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Octreotide diminishes luminal nutrient transport activity, which is reversed by epidermal growth factor
A S Seydel1, J H Miller, T P Sarac
1Department of Surgery, University of Rochester Medical Center, New York 14642, USA.
Background:
Octreotide (SMS) is a somatostatin analogue utilized in patients with short bowel syndrome (SBS) to decrease output. It may inhibit small bowel adaptation by blocking the secretion of trophic hormones such as epidermal growth factor (EGF). This study delineates the effects of SMS and EGF on nutrient transport in SBS.
Methods:
One week after 70% jejunoileal resection, 20 New Zealand White rabbits (2 kg) received subcutaneous infusions of saline or EGF (1.5 micrograms/kg/hr) and injections 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, intestinal brush border membrane vesicles were prepared and nutrient transport measured.
Results:
SMS reduced active nutrient transport. Kinetics confirmed this was secondary to a reduction in functional carriers in the brush border membrane, without a change in carrier affinity. The 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 effect and may benefit patients with SBS who require SMS to control high intestinal output.
Insights
Octreotide (SMS) hinders small bowel adaptation by reducing nutrient transport. However, epidermal growth factor (EGF) can reverse this detrimental effect, potentially benefiting patients with short bowel syndrome (SBS).
Area of Science:
- Gastroenterology
- Physiology
- Pharmacology
Background:
- Octreotide (SMS), a somatostatin analogue, is used to manage short bowel syndrome (SBS) by reducing intestinal output.
- SMS may impede small bowel adaptation by inhibiting trophic hormones like epidermal growth factor (EGF).
Purpose of the Study:
- To investigate the effects of SMS and EGF on nutrient transport in a rabbit model of SBS.
- To determine if EGF can counteract the negative impact of SMS on small bowel adaptation.
Main Methods:
- Surgical jejunoileal resection was performed on New Zealand White rabbits.
- Rabbits received subcutaneous infusions of saline or EGF and injections of saline or SMS.
- Intestinal brush border membrane vesicles were isolated to measure nutrient transport.
Main Results:
- SMS significantly reduced active nutrient transport by decreasing functional carriers in the brush border membrane.
- Epidermal growth factor (EGF) coinfusion ameliorated the negative effects of SMS.
- Combined EGF and SMS treatment led to a 26% upregulation in nutrient transport.
Conclusions:
- Octreotide (SMS) has detrimental effects on small bowel adaptation in SBS.
- Epidermal growth factor (EGF) can reverse the negative impact of SMS and may offer therapeutic benefits for SBS patients.