This research is designed to advance understanding of changes in active amino acid transport by the enterocyte after massive small bowel resection. The role of hormones and specific nutrients as mediators of these-changes will also be examined. The hypotheses to be tested are: 1. Active amino acid transport by the enterocyte is altered during adaptation after massive bowel resection. 2. Specific hormones influence amino acid transport during this adaptation. 3. Specific nutrients, including amino acids and short chain fatty acids (SCFA) may be beneficial after resection by improving amino acid uptake. New Zealand rabbits undergo 70% jejunoileal resection or sham operation. One week, one month, and six months later, small bowel mucosa will be processed to brush border membrane vesicles. Uptake of glutamine (GLN), arginine, alanine, and leucine will be quantified using a rapid mixing/filtration technique. Changes in plasma levels of neurotensin (NT) epidermal growth factor (EGF), and growth hormone (GH) will be determined by radioimmunoassay. Infusions of NT, EGF, GH and the somatostatin analogue octreotide will assess hormonal influence on amino acid transport. Octreotide's effect will be further verified by immuno- neutralization with specific antisera to NT, EGF, and GH. Dietary manipulation includes the provision of isonitrogenous, isocaloric diets with protein as whole protein, oligopeptides or free amino acids. SCFA will be supplemented either as free sodium butyrate or pectin. Influence of parenteral GLN on amino acid transport from both the lumen and the splanchnic circulation will also be quantified. The eventual goal is to develop nutrient/hormone combinations that will improve adaptation. It is hoped that the knowledge gained will contribute to new therapeutic strategies for patients with short gut syndrome.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
First Independent Research Support & Transition (FIRST) Awards (R29)
Project #
5R29DK047989-02
Application #
2147977
Study Section
Surgery and Bioengineering Study Section (SB)
Project Start
1994-09-30
Project End
1999-08-31
Budget Start
1995-09-01
Budget End
1996-08-31
Support Year
2
Fiscal Year
1995
Total Cost
Indirect Cost
Name
University of Rochester
Department
Surgery
Type
Schools of Dentistry
DUNS #
208469486
City
Rochester
State
NY
Country
United States
Zip Code
14627
Avissar, N E; Wang, H T; Miller, J H et al. (2000) Epidermal growth factor receptor is increased in rabbit intestinal brush border membrane after small bowel resection. Dig Dis Sci 45:1145-52
Iannoli, P; Miller, J H; Wang, H T et al. (1999) Characterization of L-leucine transport system in brush border membranes from human and rabbit small intestine. Metabolism 48:1432-6
Wang, H T; Miller, J H; Avissar, N et al. (1999) Small bowel adaptation is dependent on site of massive enterectomy. J Surg Res 84:94-100
Iannoli, P; Miller, J H; Ryan, C K et al. (1998) Enterocyte nutrient transport is preserved in a rabbit model of acute intestinal ischemia. JPEN J Parenter Enteral Nutr 22:387-92
Iannoli, P; Miller, J H; Sax, H C (1998) Epidermal growth factor and human growth hormone induce two sodium-dependent arginine transport systems after massive enterectomy. JPEN J Parenter Enteral Nutr 22:326-30
Iannoli, P; Miller, J H; Ryan, C K et al. (1998) Glucocorticoids upregulate intestinal nutrient transport in a time-dependent and substrate-specific fashion. J Gastrointest Surg 2:449-57
Iannoli, P; Miller, J H; Ryan, C K et al. (1997) Human growth hormone induces system B transport in short bowel syndrome. J Surg Res 69:150-8
Wang, H T; Miller, J H; Iannoli, P et al. (1997) Intestinal adaptation and amino acid transport following massive enterectomy. Front Biosci 2:e116-22
Iannoli, P; Miller, J H; Ryan, C K et al. (1997) Epidermal growth factor and human growth hormone accelerate adaptation after massive enterectomy in an additive, nutrient-dependent, and site-specific fashion. Surgery 122:721-8; discussion 728-9
Ryan, C K; Miller, J H; Seydel, A S et al. (1997) Epidermal growth factor and neurotensin induce microvillus hypertrophy following massive enterectomy. J Gastrointest Surg 1:467-73

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