Izukura M, Evers B M, Parekh D, Yoshinaga K, Uchida T, Townsend C M, Thompson J C
First Department of Surgery, Osaka University Medical School, Japan.
Ann Surg. 1992 May;215(5):520-6; discussion 526-7. doi: 10.1097/00000658-199205000-00015.
Massive small bowel resection (SBR) is characterized by increased proliferation of residual gut mucosa and pancreas. Neurotensin (NT), a gut tridecapeptide, stimulates growth of normal gut mucosa and pancreas. This study examined whether NT affected growth of the small intestine and the pancreas after either distal or proximal SBR. Male Fischer 344 rats were divided into four groups. Group 1 underwent ileal transection with reanastomosis (SHAM) and group 2 underwent 70% distal SBR. Group 3 underwent SHAM operation (jejunal transection), and group 4 underwent 70% proximal SBR. After operation, each group was further subdivided to receive either saline (control) or NT (300 micrograms/kg) subcutaneously in gelatin every 8 hours for 7 days. At death, the pancreas and proximal jejunum (from groups 1 and 2) or distal ileum (from groups 3 and 4) were removed, weighed, and analyzed for DNA, RNA, and protein content. Both proximal and distal SBR significantly increased mucosal growth in the remnant intestine; a more pronounced effect was noted with proximal SBR. Administration of NT significantly augmented the adaptive changes in both groups of rats by mechanisms involving increases in both cell size (hypertrophy) and cell number (hyperplasia). Pancreatic growth was stimulated by distal (but not proximal) SBR; NT did not augment this response. The authors conclude that NT augments intestinal growth after SBR by mechanisms involving an increase in overall mucosal cellularity. Administration of NT may be therapeutically useful to enhance mucosal regeneration during the early period of adaptive hyperplasia after SBR.
大规模小肠切除（SBR）的特征是残余肠黏膜和胰腺的增殖增加。神经降压素（NT）是一种肠道十三肽，可刺激正常肠黏膜和胰腺的生长。本研究探讨了NT在远端或近端SBR后是否会影响小肠和胰腺的生长。将雄性Fischer 344大鼠分为四组。第1组进行回肠横断并重新吻合（假手术），第2组进行70%远端SBR。第3组进行假手术（空肠横断），第4组进行70%近端SBR。术后，每组进一步细分，每8小时皮下注射明胶生理盐水（对照组）或NT（300微克/千克），共7天。处死时，取出胰腺和近端空肠（第1组和第2组）或远端回肠（第3组和第4组），称重，并分析DNA、RNA和蛋白质含量。近端和远端SBR均显著增加了残余肠道的黏膜生长；近端SBR的效果更明显。NT的给药通过涉及细胞大小增加（肥大）和细胞数量增加（增生）的机制显著增强了两组大鼠的适应性变化。远端（而非近端）SBR刺激胰腺生长；NT并未增强这种反应。作者得出结论，NT通过涉及整体黏膜细胞增多的机制增强SBR后的肠道生长。在SBR后适应性增生的早期阶段，给予NT可能对增强黏膜再生具有治疗作用。
