Transplantation of human intestine into the mouse: A novel platform for study of inflammatory enterocutaneous fistulas

Ramona S. Bruckner, Einat Nissim-Eliraz, Noga Marsiano, Eilam Nir, Hadar Shemesh, Martin Leutenegger, Claudia Gottier, Silvia Lang, Marianne R. Spalinger, Sebastian Leibl, Gerhard Rogler, Simcha Yagel, Michael Scharl, Nahum Y. Shpigel*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Background and Aims: Enteric fistulas represent a severe and medically challenging comorbidity commonly affecting Crohn's disease [CD] patients. Gut fistulas do not develop in animal models of the disease. We have used transplantation of the human fetal gut into mice as a novel platform for studying inflammatory enterocutaneous fistulas. Methods: Human fetal gut segments were transplanted subcutaneously into mature SCID mice, where they grew and fully developed over the course of several months. We first analysed the resident immune cells and inflammatory response elicited by systemic lipopolysaccharide [LPS] in normal, fully developed human gut xenografts. Thereafter, we used immunostaining to analyse fully developed xenografts that spontaneously developed enterocutaneous fistulas. Results: Resident human innate and adaptive immune cells were demonstrated in gut xenografts during steady state and inflammation. The expression of human IL-8, IL-1β, IL-6, TNF-α, A20, and IkBα was significantly elevated in response to LPS, with no change in IL-10 gene expression. Approximately 17% [19/110] of fully developed subcutaneous human gut xenografts spontaneously developed enterocutaneous fistulas, revealing striking histopathological similarities with CD fistula specimens. Immunohistochemical analyses of fistulating xenografts revealed transmural lymphocytic enteritis associated with massive expansion of resident human CD4+ lymphocytes and their migration into the intraepithelial compartment. Regionally, mucosal epithelial cells assumed spindle-shaped mesenchymal morphology and formed fistulous tracts towards chronic non-healing wounds in the host mouse skin overlying the transplants. Conclusions: Inflammation and fistulas developed in human gut xenografts lacking IL-10 gene response. This novel model system will enable systematic studies of the inflamed and fistulating human gut in live animals.

Original languageAmerican English
Pages (from-to)798-806
Number of pages9
JournalJournal of Crohn's and Colitis
Issue number6
StatePublished - Jun 2019

Bibliographical note

Publisher Copyright:
Copyright © 2018 European Crohn's and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email:


  • Crohn's disease
  • Human gut xenograft
  • fistulas
  • inflammation
  • mouse model


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