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Postshock intervention with high-lipid enteral nutrition reduces inflammation and tissue damage.
Ann Surg. 2008 Nov; 248(5):842-8.AnnS

Abstract

OBJECTIVE

To investigate the effects of high-lipid enteral nutrition in a setting of developing inflammation and tissue damage.

BACKGROUND

An excessive inflammatory response following severe trauma is associated with poor clinical outcome. Currently, therapies directed at attenuation of an ongoing inflammatory cascade are lacking. Administration of high-lipid enteral nutrition before hemorrhagic shock has been shown to effectively inhibit early and late proinflammatory cytokines by activation of the autonomic nervous system via cholecystokinin (CCK)-receptors.

METHODS

A rat model of hemorrhagic shock was used in which animals were either fasted or treated with high-lipid or control low-lipid enteral nutrition. CCK-receptor antagonists were administered before feeding. Tissues and plasma were collected to assess inflammation and intestinal integrity.

RESULTS

Administration of high-lipid enteral nutrition after shock reduced plasma interferon-gamma (IFN-gamma) significantly in comparison with those in low-lipid-treated and fasted animals (P < 0.01 and P < 0.001, respectively). Also, interleukin (IL)-10 levels in plasma were decreased in comparison with those in fasted animals (P < 0.001). Enterocyte damage, expressed as circulating ileal lipid-binding protein (ILBP), was prevented by early high-lipid nutrition in comparison with that in low-lipid-treated and fasted animals (P = 0.05 and P < 0.001, respectively). Furthermore, high-lipid feeding preserved intestinal integrity in comparison with that observed in low-lipid-treated and fasted animals, as assessed by bacterial translocation (BT) to distant organs (P < 0.05 and P < 0.001, respectively) and ileal permeability to horseradish peroxidase (HRP) (P = 0.05 and P < 0.001, respectively). The protective effects of high-lipid intervention were nullified by CCK-receptor antagonists (IFN-gamma; IL-10; BT; and HRP; P < 0.05).

CONCLUSION

High-lipid enteral nutrition given postshock reduces inflammation and preserves tissue integrity via a CCK-receptor-dependent mechanism. These findings implicate that intervention with high-lipid enteral nutrition following events such as severe trauma is a potential therapy to attenuate the developing inflammatory response.

Authors+Show Affiliations

Department of Surgery, Nutrition and Toxicology Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18948813

Citation

de Haan, Jacco-Juri, et al. "Postshock Intervention With High-lipid Enteral Nutrition Reduces Inflammation and Tissue Damage." Annals of Surgery, vol. 248, no. 5, 2008, pp. 842-8.
de Haan JJ, Lubbers T, Hadfoune M, et al. Postshock intervention with high-lipid enteral nutrition reduces inflammation and tissue damage. Ann Surg. 2008;248(5):842-8.
de Haan, J. J., Lubbers, T., Hadfoune, M., Luyer, M. D., Dejong, C. H., Buurman, W. A., & Greve, J. W. (2008). Postshock intervention with high-lipid enteral nutrition reduces inflammation and tissue damage. Annals of Surgery, 248(5), 842-8. https://doi.org/10.1097/SLA.0b013e318188752c
de Haan JJ, et al. Postshock Intervention With High-lipid Enteral Nutrition Reduces Inflammation and Tissue Damage. Ann Surg. 2008;248(5):842-8. PubMed PMID: 18948813.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Postshock intervention with high-lipid enteral nutrition reduces inflammation and tissue damage. AU - de Haan,Jacco-Juri, AU - Lubbers,Tim, AU - Hadfoune,M'hamed, AU - Luyer,Misha D, AU - Dejong,Cornelis H, AU - Buurman,Wim A, AU - Greve,Jan-Willem M, PY - 2008/10/25/pubmed PY - 2008/11/19/medline PY - 2008/10/25/entrez SP - 842 EP - 8 JF - Annals of surgery JO - Ann Surg VL - 248 IS - 5 N2 - OBJECTIVE: To investigate the effects of high-lipid enteral nutrition in a setting of developing inflammation and tissue damage. BACKGROUND: An excessive inflammatory response following severe trauma is associated with poor clinical outcome. Currently, therapies directed at attenuation of an ongoing inflammatory cascade are lacking. Administration of high-lipid enteral nutrition before hemorrhagic shock has been shown to effectively inhibit early and late proinflammatory cytokines by activation of the autonomic nervous system via cholecystokinin (CCK)-receptors. METHODS: A rat model of hemorrhagic shock was used in which animals were either fasted or treated with high-lipid or control low-lipid enteral nutrition. CCK-receptor antagonists were administered before feeding. Tissues and plasma were collected to assess inflammation and intestinal integrity. RESULTS: Administration of high-lipid enteral nutrition after shock reduced plasma interferon-gamma (IFN-gamma) significantly in comparison with those in low-lipid-treated and fasted animals (P < 0.01 and P < 0.001, respectively). Also, interleukin (IL)-10 levels in plasma were decreased in comparison with those in fasted animals (P < 0.001). Enterocyte damage, expressed as circulating ileal lipid-binding protein (ILBP), was prevented by early high-lipid nutrition in comparison with that in low-lipid-treated and fasted animals (P = 0.05 and P < 0.001, respectively). Furthermore, high-lipid feeding preserved intestinal integrity in comparison with that observed in low-lipid-treated and fasted animals, as assessed by bacterial translocation (BT) to distant organs (P < 0.05 and P < 0.001, respectively) and ileal permeability to horseradish peroxidase (HRP) (P = 0.05 and P < 0.001, respectively). The protective effects of high-lipid intervention were nullified by CCK-receptor antagonists (IFN-gamma; IL-10; BT; and HRP; P < 0.05). CONCLUSION: High-lipid enteral nutrition given postshock reduces inflammation and preserves tissue integrity via a CCK-receptor-dependent mechanism. These findings implicate that intervention with high-lipid enteral nutrition following events such as severe trauma is a potential therapy to attenuate the developing inflammatory response. SN - 1528-1140 UR - https://www.unboundmedicine.com/medline/citation/18948813/Postshock_intervention_with_high_lipid_enteral_nutrition_reduces_inflammation_and_tissue_damage_ L2 - https://Insights.ovid.com/pubmed?pmid=18948813 DB - PRIME DP - Unbound Medicine ER -