Comparison of Ileal and Jejunal Transplantation after 50% Proximal Intestinal Resection

Thompson, Jon S.; Ferguson, Debra C.; Quigley, Eamonn Martin

doi:10.1006/jsre.1998.5469

Cited by 7 publications

(1 citation statement)

References 10 publications

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“…2; Table 1) may reflect the local, transient hyperplastic effects of transection alone (49,52). We believe the ileum transection, which we and others (25,37) have used, is a more rigorous test of the adaptive response to resection, because the ileum has the greatest potential of adapting to take on the appearance of the jejunum, as reported in orally fed animals (44). However, we refrain from making comparisons between individual small bowel segments regarding the relative effects of resection on adaptive growth, because the location of the transection cut influences the baseline for interpretation of the magnitude of the results.…”

Section: Experiments 2: Early Time Course Of Intestinal Adaptation Andmentioning

confidence: 97%

Role of luminal nutrients and endogenous GLP-2 in intestinal adaptation to mid-small bowel resection

Dahly

Gillingham

Guo

et al. 2003

American Journal of Physiology-Gastrointestinal and Liver Physi

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. Role of luminal nutrients and endogenous GLP-2 in intestinal adaptation to mid-small bowel resection. Am J Physiol Gastrointest Liver Physiol 284: G670-G682, 2003. First published December 27, 2002 10.1152/ajpgi.00293.2002To elucidate the role of luminal nutrients and glucagon-like peptide-2 (GLP-2) in intestinal adaptation, rats were subjected to 70% midjejunoileal resection or ileal transection and were maintained with total parenteral nutrition (TPN) or oral feeding. TPN rats showed small bowel mucosal hyperplasia at 8 h through 7 days after resection, demonstrating that exogenous luminal nutrients are not essential for resection-induced adaptation when residual ileum and colon are present. Increased enterocyte proliferation was a stronger determinant of resection-induced mucosal growth in orally fed animals, whereas decreased apoptosis showed a greater effect in TPN animals. Resection induced significant transient increases in plasma bioactive GLP-2 during TPN, whereas resection induced sustained increases in plasma GLP-2 during oral feeding. Resection-induced adaptive growth in TPN and orally fed rats was associated with a significant positive correlation between increases in plasma bioactive GLP-2 and proglucagon mRNA expression in the colon of TPN rats and ileum of orally fed rats. These data support a significant role for endogenous GLP-2 in the adaptive response to mid-small bowel resection in both TPN and orally fed rats. parenteral nutrition; enterocyte proliferation and apoptosis; glucagon-like peptide-2; proglucagon; ileum INTESTINAL ADAPTATION AFTER bowel resection is a poorly understood, multifactorial process that results in growth and improved function of the residual intestine. Luminal nutrients, hormones, pancreaticobiliary secretions, and neural pathways in the gastrointestinal tract are thought to mediate intestinal adaptation (50). Defining the mechanisms that regulate intestinal adaptation may lead to improved treatments for short bowel syndrome, a form of intestinal failure that often requires parenteral nutrition to maintain nutritional status after bowel resection in humans.Despite the multifactorial regulation of intestinal adaptation, the literature suggests that luminal nutrients are fundamental to the adaptive response such that no adaptive intestinal growth will occur in the absence of luminal nutrients (9, 10, 30). This conclusion is largely based on studies that show significant resection-induced adaptive growth in rats (10, 30) and dogs (9) fed orally compared with those fed parenterally. However, given the clear evidence that total parenteral nutrition (TPN) causes dramatic intestinal atrophy in rats (5, 7, 31, 32) and mucosal hypoplasia in humans (2), the interpretation of these reports (9, 10, 30) is limited by the absence of appropriate parenterally fed transection control groups. We have corrected for this in the present study.The presence of ileum or colon is important in intestinal adaptation and appears to determine whether resection-induced adaptation occurs in human...

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Section: Experiments 2: Early Time Course Of Intestinal Adaptation Andmentioning

confidence: 97%