title: Effect of luminal growth factor preservation on intestinal growth.
abstract: Intestinal atrophy contributes to the clinical difficulties of patients who cannot eat normally. Atrophy is prevented by luminal food proteins but not by the equivalent aminoacids. This observation is not explained by current theories of intestinal physiology. Epidermal growth factor (EGF) and transforming growth factor alpha (TGF alpha) are secreted into the gut lumen. We speculated that these are digested by pancreatic enzymes in fasting juice, but preserved when food proteins block the active sites of these enzymes. Studies based on molecular size and bioactivity confirmed that fasting human jejunal juice destroys EGF and TGF alpha. EGF, but not TGF alpha, was preserved when the milk protein casein or an enzyme inhibitor were present; elemental diets were ineffective. Diversion of pancreatic juice to the mid point of the small intestine in rats significantly increased luminal EGF-like bioactivity and all variables of growth in the proximal enzyme-free segment. Our findings support a novel mechanism of control of intestinal growth, which has important clinical implications. The addition of enzyme-inhibiting proteins such as casein to elemental diets may preserve intestinal integrity and function.
authors.affiliation: Department of Medicine, Royal Postgraduate Medical School, London, UK.
authors.forename: R J
authors.initials: RJ
authors.lastname: Playford
authors.forename: A C
authors.initials: AC
authors.lastname: Woodman
authors.forename: P
authors.initials: P
authors.lastname: Clark
authors.forename: P
authors.initials: P
authors.lastname: Watanapa
authors.forename: D
authors.initials: D
authors.lastname: Vesey
authors.forename: P H
authors.initials: PH
authors.lastname: Deprez
authors.forename: R C
authors.initials: RC
authors.lastname: Williamson
authors.forename: J
authors.initials: J
authors.lastname: Calam
mesh_terms: D000818:Animals; D015904:Biliopancreatic Diversion; D002918:Chymotrypsin / Q000378:metabolism; D004044:Dietary Proteins / Q000494:pharmacology; D004815:Epidermal Growth Factor / Q000032:analysis / Q000378:metabolism / Q000494:pharmacology*; D005526:Food, Formulated; D006801:Humans; D066298:In Vitro Techniques; D007419:Intestinal Secretions / Q000201:enzymology; D007422:Intestines / Q000187:drug effects* / Q000254:growth & development; D008938:Mitosis / Q000187:drug effects; D010189:Pancreatic Juice / Q000378:metabolism; D051381:Rats; D016211:Transforming Growth Factor alpha / Q000378:metabolism; D014357:Trypsin / Q000378:metabolism
chemical_list: D004044:Dietary Proteins; D016211:Transforming Growth Factor alpha; D004815:Epidermal Growth Factor; D002918:Chymotrypsin; D014357:Trypsin