OCTREOTIDE DIMINISHES LUMINAL NUTRIENT TRANSPORT ACTIVITY, WHICH IS REVERSED BY EPIDERMAL GROWTH-FACTOR

BACKGROUND: Octreotide (SMS) is a somatostatin analogue utilized in pa tients with short bowel syndrome (SBS) to decrease output. It may inhi bit small bowel adaptation by blocking the secretion of trophic hormon es such as epidermal growth factor (EGF). This study delineates the ef fects of SMS and EGF on nutrient transport in SBS. METHODS: One week a fter 70% jejunoileal resection, 20 New Zealand White rabbits (2 kg) re ceived subcutaneous infusions of saline or EGF (1.5 mu g/kg/hr) and in jections of saline or SMS s.q. b.i.d. The study groups were EGF/saline , saline/saline, saline/SMS, and EGF/SMS. After 7 days of infusion, in testinal brush border membrane vesicles were prepared and nutrient tra nsport measured. RESULTS: SMS reduced active nutrient transport. Kinet ics confirmed this was secondary to a reduction in functional carriers in the brush border membrane, without a change in carrier affinity. T he coinfusion of EGF ameliorated this effect. On an individual basis, EGF alone did not significantly increase nutrient transport, but when taken as a group, nutrients transport was upregulated 26%. CONCLUSIONS : SMS is detrimental to small bowel adaptation. EGF reverses this effe ct and may benefit patients with SBS who require SMS to control high i ntestinal output.