Recombinant human interleukin-11 prevents mucosal atrophy and bowel shortening in the defunctionalized intestine.
BACKGROUND
Mucosal atrophy and bowel shortening are the hallmark of proximal intestinal diversion for extensive necrotizing enterocolitis (NEC) or Thiry-Vella fistulas (TVF), in which the ends of a defunctionalized loop of intestine are exteriorized as stomas. Recombinant human interleukin-11 (rhIL-11) is a pleiotropic cytokine that promotes epithelial regeneration and enhances adaptation after bowel resection. The authors hypothesized that rhIL-11 may prevent mucosal atrophy and bowel shortening in rats with TVF METHODS: After creation of ileal TVF, Sprague-Dawley rats were selected randomly to receive either rhIL-11 or equal volume of 0.1% bovine serum albumin (BSA) subcutaneously daily. On day 14, the TVF were excised and examined morphologically. Enterocyte apoptosis was measured using the TUNEL assay. Mucosal DNA and protein content were measured.


RESULTS
Administration of rhIL-11 resulted in a significantly greater weight gain and less shortening of TVF than BSA treatment. TVF from the rhIL-11-treated group showed evidence of hyperplasia and hypertrophy and increased crypt to villus ratio. The BSA group had substantial mucosal atrophy. There was a qualitative decrease in the incidence of apoptosis in the rhIL-11 group.


CONCLUSIONS
Recombinant human IL-11 prevents mucosal atrophy and shortening of defunctionalized intestinal loops. It may help reduce the incidence of short gut syndrome in infants with extensive NEC.
Department of Surgery, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine and the Center for Biological Imaging, Pennsylvania, USA.
E C
EC
Dickinson
R
R
Tuncer
E P
EP
Nadler
U
U
Koltuksuz
P
P
Boyle
S M
SM
Alber
S C
SC
Watkins
H R
HR
Ford
D000818:Animals; D001284:Atrophy / Q000517:prevention & control; D006801:Humans; D017370:Interleukin-11 / Q000627:therapeutic use*; D007413:Intestinal Mucosa / Q000473:pathology*; D008297:Male; D051381:Rats; D017207:Rats, Sprague-Dawley; D011994:Recombinant Proteins / Q000627:therapeutic use*; D012778:Short Bowel Syndrome / Q000150:complications*
D017370:Interleukin-11; D011994:Recombinant Proteins