine has dramatic mucus accumulation and exhibits slower interdigestive intestinal transit. These factors are proposed to play cooperative roles that foster small intestinal bacterial overgrowth (SIBO) and contribute to the innate immune response of the CF intestine. It was hypothesized that decreasing mucus accumulation would reduce SIBO and might improve other aspects of the CF intestinal phenotype. To test this, solid chow-fed CF mice were treated with an osmotic laxative to improve gut hydration, or liquid-fed mice were treated orally with N-acetylcysteine (NAC) to break mucin disulfide bonds. Treatment with laxative or NAC reduced mucus accumulation 43% and 50%, respectively, measured histologically as dilation of the intestinal crypts. Laxative and NAC also reduced bacterial overgrowth in the CF intestine by 92% and 63%, respectively. Treatment with laxative normalized small intestinal transit in CF mice, whereas NAC did not. Expression of innate immune response-related genes was significantly reduced in laxative-treated CF mice while there was no significant effect in NAC-treated CF mice. In summary, laxative and NAC treatments of CF mice reduced mucus accumulation to a similar extent but laxative was more effective than NAC at reducing bacterial load. Eradication of bacterial overgrowth by laxative treatment was associated with normalized intestinal transit and a reduction in the innate immune response. These results suggest that both mucus accumulation and slowed interdigestive small intestinal transit contribute to SIBO in the CF intestine.







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