Growth hormone and insulinlike growth factor 1 promote intestinal uptake and hepatic release of glutamine in sepsis.

OBJECTIVE: To study the effects of growth hormone (GH) and insulinlike growth factor 1 (IGF-1) on whole body and gastrointestinal (GI), hepatic, femoral, and renal glutamine (GLN) uptake and release in septic piglets. SUMMARY BACKGROUND DATA: The GI metabolism of GLN is impaired during sepsis, and this may contribute to a breakdown of the gut's mucosal barrier. GH treatment has produced increased GI GLN uptake in surgical stress. Little is known about the effects of GH and IGF-1 in sepsis. METHODS: Twenty-four piglets were randomized to three groups of eight each: a GH group received a bolus of 16 IU of Genotropin; an IGF-1 group received a continuous infusion of 1.3 mg/hour of IGF-1; and a control group received saline. After surgical preparation, sepsis was induced with live Escherichia coli bacteria. Using isotope technique, whole body turnover and organ-specific absolute uptake and release were measured before and 4 hours after sepsis. RESULTS: After sepsis, both GH and IGF-1 treatment increased GI GLN uptake compared with controls and induced hepatic release of GLN. GLN release from skeletal muscle was diminished in all groups after sepsis. Whole body GLN turnover was increased in the GH and IGF-1 groups compared with the controls, before and after sepsis. CONCLUSIONS: GH and IGF-1 treatment induced increased GI net uptake of GLN. GH and IGF-1 treatment also promoted absolute and net release of GLN from the liver. This release might facilitate increased GI uptake despite reduced hindleg release in the early phase of sepsis.