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Lipid-rich enteral nutrition reduces postoperative ileus in rats via activation of cholecystokinin-receptors.
Ann Surg. 2009 Mar; 249(3):481-7.AnnS

Abstract

OBJECTIVE

This study investigates the effect of lipid-rich nutrition on the local inflammatory response and gastrointestinal hypomotility in a rat model of postoperative ileus.

BACKGROUND

Postoperative ileus is a major clinical problem, in which inflammation of the intestinal muscularis plays a key pathogenic event. Previously, administration of lipid-rich nutrition has been shown to reduce inflammation by activation of the autonomic nervous system via cholecystokinin-receptors.

METHODS

Postoperative ileus was induced by manipulation of the small intestine in rats. Peritoneal lavage fluid, plasma, and jejunal segments were collected at several time points to determine inflammatory mediators in fasted rats and rats fed a lipid-rich or control nutrition. Gastrointestinal transit was measured 24 hours after surgery.

RESULTS

Administration of lipid-rich nutrition markedly reduced the manipulation-induced local inflammatory response compared to rats treated with control nutrition. The intervention with lipid-rich nutrition significantly reduced plasma levels of rat mast cell protease-II (P < 0.05) and peritoneal levels of tumor necrosis factor-alpha (P < 0.01) and interleukin-6 (P < 0.05). Furthermore, the influx of neutrophils, expressed as tissue level myeloperoxidase was significantly prevented by lipid-rich nutrition (P < 0.05). Above all administration of lipid-rich enteral nutrition resulted in a significant improvement of gastrointestinal transit compared to control nutrition (P < 0.05). Blocking of cholecystokinin-receptors prevented the anti-inflammatory and motility promoting effect of lipid-rich feeding.

CONCLUSION

Our data demonstrate that nutritional stimulation of the autonomic nervous system with enteral lipids reduces postoperative ileus by inhibition of inflammation. Clinically, lipid-rich enteral nutrition may be a new therapeutic option in the treatment of postoperative ileus.

Authors+Show Affiliations

Department of Surgery, Nutrition and Toxicology Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands.No 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

19247038

Citation

Lubbers, Tim, et al. "Lipid-rich Enteral Nutrition Reduces Postoperative Ileus in Rats Via Activation of Cholecystokinin-receptors." Annals of Surgery, vol. 249, no. 3, 2009, pp. 481-7.
Lubbers T, Luyer MD, de Haan JJ, et al. Lipid-rich enteral nutrition reduces postoperative ileus in rats via activation of cholecystokinin-receptors. Ann Surg. 2009;249(3):481-7.
Lubbers, T., Luyer, M. D., de Haan, J. J., Hadfoune, M., Buurman, W. A., & Greve, J. W. (2009). Lipid-rich enteral nutrition reduces postoperative ileus in rats via activation of cholecystokinin-receptors. Annals of Surgery, 249(3), 481-7. https://doi.org/10.1097/SLA.0b013e318194d187
Lubbers T, et al. Lipid-rich Enteral Nutrition Reduces Postoperative Ileus in Rats Via Activation of Cholecystokinin-receptors. Ann Surg. 2009;249(3):481-7. PubMed PMID: 19247038.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lipid-rich enteral nutrition reduces postoperative ileus in rats via activation of cholecystokinin-receptors. AU - Lubbers,Tim, AU - Luyer,Misha D P, AU - de Haan,Jacco-Juri, AU - Hadfoune,M'hamed, AU - Buurman,Wim A, AU - Greve,Jan Willem M, PY - 2009/2/28/entrez PY - 2009/2/28/pubmed PY - 2009/4/4/medline SP - 481 EP - 7 JF - Annals of surgery JO - Ann Surg VL - 249 IS - 3 N2 - OBJECTIVE: This study investigates the effect of lipid-rich nutrition on the local inflammatory response and gastrointestinal hypomotility in a rat model of postoperative ileus. BACKGROUND: Postoperative ileus is a major clinical problem, in which inflammation of the intestinal muscularis plays a key pathogenic event. Previously, administration of lipid-rich nutrition has been shown to reduce inflammation by activation of the autonomic nervous system via cholecystokinin-receptors. METHODS: Postoperative ileus was induced by manipulation of the small intestine in rats. Peritoneal lavage fluid, plasma, and jejunal segments were collected at several time points to determine inflammatory mediators in fasted rats and rats fed a lipid-rich or control nutrition. Gastrointestinal transit was measured 24 hours after surgery. RESULTS: Administration of lipid-rich nutrition markedly reduced the manipulation-induced local inflammatory response compared to rats treated with control nutrition. The intervention with lipid-rich nutrition significantly reduced plasma levels of rat mast cell protease-II (P < 0.05) and peritoneal levels of tumor necrosis factor-alpha (P < 0.01) and interleukin-6 (P < 0.05). Furthermore, the influx of neutrophils, expressed as tissue level myeloperoxidase was significantly prevented by lipid-rich nutrition (P < 0.05). Above all administration of lipid-rich enteral nutrition resulted in a significant improvement of gastrointestinal transit compared to control nutrition (P < 0.05). Blocking of cholecystokinin-receptors prevented the anti-inflammatory and motility promoting effect of lipid-rich feeding. CONCLUSION: Our data demonstrate that nutritional stimulation of the autonomic nervous system with enteral lipids reduces postoperative ileus by inhibition of inflammation. Clinically, lipid-rich enteral nutrition may be a new therapeutic option in the treatment of postoperative ileus. SN - 1528-1140 UR - https://www.unboundmedicine.com/medline/citation/19247038/Lipid_rich_enteral_nutrition_reduces_postoperative_ileus_in_rats_via_activation_of_cholecystokinin_receptors_ L2 - https://Insights.ovid.com/pubmed?pmid=19247038 DB - PRIME DP - Unbound Medicine ER -