The effects of bilio-jejunal diversion on streptozotocin diabetes in the rat
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Summary
Previous experimental indications that the internal biliary diversion (IBD), consisting in bilio-jejunal anastomosis, provokes an increase in glucose tolerance in healthy rats provide the basis for testing the hypothesis that this surgical procedure is capable of correcting pharmacologically-induced diabetes mellitus. To this object, the carbohydrate metabolism of an experimental group of six rats suffering from streptozotocin diabetes and treated with IBD (Lambert prosthetic choledoco-jejunostomy) was studied and comparated with that of three control groups: normal, diabetic without surgery and diabetic with sham-surgery. Carbohydrate metabolism, assessed during 60-day period by means of specific tests (basal and fasting blood glucose and insulin, glucose tolerance and insulin sensitivity), demonstrated that the IBD provokes a definitive remission, either total or partial, of the artificial diabetes mellitus. The results lead to the hypothetical explanation that diversion of bile flow from the duodenum to the proximal jejunum activates the ‘entero-insular axis’, specifically by potentiating the B-cell stimulating effect of the so-called enteric hormone ‘incretin’.
Key-words
Bilio-enteric diversion Choledoco-jejunostomy Diabetes treatment Entero-insular axis Experimental diabetes Incretin Streptozotocin diabetesPreview
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References
- 1.Barco P., Giannoni G.: Derivazione totale della bile e funzionalità pancreatica. (Studio sperimentale) —Clin. chir.10, 882–890, 1934.Google Scholar
- 2.Brown J. C., Otte S. C.: Gastrointestinal hormones and the control of insulin secretion— Diabetes27, 782–787, 1978.PubMedGoogle Scholar
- 3.Brown J. C., Otte S. C.: GIP and the entero-insular axis—Clin. Endocrinol. Metabol.8, 365–377, 1979.CrossRefGoogle Scholar
- 4.Creutzfeldt W.: Insulin-releasing factors on the gastrointestinal mucosa (incretin)—Gastroenterology67, 748–750, 1974.PubMedGoogle Scholar
- 5.Creutzfeldt W.: The incretin concept today—Diabetologia16, 75–85, 1979.PubMedCrossRefGoogle Scholar
- 6.Creutzfeldt W., Ebert R.: New developments in incretine concept—Diabetologia28, 565–573, 1985.PubMedCrossRefGoogle Scholar
- 7.Creutzfeldt W., Feurle G., Ketterez H.: Effect of gastrointestinal hormones on insulin and glucagon secretion—New Engl. J. Med.282, 1139–1141, 1970.PubMedCrossRefGoogle Scholar
- 8.Dupré J., Beck J. C.: Stimulation of release of insulin by an extract of intestinal mucosa— Diabetes15, 155–159, 1966.Google Scholar
- 9.Eloy R., Garaud J. C., Moody A., Jaeck D., Grenier J. F.: Jejunal factor stimulating insulin release in the isolated perfused canine pancreas and jejunum—Hormone metabol. Res.7, 461–467, 1975.CrossRefGoogle Scholar
- 10.Ermini M., Macaluso C., Masiello P.: Functional modifications of endocrine pancreas after internal biliary fistula (experimental research)—Acta diabetol. lat.15, 303–309, 1978.PubMedCrossRefGoogle Scholar
- 11.Ermini M., Seccia M., Evangelista G.: Modifications of pancreatic islet tissue after internal biliary fistula (experimental research)—Acta diabetol. lat.12, 150–159, 1975.PubMedCrossRefGoogle Scholar
- 12.Lambert R.: Biliary fistula in the small intestine. In: Surgery of the Digestive System of the Rat. Charles C. Thomas Publ., Springfield/IL, 1965; pp. 142–149.Google Scholar
- 13.Leriche R., Joung A.: Essai sur le traitement chirurgical du diabète par la dérivation biliaire: documents expérimentaux et cliniques—Ann. Endocrinol.1, 3–10, 1939.Google Scholar
- 14.Loew E. R., Gray J. S., Ivy A. C.: Is a duodenal hormone involved in carbohydrate metabolism? —Amer. J. Physiol.129, 659–663, 1940.Google Scholar
- 15.Manfredini G., Ermini M., Scopsi L., Bonaguidi F., Ferrannini E.: Internal biliary diversion improves glucose tolerance in the rat—Amer. J. Physiol.249, G519-G527, 1985.PubMedGoogle Scholar
- 16.Moody A. J.: Insulin releasing polypeptides. In:Bajaj J. S. (Ed.): Diabetes. Excerpta Med. Intern. Congr. Ser. 413, Amsterdam, 1977; pp. 76–82.Google Scholar
- 17.Moody A. J., Markussen J., Schaich Fries A., Steenstrup C., Sundby F., Malaisse W., Malaisse-Lagae F.: The insulin releasing activities of extracts of pork intestine—Diabetologia6, 135–140, 1970.PubMedCrossRefGoogle Scholar
- 18.Rehfeld J. F.: Gastrointestinal hormones and insulin secretion—Scand. J. Gastroenterol.7, 289–292, 1972.CrossRefGoogle Scholar
- 19.Rey F., Mauron C., Bobbioni E., Jeanrenaud B., Mutt V., Felber J.-P.: Evidence for the presence of a neutral insulinotrophic peptide in the porcine duodenum—Acta endocrinol. (Kbh.)105, 398–406, 1984.Google Scholar
- 20.Reyes-Leal B., Castro A., Bernal E., Guardiola O.: Le role du duodénum dans l’insulino sécrétion—Sem. Hôp. Paris49, 1611–1617, 1973.PubMedGoogle Scholar
- 21.Szecowka J., Lins Pe., Efendic S.: Effects of cholecystokinin, gastric inhibitory polypeptide and secretin on insulin and glucagon secretion in rats—Endocrinology110, 1268–1272, 1982.PubMedGoogle Scholar
- 22.Togni G.: Contributo alla conoscenza dei rapporti tra deviazione biliare e diabete—Minerva med.2, 43–45, 1942.Google Scholar
- 23.Turner D. S., Etheridge L., Marks V., Brown J. C., Mutt V.: Effectiveness of the intestinal polypeptides, IRP, GIP, VIP and motilin on insulin release in the rat—Diabetologia10, 459–463, 1974.PubMedCrossRefGoogle Scholar
- 24.Turner D. S., Shabaam A., Etheridge L., Marks V.: The effect of an intestinal polypeptide fraction on insulin release in the ratin vitro andin vivo—Endocrinology93, 1323–1328, 1973.PubMedCrossRefGoogle Scholar
- 25.Unger R. H., Eisentraut A. M.: Entero-insular axis—Arch. intern. Med.123, 261–266, 1969.PubMedCrossRefGoogle Scholar
- 26.Unger R. H., Ketterer H., Dupré J., Eisentraut A. M.: The effects of secretin, pancreozymin and gastrin on insulin and glucagon secretion in anesthetized dogs—J. clin. Invest.46, 630–645, 1967.PubMedGoogle Scholar
- 27.Verspohl E. J., Ammon H. P. T., Williams J. A., Goldfine I. D.: Evidence that cholecystokinin interacts with specific receptors and regulates insulin release in isolated rat islets of Langerhans— Diabetes35, 38–43, 1986.PubMedCrossRefGoogle Scholar