Sacral nerve stimulation enhances epithelial barrier of the rectum: results from a porcine model

Authors

  • G. Meurette,

    1. Institut National de la Santé et de la Recherche Médicale U913, Nantes, France
    2. Université de Nantes- Faculté des Sciences et Techniques, Nantes, France
    3. Institut des Maladies de l’Appareil Digestif, Clinique de chirurgie digestive, CHU Nantes, France
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  • C. Blanchard,

    1. Institut National de la Santé et de la Recherche Médicale U913, Nantes, France
    2. Université de Nantes- Faculté des Sciences et Techniques, Nantes, France
    3. Institut des Maladies de l’Appareil Digestif, Clinique de chirurgie digestive, CHU Nantes, France
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  • E. Duchalais-Dassonneville,

    1. Institut National de la Santé et de la Recherche Médicale U913, Nantes, France
    2. Université de Nantes- Faculté des Sciences et Techniques, Nantes, France
    3. Institut des Maladies de l’Appareil Digestif, Clinique de chirurgie digestive, CHU Nantes, France
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  • S. Coquenlorge,

    1. Institut National de la Santé et de la Recherche Médicale U913, Nantes, France
    2. Université de Nantes- Faculté des Sciences et Techniques, Nantes, France
    3. Institut des Maladies de l’Appareil Digestif, Clinique de chirurgie digestive, CHU Nantes, France
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  • P. Aubert,

    1. Institut National de la Santé et de la Recherche Médicale U913, Nantes, France
    2. Université de Nantes- Faculté des Sciences et Techniques, Nantes, France
    3. Institut des Maladies de l’Appareil Digestif, Clinique de chirurgie digestive, CHU Nantes, France
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  • M. Wong,

    1. Institut des Maladies de l’Appareil Digestif, Clinique de chirurgie digestive, CHU Nantes, France
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  • P.-A. Lehur,

    1. Institut des Maladies de l’Appareil Digestif, Clinique de chirurgie digestive, CHU Nantes, France
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  • M. Neunlist

    1. Institut National de la Santé et de la Recherche Médicale U913, Nantes, France
    2. Université de Nantes- Faculté des Sciences et Techniques, Nantes, France
    3. Institut des Maladies de l’Appareil Digestif, Clinique de chirurgie digestive, CHU Nantes, France
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Address for Correspondence
Guillaume Meurette, Inserm U913- Clinique de chirurgie digestive et endocrine, CHU Nantes, France.
Tel: +33240083022; fax: +33240083036;
e-mail: guillaume.meurette@chu-nantes.fr

Abstract

Background  The mechanism of action of sacral nerve stimulation (SNS) remains largely elusive. The aims of this study were to develop a clinically relevant animal model for percutaneous SNS and to describe its effect on the epithelial barrier of the rectum.

Methods  Under general anesthesia and after percutaneous electrode placement for S3 nerve root stimulation, six pigs underwent unilateral stimulation and six bilateral stimulation. Animals were stimulated for 3 h using an external pulse generator (1–2.5 V; 14 Hz; 210 μs). Six animals underwent electrode implantation without stimulation and served as controls. Full-thickness rectal biopsies were performed prior to and after stimulation. Paracellular permeability was evaluated by measuring sulfonic acid flux across the rectal mucosa in Ussing chambers. Histological assessment of mucosal thickness, epithelial desquamation, and mucus expression were performed.

Key Results  Percutaneous stimulation resulted in successful anal contractions whose amplitude and uniformity was enhanced following bilateral compared with unilateral stimulation. In controls, paracellular permeability significantly increased during the stimulation period whereas it remained unchanged following unilateral stimulation. In contrast, permeability was significantly reduced by bilateral stimulation. This effect was associated with a concomitant reduction in mucosal thickness and a trend toward increased amount of mucus on surface epithelium compared with controls.

Conclusions & Inferences  The development of a porcine model of percutaneous SNS revealed the ability of neuromodulation to reinforce rectal epithelial barrier. Furthermore, our results suggest that SNS could be used for treatment of gastrointestinal pathologies with reduced rectal mucosal barrier functions

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