Molecular basis of intestinal adaptation: the role of the insulin-like growth factor system

Ongoing and future approaches to the cellular and molecular actions of insulin-like growth factor I (IGF-I) and growth hormone (GH) in intestinal adaptation are reviewed. This is highly relevant to understanding the benefits and risks associated with increasing use of GH and IGF-I in patients with short bowel syndrome or other bowel diseases. As other growth factors share some of the properties of IGF-I including local expression in bowel, activation of signaling pathways common to other growth factors or cytokines, and modulation of action by growth factor-binding proteins or secreted receptor isoforms. The general issues and approaches outlined for IGF-I should, therefore, serve as a model for studies aimed at understanding the cellular and molecular mechanisms of action of other growth factors that are implicated in intestinal adaptation.