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Effect of luminal growth factor preservation on intestinal growth

journal contribution
posted on 2023-05-17, 08:04 authored by Playford, RJ, Woodman, AC, Clark, P, Watanapa, P, Vesey, D, Deprez, PH, Williamson, RCN, Calam, J
Intestinal atrophy contributes to the clinical difficulties of patients who cannot eat normally. Atrophy is prevented by luminal food proteins but not by the equivalent aminoacids. This observation is not explained by current theories of intestinal physiology. Epidermal growth factor (EGF) and transforming growth factor α (TGFα) are secreted into the gut lumen. We speculated that these are digested by pancreatic enzymes in fasting juice, but preserved when food proteins block the active sites of these enzymes. Studies based on molecular size and bioactivity confirmed that fasting human jejunal juice destroys EGF and TGFα. EGF, but not TGFα, was preserved when the milk protein casein or an enzyme inhibitor were present; elemental diets were ineffective. Diversion of pancreatic juice to the mid point of the small intestine in rats significantly increased luminal EG F-like bioactivity and all variables of growth in the proximal enzyme-free segment. Our findings support a novel mechanism of control of intestinal growth, which has important clinical implications. The addition of enzyme-inhibiting proteins such as casein to elemental diets may preserve intestinal integrity and function. © 1993.

History

Publication title

The Lancet

Volume

341

Issue

8849

Pagination

843-848

ISSN

0140-6736

Department/School

College Office - College of Health and Medicine

Publisher

Lancet Ltd

Place of publication

84 Theobalds Rd, London, England, Wc1X 8Rr

Repository Status

  • Restricted

Socio-economic Objectives

Clinical health not elsewhere classified

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