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Ischemia-reperfusion injury occurs in a variety of conditions including shock, vascular surgery, strangulated bowel, trauma, intestinal volvulus, and intestinal transplantation, leaving both human and veterinary patients with a decreased chance of survival as the mucosal barrier is lost due to resultant tissue hypoxia, inflammation, and cellular infiltration [60,62]

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However, the restoration of hepatic enzyme production over weeks could theoretically alter metabolism of drugs processed by the liver, potentially requiring dose adjustments for medications with narrow therapeutic windows

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IGF-1 has also anabolic actions on skeletal muscle, especially upon denervation 26 , which might be beneficial in ALS