Effect of growth hormone, epidermal growth factor, and insulin on bacterial translocation in experimental short bowel syndrome

Background/Purpose: An adaptive process starts in the remaining intestine a fter massive resection, and several trophic factors including growth hormon e (GH), epidermal growth factor (EGF), and insulin (INS) have been shown to have a positive effect on it. Bacterial translocation (BT) is frequent aft er extensive small bowel resection, but the effects of GH, EGF, or INS have not been investigated in experimental short bowel syndrome (SBS). This stu dy rests the hypothesis that GH, EGF, or INS decrease BT in SBS in Fats wit h parenteral nutrition (PN). Methods: Thirty-eight adult Wistar rats underwent central venous cannulatio n and were assigned randomly to 1 of 4 groups receiving for 10 days 4 treat ment regimes: (1) PN group (n = 10): fasting, all-in-one PN solution (300 m L/kg/24 h, 280 kcal/kg/24 h), 80% gut resection including ileo-cecal valve; (2) GH group (n = 9): fasting, same PN regime and resection, GH (1 mg/kg/d , subcutaneously); (3) EGF group (n = 9): fasting, PN, resection, EGF (150 mu g/24 h intravenously); (4) INS group (0 = 9): fasting, PN, resection, IN S (1 UI/100 8/24 h subcutaneously). At the end of the experiment they were killed, and mesenteric lymph nodes (MLN) and peripheral and portal blood sa mples were recovered and cultured. Several fragments of intestine were take n to determine cell proliferation (PCNA index) and morphometric parameters (villous height, crypt depth). Results: GH, EGF, and INS groups showed a 28%, 29%, and 30% increase in gut mucosal thickness, and PCNA index rose 21%, 20%, and 25%, respectively in comparison with PN controls. Bacterial translocation to peripheral blood wa s detected in 0% of PN animals and in 44%, 40%, and 28% of GH, EGF, or INS rats, respectively (P < .05). No differences were found in BT in MLN or por tal blood among groups. Conclusion: Administration of GH, EGF, or INS improves gut mucosal structur e in rats with SBS under PN, but, surprisingly, the incidence of BT detecte d in peripheral blood was increased rather than decreased in animals receiv ing these treatments. Copyright (C) 2000 by W.B. Saunders Company.