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Changes of morphometric parameters of small intestinal lymphoid tissue in polyposis

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https://www.eduzhai.net American Journal of Medicine and Medical Sciences 2021, 11(10): 673-677 DOI: 10.5923/j.ajmms.20211110.03 Changes in Morphometric Parameters of the Lymphoid Tissue of the Small Intestine in the Conditions of Polypragmasia Nasirova Sabina Bukhara State Medical Institute, The Republic of Uzbekistan Abstract Various clinical symptoms of inflammatory diseases in combination with the limited possibilities of etiotropic therapy, a large number of symptomatic agents became the causes of polypharmacy. Unreasonable treatment often slows down the natural healing process. Recently, the gastrointestinal tract is considered as an essential component of the general defense of the body. Therefore, without accurate knowledge of the structural features and the effect of drugs on the morphological structure of the small intestine, it is impossible to understand the degree of their participation in the body's defense reactions. Keywords Morphology, Small intestine, Polypharmacy 1. Introduction The protective function of the intestine is the main barrier to foreign microorganisms. One of the large peripheral parts of the immune system is the gut-associated lymphoid tissue. The immune structures associated with the mucous membrane are immunologically active tissue. About 80% of all immune competent cells in the body are associated with the intestinal mucosa. The integrity of the mucous membrane is one of the main qualities of a healthy organism. Among the immune formations of the digestive system, lymphoid nodules (Peyer's patches) of the small intestine play an exceptional role. They, like the thymus, amygdala, mammalian appendix, belong to the lymphoepithelial organs, in which lymphopoiesis occurs and are in close interaction with the reticular tissue, the epithelium. The use of a large number of drugs can adversely affect the function and structure of the mucous membrane of the small intestine. Anti-inflammatory drugs are one of the most commonly used drug groups in medicine. Identifying the side effects of polypharmacy is an urgent problem today. The aim of this study was to study polypharmacy with anti-inflammatory drugs on the structural and cellular structure of the wall and lymphoid nodules of the small intestine of white rats. 2. Material and Research Methods Received: Sep. 25, 2021; Accepted: Oct. 14, 2021; Published: Oct. 20, 2021 Published online at https://www.eduzhai.net Sexually mature white outbred rats weighing 200-250 g, 5 months of age, were used in the work. The experiment was carried out on 120 animals kept in the general regime of the vivarium. For 10 days, the animals were injected enterally through a tube into the stomach with anti-inflammatory drugs at the rate of hydroxychloroquine 6.5 mg/kg, paracetamol 15 mg/kg, aspirin 5 mg/kg, dexamethasone 0.1 mg/kg. All laboratory animals were divided into 4 groups: group 1 - control animals (30 rats) receiving distilled water through a tube, group 2 (30 rats) - laboratory animals that received 2 types of anti-inflammatory drugs (Hydroxychloroquine, dexamethasone); Group 3 (30 rats) - laboratory animals that received 3 types of anti-inflammatory drugs (Hydroxychloroquine, dexamethasone, paracetamol); Group 4 (30 rats) - laboratory animals that received 4 types of anti-inflammatory drugs (Hydroxychloroquine, dexamethasone, paracetamol, aspirin). The material was collected on day 11, after 10 days of drug administration. The animals were slaughtered at the appropriate time in the morning, on an empty stomach by means of instant decapitation under ether anesthesia. After opening the abdominal cavity, the small intestine was removed. To conduct a morphological study, the mesentery of the small intestine was mobilized (along the intended line of intersection of the intestine), followed by its resection and dissection along the mesenteric edge along the entire length with microscissors. After that, the length of the mesenteric part of the small intestine, the width of the small intestine in the initial, middle and final parts of the mesenteric part of the small intestine were measured with a millimeter ruler. After washing the obtained total preparations of the small intestine in running water, they 674 Nasirova Sabina: Changes in Morphometric Parameters of the Lymphoid Tissue of the Small Intestine in the Conditions of Polypragmasia were stained with hematoxylin - H (Harris) and clarified with 3% acetic acid, followed by repeated washing of the preparations in distilled water. The number, shape, size of aggregated lymphoid nodules, the distance between aggregated lymphoid nodules, the number of lymphoid nodules in them, and the area of the mesenteric part of the intestine covered with aggregated lymphoid nodules were studied on total macropreps stained with Harris's hematoxylin. Shape, size of lymphoid nodules in aggregated lymphoid nodes, distance between nodules. The number of single lymphoid nodules in 1 cm2 of the mesenteric area of the small intestine. For the morphological and morphometric study of the mesenteric part of the small intestine and its lymphoid formations, pieces were taken from the initial, middle and final parts of the mesenteric part of the small intestine. Pieces of tissue were fixed in a 10% solution of neutral formalin. After appropriate processing, the material was embedded in paraffin and sections with a thickness of 4-6 mm. were prepared, which were stained with hematoxylin and eosin. Sections were examined morphometrically, using an eyepiece micrometer DN-107T/ Model NLCD-307B (Novel, China), the thickness of the mucosa, submucosa, muscle and serous membranes of the mesenteric part of the small intestine was measured, especially the places where the lymphoid formations are located. According to our results, the study of the middle part of the wall of the small intestine, there is a different degree of morphological changes when exposed to different amounts of drugs. It was found that after exposure to drugs, the size and ratio of structural components in the walls of the small intestine change markedly. In the mucous membrane of the small intestine of the experimental group of animals, an intense desquamation of epithelial cells into the intestinal lumen was observed at the tops of the villi. The stroma of the villi is edematous, it contains a large number of macrophages and lymphocytes, and necrosis of the villi is observed in some areas. Figure 1. 3. Results and Discussion Microscopic examination of the middle part of the small intestine of white rats of the control group showed that the mucous, muscular and serous membranes are well developed and have distinct boundaries. The mucous membrane contains villi of large diameter and crypts of smaller diameter. On the surface of the villi and crypts are cylindrical epithelial cells with oval nuclei. Among the epithelial cells are goblet cells, the largest number of which is observed in crypts. Figure 2. Intestinal villus. Arrows indicate goblet cells filled with mucus. Hematoxylin-eosin staining An increase in the number of goblet cells, an increase in mucus secretion by villous cells and its release in the intestinal lumen were noted. Figure 2. Figure 3. Intestinal villus. Heteromorphic structure. Edema and atrophy of epithelial cells of villi of white rats, desquamation of epithelial cells. Hematoxylin-eosin staining Figure 1. Intestinal villus. Arrows show the areas of desquamation of epithelial cells of the villi of white rats. Hematoxylin-eosin staining When analyzing histological preparations, a pronounced heteromorphism of the structure of the villi of the small intestine was noted. The villi were deformed in places. The epithelium covering the villi was edematous and American Journal of Medicine and Medical Sciences 2021, 11(10): 673-677 675 significantly infiltrated with lymphocytes. Most of the epithelial cells showed signs of degenerative changes. Tissue edema was accompanied by local desquamation of epithelial cells. In some places, necrotic changes in the tissue structures of the intestinal mucosa occurred, sometimes penetrating to the muscular and submucosa. Figure 3. When the morphometry of single lymphoid nodules in the initial section of the mesenteric part of the small intestine of 5-month-old rats was within 11±2.4 per 1 cm2 of the intestinal area, their sizes fluctuate on average 0.3x0.4 mm. In the fourth group, the number of single lymphoid nodules was 8.7±0.99, the size decreased to 0.27x0.29. Figure 4. Figure 4. Germinative zone of the Peyer's patch lymph node in the ileum of 5-month-old rats of the control group. Coloring: hematoxylin-eosin In the second and third groups, the number of single lymphoid nodules in the initial section of the mesenteric part of the small intestine decreased, namely, 9.5±1.46 in the second and 9.1±1.5 in the third groups, respectively. In the middle part of the mesenteric part of the small intestine, the number of single lymph nodules per 1 cm2 of area on average is 14.0 ± 2.28, with an average size of 0.35x0.46 mm. After using 4 types of anti-inflammatory drugs, the number of lymphoid nodules decreased, 12.2±1.26 piece. dimensions have been reduced on average by 17%. In the distal part of the small intestine, the number of single lymphoid nodules was on average 18 ± 3.4 per 1 cm2 of intestinal area. The dimensions of single lymphoid nodules in this section are 0.4x0.48 mm. In the second and third groups, the size of single lymphoid nodules in the distal part of the small intestine decreased by 2.5%. Changes in the size of lymphoid nodules in the fourth group were reduced by 13%, respectively. Group lymphoid nodules of the control group were located along the antimesenteric wall of the small intestine and their number throughout the intestine fluctuated on average - 22.0 ± 2.3. In the proximal mesenteric part of the small intestine, the number of group plaques varied on average - 5.2±0.72, their size on average - 2.9x3.25 mm. Figure 5. In the second and third groups, after using two and three types of anti-inflammatory drugs, the sizes of group lymphoid nodules in the proximal part of the small intestine decreased by 8%, 12%, and the number of lymphoid nodules in lymphoid plaques did not change. The dynamics in the fourth group showed the most pronounced changes. The size of the group lymphoid nodules averaged 2.2x2.8 mm. In the middle section of the mesenteric part of the small intestine, an average of 7.5±1.7 was found, and their dimensions varied on average - 3.36x4.25 mm. The size of the group lymphoid nodules in the fourth group averaged 3.0x3.9 mm. In the second and third groups, the size of the group lymphoid nodules in the middle part of the small intestine decreased by 7% and 10%. In the distal mesenteric part of the small intestine, 5-month-old rats of the control group are located on average - 9.4±1.74 piece aggregated lymphoid nodules. In the second and third groups, their number was 8.7±1.7 in the second group, 8.2±1.38 in the third group. The sizes of group lymphoid nodules in dynamics in the second and third groups also decreased, but in the fourth group there were pronounced changes and averaged the number of grouped lymphoid nodules 7.8 ±5.6 piece. dimensions have decreased to 4.9x5.5mm. The total area of group plaques of the small intestine along its length varied on average –246.6 mm2. And after treatment it was 145.9 mm2. Figure 6. Figure 6. Aggregated oval-shaped lymphoid nodule in the middle part of the small intestine of a 5-month-old rat of the control and fourth groups. Coloring according to Helman 4. Сonclusions Figure 5. Aggregated oval-shaped lymphoid nodule in the proximal part of the small intestine of a 5-month-old rat of the control and fourth groups. Coloring according to Helman As a result of studies in the wall of the small intestine of rats treated with anti-inflammatory drugs, changes of a destructive nature were found, depending on the use of the amount of drugs. Destructive changes are characterized by edema of the stroma of the villi, their desquamation into the intestinal lumen, a decrease in the height of the villi, which were clearly observed in the fourth group when using four types of anti-inflammatory drugs. At the same time, the observed increase in the number of goblet cells in the villi. 676 Nasirova Sabina: Changes in Morphometric Parameters of the Lymphoid Tissue of the Small Intestine in the Conditions of Polypragmasia Presumably, this is due to an increase in degenerative processes in epithelial cells under the influence of polypharmacy. Polypharmacy also negatively affected the number and size of single lymph nodes. Lymphoid nodules react to polypharmacy with anti-inflammatory drugs with a decrease in size. The size of group lymph nodes and the size of lymphoid nodules in them against the background of polypharmacy decreases, which depends on the dose and time of use. It was found that with polypharmacy, the distance between the group lymphoid nodes decreases due to a decrease in size. 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