Duodenal mucosal ablation with irreversible electroporation reduces liver lipids in rats with non-alcoholic fatty liver disease

Figure 1  Experimental design scheme.

Figure 2 Operation of duodenal mucosal ablation using irreversible electroporation in non-alcoholic fatty liver disease rats. A-C: Ablation catheter; D: Finite element analysis of electrode electric field distribution during operation. Duodenal mucosal ablation was performed using electroporation induced by a 250 V/cm electric field strength (pulse duration: 100 μs, pulse number: 90, and frequency: 1 Hz); E: Rats receiving duodenal mucosal ablation using irreversible electroporation; F and G: Macroscopic observation of the duodenum preoperatively and postoperatively.

Figure 3 Non-alcoholic fatty liver disease rat characteristics between the two groups. A: Body weight; B: Food intake; C: Coefficient of the liver. Data are expressed as the mean ± SD (n = 6). ^aP < 0.05 vs sham-control group. DMA: Duodenal mucosal ablation; COL: Coefficient of the liver.

Figure 4 Histological examination of the duodenal tissue. A: Complete layer of the duodenal wall, sham-control group; B: Measurement scheme of the length (a long dashed black line) and thickness (a short dashed black line) of the villus, sham-control group; C: Measurement scheme of the depth (a long dashed black line) and thickness (a short dashed black line) of the crypt, sham-control group; D: Measurement scheme of the longitudinal (a continuous black line) and circular (a continuous green line) lamina, sham-control group; E: Complete layer of the duodenal wall, duodenal mucosal ablation group; F: Measurement scheme of the length (a long dashed black line) and thickness (a short dashed black line) of the villus, duodenal mucosal ablation group; G: Measurement scheme of the depth (a long dashed black line) and thickness (a short dashed black line) of the crypt, duodenal mucosal ablation group; H: Measurement scheme of the longitudinal (a continuous black line) and circular (a continuous green line) lamina, duodenal mucosal ablation group. DMA: Duodenal mucosal ablation.

Figure 5 Liver function parameter test, histological examination, and serum lipid parameter test among different groups. A: Serum aspartate aminotransferase levels; B: Alanine aminotransferase; C: Total bile acids; D-G: Histological examination of the liver tissue via hematoxylin and eosin staining and oil red O staining from the sham-control group and from the duodenal mucosal ablation group; H-L: Serum total cholesterol, triacylglycerol, free fatty acid, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol levels. Data are expressed as the mean ± SD (n = 6). ^aP < 0.05 vs sham-control group, ^bP < 0.01 vs sham-control group. DMA: Duodenal mucosal ablation; AST: Aspartate aminotransferase; ALT: alanine aminotransferase; TBA: Total bile acid; HE: Hematoxylin and eosin; T-CHO: Total cholesterol; TG: Triacylglycerol; FFA: Free fatty acid; HDL-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein cholesterol.

Figure 6 Enteroendocrine test and representative images of duodenal immunofluorescence staining. A: Serum gastric inhibitory polypeptide levels; B: Glucagon-like peptide-1; C: Cholecystokinin; D-I: Immunofluorescence staining of the duodenum from sham-control and duodenal mucosal ablation groups; J-L: Number of gastric inhibitory polypeptide⁺ cells, glucagon-like peptide-1⁺, and cholecystokinin⁺ cells among different groups. ^aP < 0.05 vs sham-control group, ^bP < 0.01 vs sham-control group. DMA: Duodenal mucosal ablation; GIP: Gastric inhibitory polypeptide; GLP-1: Glucagon-like peptide-1; CCK: Cholecystokinin.

Figure 7 Immunohistochemistry staining of the duodenum among different groups. A-H: Immunohistochemistry staining of the duodenum from the sham-control (A-D) and duodenal mucosal ablation (E-H) groups; I-K: Quantitative analysis of zonula occludens-1, claudin and lipopolysaccharide among different groups. ^bP < 0.01 vs sham-control group. ZO-1: Zonula occludens-1; DMA: Duodenal mucosal ablation; LPS: Lipopolysaccharide.