{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T21:43:18Z","timestamp":1789076598132,"version":"build-2803163510"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T00:00:00Z","timestamp":1629936000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n            <jats:title>Background and Aims<\/jats:title>\n            <jats:p>Automated chyme reinfusion (CR) in patients with intestinal failure (IF) and a temporary double enterostomy (TDE) restores intestinal function and protects against liver injury, but the mechanisms are incompletely understood. The aim was to investigate whether the beneficial effects of CR relate to functional recovery of enterohepatic signaling through the bile salt\u2013FGF19 axis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Approach and Results<\/jats:title>\n            <jats:p>Blood samples were collected from 12 patients, 3\u00a0days before, at start, and 1, 3, 5, and 7\u00a0weeks after CR initiation. Plasma FGF19, total bile salts (TBS), 7\u2010\u03b1\u2010hydroxy\u20104\u2010cholesten\u20103\u2010one (C4; a marker of bile salt synthesis), citrulline (CIT), bile salt composition, liver tests, and nutritional risk indices were determined. Paired small bowel biopsies prior to CR and after 21\u00a0days were taken, and genes related to bile salt homeostasis and enterocyte function were assessed. CR induced an increase in plasma FGF19 and decreased C4 levels, indicating restored regulation of bile salt synthesis through endocrine FGF19 action. TBS remained unaltered during CR. Intestinal farnesoid X receptor was up\u2010regulated after 21\u00a0days of CR. Secondary and deconjugated bile salt fractions were increased after CR, reflecting restored microbial metabolism of host bile salts. Furthermore, CIT and albumin levels gradually rose after CR, while abnormal serum liver tests normalized after CR, indicating restored intestinal function, improved nutritional status, and amelioration of liver injury. CR increased gene transcripts related to enterocyte number, carbohydrate handling, and bile salt homeostasis. Finally, the reciprocal FGF19\/C4 response after 7\u00a0days predicted the plasma CIT time course.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>CR in patients with IF\u2010TDE restored bile salt\u2013FGF19 signaling and improved gut\u2013liver function. Beneficial effects of CR are partly mediated by recovery of the bile salt\u2013FGF19 axis and subsequent homeostatic regulation of bile salt synthesis.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.32017","type":"journal-article","created":{"date-parts":[[2021,6,16]],"date-time":"2021-06-16T12:36:36Z","timestamp":1623846996000},"page":"2670-2683","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":18,"title":["Chyme Reinfusion Restores the Regulatory Bile Salt\u2013FGF19 Axis in Patients With Intestinal Failure"],"prefix":"10.1097","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5209-6775","authenticated-orcid":false,"given":"Kiran V.K.","family":"Koelfat","sequence":"first","affiliation":[{"name":"Department of Surgery,Maastricht University Medical Center,Maastricht,the Netherlands"},{"name":"NUTRIM School of Nutrition and Translational Research in Metabolism,Maastricht University,Maastricht,the 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Eijk","sequence":"additional","affiliation":[{"name":"Department of Surgery,Maastricht University Medical Center,Maastricht,the Netherlands"},{"name":"NUTRIM School of Nutrition and Translational Research in Metabolism,Maastricht University,Maastricht,the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sander M.J.","family":"van Kuijk","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Medical Technology Assessment,Maastricht University Medical Center,Maastricht,the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Lenicek","sequence":"additional","affiliation":[{"name":"Institute of Medical Biochemistry and Laboratory Diagnostics,1st Faculty of Medicine,Charles University,Prague,Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Layec","sequence":"additional","affiliation":[{"name":"Department of Nutritional and Digestive Rehabilitation,Clinique Saint Yves,Rennes,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Carsin","sequence":"additional","affiliation":[{"name":"Department of Nutritional and Digestive Rehabilitation,Clinique Saint Yves,Rennes,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Dussaulx","sequence":"additional","affiliation":[{"name":"Department of Nutritional and Digestive Rehabilitation,Clinique Saint Yves,Rennes,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eloi","family":"Seynhaeve","sequence":"additional","affiliation":[{"name":"Department of Nutritional and Digestive Rehabilitation,Clinique Saint Yves,Rennes,France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence","family":"Trivin","sequence":"additional","affiliation":[{"name":"Department of Nutritional and Digestive Rehabilitation,Clinique Saint 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