Growth factors: possible roles for clinical management of the short bowel syndrome.
The structural and functional changes during intestinal adaptation are necessary to compensate for the sudden loss of digestive and absorptive capacity after massive intestinal resection. When the adaptive response is inadequate, short bowel syndrome (SBS) ensues and patients are left with the requirement for parenteral nutrition and its associated morbidities. Several hormones have been studied as potential enhancers of the adaptation process. The effects of growth hormone, insulin-like growth factor-1, epidermal growth factor, and glucagon-like peptide 2 on adaptation have been studied extensively in animal models. In addition, growth hormone and glucagon-like peptide 2 have shown promise for the treatment of SBS in clinical trials in human beings. Several lesser studied hormones, including leptin, corticosteroids, thyroxine, testosterone, and estradiol, are also discussed.
McMellen
Mark E
ME
Division of Pediatric Surgery, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Wakeman
Derek
D
Longshore
Shannon W
SW
McDuffie
Lucas A
LA
Warner
Brad W
BW
D000222:Adaptation, Physiological; D000818:Animals; D049109:Cell Proliferation / Q000187:drug effects; D020895:Enterocytes / Q000187:drug effects; D004815:Epidermal Growth Factor / Q000494:pharmacology / Q000627:therapeutic use; D053767:Glucagon-Like Peptide 2 / Q000494:pharmacology / Q000627:therapeutic use; D013006:Growth Hormone / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000494:pharmacology / Q000627:therapeutic use*; D007421:Intestine, Small / Q000166:cytology / Q000187:drug effects* / Q000254:growth & development; D036361:Peptide Hormones / Q000494:pharmacology / Q000627:therapeutic use*; D051381:Rats; D012778:Short Bowel Syndrome / Q000188:drug therapy* / Q000473:pathology; D013002:Somatomedins / Q000494:pharmacology / Q000627:therapeutic use
D053767:Glucagon-Like Peptide 2; D036341:Intercellular Signaling Peptides and Proteins; D036361:Peptide Hormones; D013002:Somatomedins; D004815:Epidermal Growth Factor; D013006:Growth Hormone