Erythropoietin restores bowel damage and hypoperistalsis in gastroschisis.
OBJECTIVE
Despite the decreased mortality in gastroschisis (Gx), patients experience postoperative intestinal hypoperistalsis, malabsorption, and shortened bowel length. The trophic effects of recombinant human erythropoietin (rEpo) in the developing small bowel have been reported, increasing the length and height of the villi, and villous surface area. This study investigated the effects of rEpo on intestinal malfunction in the chick embryos with Gx.


METHODS
Thirteen-day-old fertilized chicken eggs were used to create Gx model. Study groups included the following: group 1, control; group 2, Gx-only; group 3, Gx + 0.075% saline exchange; group 4, Gx + 10 IU rEpo exchange; group 5, Gx + 20 IU rEpo exchange. The bowels were evaluated by in vitro muscle strip technique, and the response was expressed as a percentage of the maximum carbachol-evoked contraction (Emax). In addition, parasympathetic ganglion cells per 10 plexuses and villi height were determined by light microscopy. Results were evaluated statistically by Mann-Whitney U, chi2, and Fisher's Exact test tests.


RESULTS
Saline exchange had no effect on ganglion cell number (P = .63) and villi height (P = .10). In group 4, ganglion cell number was not increased (P = .82), but villi height increase was significant (P = .03). In Gx + 20 IU rEpo group, both the number of ganglia (P = .0001) and villi height (P = .002) were significantly increased. The decrease in contractility in group 2 (P = .0121) was significantly reversed by rEpo 20 IU treatment (P = .0216), no significant difference was obtained in groups 3 (P = .0809) and 4 (P = .1516) compared with group 2.


CONCLUSIONS
These data suggest that rEpo has prokinetic effects on hypoperistalsis and restores bowel damage in Gx.
Department of Pediatric Surgery, Dr. Behcet Uz Children's Hospital, Izmir, Turkey.
Aykut
A
Ozdamar
Koray
K
Topcu
Mukaddes
M
Gumustekin
Duygu
D
Gurel
Ayse
A
Gelal
Erdener
E
Ozer
Basak
B
Ucan
Gunyuz
G
Temir
Aytac
A
Karkiner
Irfan
I
Karaca
Munevver
M
Hosgor
D000818:Animals; D002642:Chick Embryo; D004921:Erythropoietin / Q000494:pharmacology*; D020139:Gastroschisis / Q000503:physiopathology*; D007422:Intestines / Q000187:drug effects* / Q000473:pathology*; D010528:Peristalsis / Q000187:drug effects*; D011994:Recombinant Proteins
D011994:Recombinant Proteins; D004921:Erythropoietin