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1 Division of Pediatric Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA; Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
2 Division of Endocrinology, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
* To whom correspondence should be addressed. E-mail: Brad.Warner{at}cchmc.org.
Prior studies of intestinal adaptation following massive small bowel resection
(SBR) have focused on growth factors and their effects on amplification of the gut
mucosa. Since adaptive changes have also been described in intestinal smooth muscle, we
sought to determine the effect of targeted smooth muscle growth factor overexpression on
resection-induced intestinal adaptation. Male transgenic mice with smooth muscle cell
overexpression of insulin-like growth factor-I (IGF-1) by virtue of an
-smooth muscle
actin promoter were obtained. SMP8 IGF-1 transgenic (IGF-1 TG) and non-transgenic
littermates (NT) underwent 50% proximal SBR or sham operation and were then
sacrificed after 3 or 28 days. NT mice showed the expected alterations in mucosal
adaptive parameters after SBR such as increased wet weight and villus height. The IGF -I
TG mice had inherently taller villi, which did not increase significantly after SBR. In
addition, IGF-1 TG mice had a 50% postresection persistent increase in remnant
intestinal length, which was associated with an early decline and later increase in relative
mucosal surface area. These results indicate that growth factor overexpression within the
muscularis layer of the bowel wall induces significant postresection adaptive intestinal
lengthening and a unique mucosal response. IGF-1 signaling within the muscle wall may
play an important role in the pathogenesis of resection-induced adaptation.
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