Basic Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 28, 2022; 28(12): 1239-1256
Published online Mar 28, 2022. doi: 10.3748/wjg.v28.i12.1239
Spinal anesthesia alleviates dextran sodium sulfate-induced colitis by modulating the gut microbiota
Yu Hong, Jie Zhao, Ye-Ru Chen, Zi-Hao Huang, Li-Dan Hou, Bo Shen, Yu Xin
Yu Hong, Jie Zhao, Bo Shen, Department of General Surgery, Sir Run Run Shaw Hospital of Zhejiang University, Hangzhou 310012, Zhejiang Province, China
Ye-Ru Chen, Department of Anaesthesiology, Sir Run Run Shaw Hospital of Zhejiang University, Hangzhou 310012, Zhejiang Province, China
Zi-Hao Huang, College of Medicine, Zhejiang University, Hangzhou 310012, Zhejiang Province, China
Li-Dan Hou, Biomedical Research Center, Sir Run Run Shaw Hospital of Medical School, Zhejiang University, Hangzhou 310012, Zhejiang Province, China
Yu Xin, Department of Anesthesiology, Sir Run Run Shaw Hospital of Zhejiang University, Hangzhou 310012, Zhejiang Province, China
Author contributions: Hong Y and Zhao J contributed equally to this work; Xin Y, Hong Y, and Chen YR designed the research study; Huang ZH and Chen YR performed the research; Zhao J and Hou LD contributed analytic tools; Shen B and Zhao J analyzed the data and wrote the manuscript; all authors have read and approved the final manuscript.
Supported by the Zhejiang Provincial Natural Science Foundation, No. LY19H030011, No. LQ20C010005, and No. LQ19H030009; and Key Project of Province and Ministry Foundation, No. WKJZJ2124.
Institutional review board statement: The study was reviewed and conducted in accordance with guidelines for laboratory animal care after approval by the Laboratory Animals Ethics Committee of Zhejiang University.
Institutional animal care and use committee statement: All animal procedures were conducted in accordance with guidelines for laboratory animal care after approval by the Laboratory Animals Ethics Committee of Zhejiang University.
Conflict-of-interest statement: Xin Y, Chen YR, and Zhao J have received research funding from Zhejiang Provincial Natural Science Foundation. And Hong Y has received research funding from Zhejiang Science and Technology Department and Zhejiant Health Commission.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at [xinxin_yu@zju.edu.cn].
ARRIVE guidelines statement: The authors have read the ARRIVE guidelines, and the manuscript was prepared and revised according to the ARRIVE guidelines.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yu Xin, PhD, Attending Doctor, Chief Physician, Department of Anesthesiology, Sir Run Run Shaw Hospital of Zhejiang University, No. 3 Qingchun Road, Hangzhou 310012, Zhejiang Province, China. xinxin_yu@zju.edu.cn
Received: September 21, 2021
Peer-review started: September 21, 2021
First decision: November 7, 2021
Revised: November 22, 2021
Accepted: February 16, 2022
Article in press: February 16, 2022
Published online: March 28, 2022
Processing time: 184 Days and 21 Hours
Abstract
BACKGROUND

Inflammatory bowel disease (IBD) is a chronic disease with recurrent intestinal inflammation. Although the exact etiology of IBD remains unknown, the accepted hypothesis of the pathogenesis to date is that abnormal immune responses to the gut microbiota are caused by environmental factors. The role of the gut microbiota, particularly the bidirectional interaction between the brain and gut microbiota, has gradually attracted more attention.

AIM

To investigate the potential effect of spinal anesthesia on dextran sodium sulfate (DSS)-induced colitis mice and to detect whether alterations in the gut microbiota would be crucial for IBD.

METHODS

A DSS-induced colitis mice model was established. Spinal anesthesia was administered on colitis mice in combination with the methods of cohousing and fecal microbiota transplantation (FMT) to explore the role of spinal anesthesia in IBD and identify the potential mechanisms involved.

RESULTS

We demonstrated that spinal anesthesia had protective effects against DSS-induced colitis by alleviating clinical symptoms, including reduced body weight loss, decreased disease activity index score, improved intestinal permeability and colonic morphology, decreased inflammatory response, and enhanced intestinal barrier functions. Moreover, spinal anesthesia significantly increased the abundance of Bacteroidetes, which was suppressed in the gut microbiota of colitis mice. Interestingly, cohousing with spinal anesthetic mice and FMT from spinal anesthetic mice can also alleviate DSS-induced colitis by upregulating the abundance of Bacteroidetes. We further showed that spinal anesthesia can reduce the increase in noradrenaline levels induced by DSS, which might affect the gut microbiota.

CONCLUSION

These data suggest that microbiota dysbiosis may contribute to IBD and provide evidence supporting the protective effects of spinal anesthesia on IBD by modulating the gut microbiota, which highlights a novel approach for the treatment of IBD.

Keywords: Spinal anesthesia; Inflammatory bowel disease; Gut microbiota; Intestinal barrier; Intestinal inflammation; Intestinal immune

Core Tip: Inflammatory bowel disease (IBD) is a chronic inflammation with rising trends, but the pathogenesis is still not well understood. The effects of the gut microbiota, particularly the bi-directional interaction between brain and gut microbiota, have gradually attracted increasing attention. In the present study, we found that spinal anesthesia, a regional sympathetic block, alleviated the intestinal inflammation, maintained immunological function, and improved intestinal barrier function by modulating the gut microbiota. And reducing the increase of noradrenaline level in dextran sodium sulfate-treated mice by spinal anesthesia could be one of the mechanisms. The study highlights a novel approach for the treatment of IBD.