title: Insulin-like growth factor I improves aspects of mycophenolate mofetil-impaired anastomotic healing in an experimental model.
abstract: BACKGROUND
  Patients taking immunosuppressants after transplantation may require intestinal surgery. Mycophenolate mofetil (MMF) has been found to impair the healing of colonic anastomoses in rats. This study examined whether insulin-like growth factor (IGF) I prevents MMF impairment of anastomotic healing.
  
  
  METHODS
  Sixty-three rats were divided into three groups (MMF, MMF/IGF and control). Animals underwent a sigmoid colon anastomosis with a 6/0 suture, and were killed on days 2, 4 and 6 after surgery. Investigations included bursting pressure measurement, morphometric analysis, and assessment of mucosal proliferation by 5-bromo-2'-deoxyuridine and Ki67 immunohistochemistry of the anastomoses.
  
  
  RESULTS
  The leak rate was three of 21, one of 20 and two of 20 in the MMF, MMF/IGF-I and control groups respectively. Anastomotic bursting pressures were significantly lower in the MMF group than in the control group on days 2 and 4, but there was no significant difference by day 6. Values in the MMF/IGF-I and control groups were similar. Colonic crypt depth was significantly reduced in MMF-treated animals on days 2 and 4, but this impairment was attenuated by IGF-I on day 4. Similarly, IGF-I reduced the negative impact of MMF on mucosal proliferation on days 2 and 6.
  
  
  CONCLUSIONS
  Exogenous IGF-I improves some aspects of MMF-impaired anastomotic healing.
authors.affiliation: Department of Visceral and Transplantation Surgery, Inselspital, University of Berne, CH-3010 Berne, Switzerland.
authors.forename: R A
authors.initials: RA
authors.lastname: Inglin
authors.forename: G
authors.initials: G
authors.lastname: Baumann
authors.forename: O J
authors.initials: OJ
authors.lastname: Wagner
authors.forename: D
authors.initials: D
authors.lastname: Candinas
authors.forename: B
authors.initials: B
authors.lastname: Egger
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D000963:Antimetabolites; D001973:Bromodeoxyuridine; D049109:Cell Proliferation; D012809:Colon, Sigmoid / Q000166:cytology / Q000502:physiology / Q000601:surgery; D007150:Immunohistochemistry; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007334:Insulin-Like Growth Factor I / Q000494:pharmacology*; D007413:Intestinal Mucosa / Q000166:cytology; D019394:Ki-67 Antigen / Q000378:metabolism; D008297:Male; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives*; D011312:Pressure; D051381:Rats; D017207:Rats, Sprague-Dawley; D013529:Surgical Wound Dehiscence / Q000473:pathology / Q000503:physiopathology; D014945:Wound Healing / Q000187:drug effects* / Q000502:physiology
chemical_list: D000963:Antimetabolites; D007166:Immunosuppressive Agents; D019394:Ki-67 Antigen; D007334:Insulin-Like Growth Factor I; D001973:Bromodeoxyuridine; D009173:Mycophenolic Acid