Abstract
Adequate nutritional support can enhance theprotective action of growth hormone in radiation-inducedmucositis. Our aim is to address the evolutionarypattern of radiation injury to the small intestine of rats fed a high-protein diet and treatedwith growth hormone before irradiation. Male Wistar ratswere fed a high-protein diet and killed two, four orseven days after irradiation. Animals were given either growth hormone or saline. Thecombination of growth hormone and high-protein dietreduced mortality, increased mucosal height and cryptproliferation, and reduced apoptosis from day 2 to day7 after irradiation. Bacterial translocation wasincreased in rats fed the high-protein formula.Insulin-like growth factor was reduced by radiation andfurther reduced by the high-protein diet. Thecombination of growth hormone and high-protein dietprotects from the damage caused by radiation to thebowel and accelerates its recovery. This effect does notseem to be mediated through insulin-like growth factor levels.
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REFERENCES
Pierce GF, Yanagihara D, Klopchin K, et al: Stimulation of all epithelial elements during skin regeneration by keratinocyte growth factor. J Exp Med 170:831-840, 1994
Gurbuz AT, Kunzelman J, Ratzer EE: Supplemental dietary arginine accelerates intestinal mucosal regeneration and enhances bacterial clearance following radiation enteritis in rats. J Surg Res 74:149-154, 1998
Wiseman JS, Senagore AJ, Chaudry IH: Methods to prevent colonic injury in pelvic radiation. Dis Colon Rectum 37:1090-1094, 1994
Evers BM, Izukura M, Townsend CMJ, Uchida T, Thompson JC: Neurotensin prevents intestinal mucosal hypoplasia in rats fed an elemental diet. Dig Dis Sci 37:426-431, 1992
McAnena OJ, Harvey LP, Bonau RA, Daly JM: Alteration of methotrexate toxicity in rats by manipulation of dietary components. Gastroenterology 92:354-360, 1987
Shou J, Lieberman MD, Hofmann K, et al: Dietary manipulation of methotrexate-induced enterocolitis. JPEN 15:307-312, 1991
Vagianos C, Karatzas T, Scopa CD, et al: Neurotensin reduces microbial translocation and improves intestinal mucosa integrity after abdominal radiation. Eur Surg Res 24:77-83, 1992
Chu KU, Higashide S, Evers M, et al: Bombesin improves survival from methotrexate-induced enterocolitis. Ann Surg 220:570-577, 1994
Howarth GS, Fraser R, Frisby CL, Schimer MB, Yeoh EK: Effects of insulin-like growth factor-I administration on radiation enteritis in rats. Scand J Gastroenterol 32:1118-1124, 1997
Farrell CL, Bready JV, Rex KL, et al: Keratinocyte growth factor protects mice from chemotherapy and radiation induced gastrointestinal injury and mortality. Cancer Res 58:933-939, 1998
McKenna K, Ligano S, Kauffman G, Abt A, Stryker J, Conter R: Epidermal growth factor enhances intestinal mitotic activity and DNA content after acute abdominal radiation. Surgery 115:626-632, 1994
Gomez de Segura IA, Prieto I, Grande AG, et al: Growth hormone reduces mortality and bacterial translocation in irradiated rats. Acta Oncol 37:179-185, 1998
Wolf RF, Pearlstone DB, Newman E, et al: Growth hormone and insulin reverse net whole body and skeletal muscle protein catabolism in cancer patients. Ann Surg 216:280-288, 1992
Souba WW, Klimberg VS, Hautamaki RD, et al: Oral glutamine reduces bacterial translocation following abdominal radiation 1. J Surg Res 48:1-5, 1990
Guzman-Stein G, Bonsack M, Liberty J, Delaney JP: Abdominal radiation causes bacterial translocation. J Surg Res 46:104-107, 1989
Rosekrans PC, Meijer CJ, Cornelisse CJ, van der Wal AM, Lindeman J: Use of morphometry and immunohistochemistry of small intestinal biopsy specimens in the diagnosis of food allergy. J Clin Pathol 33:125-130, 1980
Sarraf CE, McCormick CS, Brown GR, et al: Proliferating cell nuclear antigen immunolocalization in gastro-intestinal epithelia. Digestion 50:85-91, 1991
Gavrieli Y, Sherman Y, Ben-Sasson SA: Identification of programmed cell death in situ via specific labeling of nuclear DNA fragmentation. J Cell Biol 119:493-501, 1992
Dowling RH: Small bowel adaptation and its regulation. Scand J Gastroenterol 17:53-74, 1982
Souba WW, Herskowitz K, Austgen TR, Chen MK, Salloum RM: Glutamine nutrition: Theoretical considerations and therapeutic impact. JPEN 14:237S-243S, 1990
Vanderhoof JA, Blackwood DJ, Mohammadpour H, Park JH: Effect of oral supplementation of glutamine on small intestinal mucosal mass following resection. J Am Coll Nutr 11:223-227, 1992
Wiren M, Magnusson KE, Larsson J: Enteral glutamine increases growth and absorptive capacity of intestinal mucosa in the malnourished rat. Scand J Gastroenterol 30:146-152, 1995
Souba WW, Klimberg VS, Copeland EM: Glutamine nutrition in the management of radiation enteritis. JPEN 14:106S-108S, 1990
Scott TE, Moellman JR: Intravenous glutamine fails to improve gut morphology after radiation injury. JPEN 16:440-444, 1992
Wilmore DW: Glutamine and the gut. Gastroenterology 107:1885-1901, 1994
Grant AP, Grant JP, Snyder PJ, Chapman G, Russel M: Effects of enteral feeding products on survival from Escherichia coli peritonitis. J Trauma 37:778-785, 1994
Chevreau N, Funk-Archuleta M: Effect of enteral formulas on me thotrexate toxicity. Nutr Cancer 23:185-204, 1995
Oster MH, Fielder PJ, Levin N, Cronin MJ: Adaptation of the growth hormone and insulin-like growth factor-I axis to chronic and severe calorie or protein malnutrition. J Clin Invest 95:2258-2265, 1995
Byrne TA, Morrissey TB, Nattkom TV, Ziegler TR, Wilmore DW: Growth hormone, glutamine, and a modified diet enhance nutrient absorption in patients with severe short bowel syndrome. JPEN 19:296-302, 1995
Iliakis G: Cellcycle regulation in irradiated and nonirradiated cells. Sem Oncol 24:602-615, 1997
Dulic V, Lees E, Reed SI: Association of human cyclin E with a periodic G1-S phase protein kinase. Science 257:1958-1961, 1992
Murphy LJ, Bell GI, Friessen H: Growth hormone stimulates sequential induction of c-myc and insulin-like growth factor I expression in vivo. Endocrinology 120:1806-1812, 1987
Triest SK, Thissen JP, Maiter DM, Mauerhoff T, Ketelslegers JM: Dietary protein restriction inhibits growth hormoneinduced DNA synthesis without impairing c-myc and c-Ha-ras expression in the liver of hypophysectomized rats. J Nutr 125:1847-1853, 1995
Roberts TJ, Azain MJ, White BD, Martin RJ: Rats treated with somatotropin select diets higher in protein. J Nutr 125:2669-2678, 1995
Donoway RB, Torosian MH: Growth hormone inhibits tumor metastases. Surg Forum 40:413-415, 1989
Binnerts A, Uittterlinden P, Hofland LJ, van-Koetsveld P, Lamberts SW: The in vitro and in vivo effects of human growth hormone administration on tumor growth of rats bearing a transplantable rat pituitary tumor (7315b). Eur J Cancer 26:269-276, 1990
Harrison LE, Blumberg D, Berman R, et al: Effect of human growth hormone on human pancreatic carcinoma growth, protein, and cell cycle kinetics. J Surg Res 61:317-322, 1996
Yoshida S, Kaibara A, Yamasaki K, Ishibashi N, Noake T, Kakegawa T: Effect of glutamine supplementation on protein metabolism and glutathione in tumor-bearing rats. JPEN 19:492-497, 1995
Oka T, Ohwada K, Nagao M, Kitazato K: Effect of arginine-enriched total parenteral nutrition on the host-tumor interaction in cancer-bearing rats. JPEN 17:375-383, 1993
Klimberg VS, Souba WW, Salloum RM, et al: Glutamine-enriched diets support muscle glutamine metabolism without stimulating tumor growth. J Surg Res 48:319-323, 1990
Fahr MJ, Kornbluth J, Blossom S, Schaeffer R, Klimberg VS: Glutamine enhances immunoregulation of tumor growth. JPEN 18:471, 1994
Daughaday WH, Rotwein P: Insulin-like growth factors I and II. Peptide, messenger ribonucleic acid and gene structures, serum, and tissue concentration. Endocrinol Rev 10:68-91, 1989
Adrian TE, Savage AP, Fuessl HS, Wolfe K, Besterman HS, Bloom SR: Release of peptide YY (PYY) after resection of small bowel, colon, or pancreas in man. Surgery 101:715-719, 1987
Huang KF, Chung DH, Herndon DN: Insulin like growth factor 1 (IGF-1) reduces gut atrophy and bacterial translocation after severe burn injury. Arch Surg 128:47-53, 1993
Gomez de Segura I, Aguilera MJ, Codesal J, Codoceo R, De Miguel E: Comparative effects of growth hormone in large and small bowel resection in the rat. J Surg Res 62:5-10, 1996
Savage AP, Gomacz GE, Adrian TE, et al: Is raised plasma peptide YY after intestinal resection in the rat responsible for the trophic response? Gut 26:1353-1358, 1985
Goodlad RA, Lenton W, Ghatei MA, Adrian TE, Bloom SR, Wright NA: Effects of an elemental diet, inert bulk and different types of dietary fibre on the response of the intestinal epithelium to re feeding in the rat and relationship to plasma gastrin, enteroglucagon, and PYY concentrations. Gut 28:171-180, 1987
Goodlad RA, Lee CY, Gilbey SG, Ghatei MA, Bloom SR: Insulin and intestinal epithelial cell proliferation. Exp Physiol 78:697-705, 1993
Bass BL, Fischer BA, Richardson C, Harmon JW: Somatostatin analogue treatment inhibits post-resectional adaptation of the small bowel in rats. Am J Surg 161:107-111, 1991
Vanderhoof JA, Kollman KA: Lack of inhibitory effect of octreotide on intestinal adaptation in short bowel syndrome in the rat. J Pediatr Gastroenterol Nutr 26:241-244, 1998
Brogan RS, Fife SK, Conley LK, Giustina A, Wehrenberg WB: Effects of food deprivation on the GH axis: Immunocytochemical and molecular analysis. Neuroendocrinology 65:129-135, 1997
Bochenek WJ, Narczewska B, Grzebieluch M: Effect of massive proximal small bowel resection on intestinal sucrase and lactase activity in the rat. Digestion 9:224-230, 1973
Philpott DJ, Kirk DR, Butzner JD: Luminal factors stimulate intestinal repair during there feeding of malnourished infant rabbits. Can J Physiol Pharmacol 71:650-656, 1993
Becciolini A, Castagnoli P, Arganini L, De Giuli G: Postirradiation enzyme activities of rat small intestine: Effects of dose fractionation. Radiat Res 55:291-303, 1973
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Vazquez, I., Gomez-De-Segura, I.A., Grande, A.G. et al. Protective Effect of Enriched Diet Plus Growth Hormone Administration on Radiation-Induced Intestinal Injury and on Its Evolutionary Pattern in the Rat. Dig Dis Sci 44, 2350–2358 (1999). https://doi.org/10.1023/A:1026637611298
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DOI: https://doi.org/10.1023/A:1026637611298