Effect of Massive Small Bowel Resection on the Bax/Bcl-w Ratio and Enterocyte Apoptosis

Lawrence E. Stern, Richard A. Falcone, Christopher J. Kemp, Lorie A. Stuart, Christopher R. Erwin, Brad W. Warner

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37 Scopus citations


Following small bowel resection (SBR), the remnant intestine undergoes adaptation. Enterocyte proliferation is increased and counterbalanced by increased rates of apoptosis. To elucidate a mechanism for increased enterocyte apoptosis, this study tested the hypothesis that the ratio between pro-apoptotic Bax and pro-survival Bcl-w correlates with the apoptosis that occurs following SBR. Mice (C57B1/6; n = 76) underwent a 50% proximal SBR or sham operation. After 12 hours and 1, 2, 3, and 7 days, the ileum was removed, the apoptotic index (apoptotic bodies/crypt) was recorded, and the messenger RNA and protein for Bax and Bcl-w were quantified. The apoptotic index was equivalent in the sham and SBR mice at 12 hours; however, it was significantly elevated following SBR at every other day measured. The ratio of Bax to Bcl-w messenger RNA relative to sham operation increased after SBR at 24 hours, decreased by day 3, and returned to baseline levels by 1 week. The protein ratio showed an increase by day 1, which remained elevated through day 7. An augmented ratio of Bax to Bcl-w messenger RNA and protein corresponded with the increase in enterocyte apoptosis. Alterations in the expression ratio of these genes may play a role in establishing a new homeostatic set point between proliferation and apoptosis during adaptation.

Original languageEnglish
Pages (from-to)93-100
Number of pages8
JournalJournal of Gastrointestinal Surgery
Issue number1
StatePublished - 2000


  • Apoptosis
  • Bax
  • Bcl-w
  • Intestine
  • Short bowel syndrome


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