Effect of Oral Insulin on the Severity and Recovery of Methotrexate-induced Gastrointestinal Mucositis in the Rat.

Objectives: Gastrointestinal (GI) mucositis is a severe side effect of chemo- and radiotherapy. Oral insulin has been suggested as possible intestinal growth factor and possible intervention for GI mucositis. We aimed to determine the effect of oral insulin on the severity and recovery of mucositis in a methotrexate (MTX)-induced GI mucositis rat model. Methods: Male Wistar rats (n = 24) received a single injection of 60 mg/kg MTX iv at day 0. From day -3 oral insulin was added to the drinking water. Group MTX received normal drinking water, group MTX+INS0.5 received 0.5 U/ml insulin and group MTX+INS1 received 1 U/ml insulin in drinking water. The severity of mucositis was determined by intake, bodyweight, illness and plasma citrulline. In the recovery phase the function of the gut was tested with an oral glucose tolerance test, and villus and crypt length of the small intestine were measured. Results: MTX induced mucositis in all three groups and oral insulin did not cause a change in the severity of mucositis, with comparable bodyweight, food intake and water intake. Oral insulin did not alter the enterocyte mass, determined with plasma citrulline. The glucose level after bolus was higher in the MTX group compared to MTX+INS1 group (p

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