Abstract
Aim
This study focuses on the effects of growth hormone (GH) on adaptation in an animal model of pigs that underwent massive intestinal resection.
Background
The structural and functional changes during intestinal adaptation are necessary to compensate for the sudden loss of digestive and absorptive capacity after massive intestinal resection. If the adaptive response is inadequate, short bowel syndrome (SBS) ensues and patients are left with its associated pathogenicity and the need for parenteral nutrition. This complication increases treatment costs and affects the patient’s quality of life. Hence, medical interventions become necessary to boost this adaptation. In an effort to establish the methodology with best results, both surgical interventions and hormonal implementation are under investigation.
Method
In our study, animals were randomly assigned to control and treatment groups. They were monitored for two months to assess their recovery rate, measuring both biochemical and haematological parameters. Finally, the animals were sacrificed and remodelling of intestinal villa was assessed, correlated with the previously attained data, and compared between groups.
Results
Our results suggest that growth hormone facilitates nutrient absorption as confirmed by the biochemical evidence, and enhances recuperation after surgery as indicated by the haematological findings. This is probably due to the remodelling of the intestinal epithelium observed in the treated animals.
Conclusion
Overall, our results suggest that growth hormone confers an advantage to the animals, leading to a faster and more efficient recuperation. This renders growth hormone a very promising treatment for SBS therapy.
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References
Dowling RH. Small bowel adaptation and its regulation. Scand J Gastroenterol Suppl 1982;74:53–74
Messing B, Crenn P, Beau P, et al. Long-term survival and parenteral nutrition dependence in adult patients with the short bowel syndrome. Gastroenterology 1999;117:1043–50
Iakoubov R, Lauffer LM, Trivedi S, Kim YI, Brubaker PL. Carcinogenic effects of exogenous and endogenous glucagonlike peptide-2 in azoxymethane-treated mice. Endocrinology 2009;150:4033–43
Papamichail M, Digalakis M, Prigouris P, Paisios O, Loti S, Sergentanis T. Endogenous growth hormone and insulin after interposition of a reversed jejunal segment in short bowel syndrome. An experimental study on pigs BMC Research Notes 2012;5:463
Rosenfeld RG, Hwa V. The growth hormone cascade and its role in mammalian growth. Horm Res 2009;71(Suppl 2):36–40
Lichanska AM, Waters MJ. How growth hormone controls growth, obesity and sexual dimorphism. Trends Genet 2008;24:41–7
Delehaye-Zervas MC, Mertani H, Martini JF, et al. Expression of the growth hormone receptor gene in human digestive tissue. J Clin Endocrinol Metab 1994;78:1473–80
Digalakis M, Papamichail M, Glava C, Grammatoglou X, Sergentanis TN, Papalois A, et al. Interposition of a Reversed Jejunal Segment Enhances Intestinal Adaptation in Short Bowel Syndrome: An Experimental Study on Pigs. J Surg Res 2011;171:551–7
Nucci AM, Finegold DN, Yaworski JA, et al. Results of growth trophic therapy in children with short bowel syndrome. J Pediatr Surg 2004;39:335–9
Wales PW, Nasr A, de Silva N, Yamada J. Human growth hormone and glutamine for patients with short bowel syndrome. Cochrane Database Syst Rev 2010; (6):CD006321
Iqbal CW, Qandeel HG, Zheng Y, Duenes JA, Sarr MG. Mechanisms of ileal adaptation for glucose absorption after proximal-based small bowel resection. J Gastrointest Surg 2008;12:1854–64; discussion 1864-5
Scolapio JS, Camilleri M, Fleming CR, et al. Effect of growth hormone, glutamine, and diet on adaptation in short-bowel syndrome: a randomized, controlled study. Gastroenterology 1997;113:1074–81
Wu GH, Wu ZH, Wu ZG. Effects of bowel rehabilitation and combined trophic therapy on intestinal adaptation in short bowel patients. World J Gastroenterol 2003;9:2601–4
Borgstrom B, Dahlquist A, Lundh G, et al. Studies of intestinal digestion and absorption in the human. J Clin Invest 1957;36:1521–36
McMellen M, Wakeman D, Longshore SW, McDuffie LA, Warner BW. Growth Factors: Possible Roles for Clinical Management of the Short Bowel Syndrome. Semin Pediatr Surg 2010;19:35–43
Waitzberg DL, Cukier C, Mucerino DR, et al. Small bowel adaptation with growth hormone and glutamine after massive resection of rat's small bowel. Nutr Hosp 1999;14:81–90
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Gkiouzelis, D.P., Digalakis, M.K., Nomikos, A. et al. Growth hormone in the clinical management of the short bowel syndrome in a pig model. Hellenic J Surg 86, 287–295 (2014). https://doi.org/10.1007/s13126-014-0147-4
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DOI: https://doi.org/10.1007/s13126-014-0147-4