The role of basic fibroblast growth factor to enhance fetal intestinal mucosal cell regeneration in vivo.

BACKGROUND/PURPOSE: The limited application of small bowel transplantation for short bowel syndrome, mainly on the account of the morbidity and long-term implications of the procedure, has led to a search for alternative therapies. The purpose of this study was to evaluate whether basic fibroblast growth factor (bFGF) could facilitate regeneration of fetal small intestinal mucosa in vivo.

METHODS: Intestinal epithelial organoid units harvested from fetal Lewis rats were injected into adult male Lewis rats whose colon was denuded of mucosa, as syngeneic recipients. One experimental group transplanted with the addition of 50 ng/ml bFGF, was compared with a control group that were transplanted without bFGF. The grafts were harvested and analyzed using histology and immunohistochemistry 3 weeks after operation.

RESULTS: There were 4 anesthetic deaths, two in each group, and 11 deaths due to adhesive ileus. In no rat did neomucosa fully cover the denuded colonic muscle throughout the whole length of lumen. Histologically, the structure of the neomucosa, when present, was normal small intestinal mucosa. The small intestinal mucosa was partially restored in 100% (6 of 6) of bFGF, and in 28.6% (2 of 7) of those not given bFGF (P = 0.0021).

CONCLUSIONS: These data demonstrate that bFGF can facilitate the restoration of intestinal epithelial cells, at least to some degree. Potentially, refinements of this technique could be used to facilitate the physiologic tissue engineering of small intestine in a way that allows it to move peristaltically, and have an application in the management of patients with short bowel syndrome.