Intestinal
radiation injury is dose limiting during abdominal and pelvic
radiotherapy and critical for the outcome after accidental whole-body radiation exposure. The multifunctional
cytokine,
interleukin-11 (IL-11), ameliorates the intestinal radiation response, but its clinical use is hampered by severe toxicity after systemic administration. This study addressed whether protection against intestinal
radiation injury can be achieved by intraluminal administration of
IL-11. Male rats underwent surgical transposition of a 4-cm small bowel loop to the scrotum. For repeated intraluminal
drug administration, an
ileostomy, proximal to the bowel loop in the scrotum, was created. The transposed intestinal loop was exposed to 5 Gy fractions on 9 consecutive days. Recombinant human
IL-11 (rhIL-11; 2 mg/kg/d) or vehicle was given through the
ileostomy from 2 days before until 2 weeks after irradiation. At 2 weeks, structural, cellular, and molecular aspects of intestinal
radiation injury were assessed.
rhIL-11 ameliorated structural manifestations of radiation enteropathy, including
radiation injury score (6.5 +/- 0.6 in the vehicle group versus 4.0 +/- 0.3 in the IL-11 group; P = 0.001), mucosal surface area loss (0.2 +/- 0.1 versus 0.5 +/- 0.03; P < 0.0001), and intestinal wall thickening (842 +/- 66 microm versus 643 +/- 54 microm; P = 0.02), reduced postradiation
transforming growth factor-beta overexpression, and reduced numbers of ED2-positive cells. Postirradiation mucosal mast cell numbers were partially restored by
rhIL-11. These data show that local administration of
rhIL-11 ameliorates early intestinal
radiation injury and support further development of
rhIL-11 to reduce manifestations of intestinal
radiation injury in the clinic.