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Protection against early intestinal compromise by lipid-rich enteral nutrition through cholecystokinin receptors.
Crit Care Med. 2010 Jul; 38(7):1592-7.CC

Abstract

OBJECTIVE

Early gut wall integrity loss and local intestinal inflammation are associated with the development of inflammatory complications in surgical and trauma patients. Prevention of these intestinal events is a potential target for therapies aimed to control systemic inflammation. Previously, we demonstrated in a rodent shock model that lipid-rich enteral nutrition attenuated systemic inflammation and prevented organ damage through a cholecystokinin receptor-dependent vagal pathway. The influence of lipid-rich nutrition on very early intestinal compromise as seen after shock is investigated. Next, the involvement of cholecystokinin receptors on the nutritional modulation of immediate gut integrity loss and intestinal inflammation is studied.

DESIGN

Randomized controlled in vivo study.

SETTING

University research unit.

SUBJECTS

Male Sprague-Dawley rats.

INTERVENTIONS

Liquid lipid-rich nutrition or control low-lipid feeding was administered per gavage before hemorrhagic shock. Cholecystokinin receptor antagonists were used to investigate involvement of the vagal antiinflammatory pathway.

MEASUREMENTS AND MAIN RESULTS

Gut permeability to horseradish peroxidase increased as soon as 30 mins postshock and was prevented by lipid-rich nutrition compared with low-lipid (p<.01) and fasted controls (p<.001). Furthermore, lipid-rich nutrition reduced plasma levels of enterocyte damage marker ileal lipid binding protein at 60 mins (p<.05). Early gut barrier dysfunction correlated with rat mast cell protease plasma concentrations at 30 mins (rs=0.67; p<.001) and intestinal myeloperoxidase levels at 60 mins (rs=0.58; p<.05). Lipid-rich nutrition significantly reduced plasma rat mast cell protease (p<.01) and myeloperoxidase (p<.05) before systemic inflammation was detectable. Protective effects of lipid-rich nutrition were abrogated by cholecystokinin receptor antagonists (horseradish peroxidase; p<.05 and rat mast cell protease; p<.05).

CONCLUSIONS

Lipid-rich enteral nutrition prevents early gut barrier loss, enterocyte damage, and local intestinal inflammation before systemic inflammation develops in a cholecystokinin receptor-dependent manner. This study identifies activation of the vagal antiinflammatory pathway with lipid-rich nutrition as a potential therapy in patients prone to develop a compromised gut.

Authors+Show Affiliations

Department of Surgery, Maastricht University Medical Center & NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht, The Netherlands.No affiliation info availableNo 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

20453642

Citation

de Haan, Jacco J., et al. "Protection Against Early Intestinal Compromise By Lipid-rich Enteral Nutrition Through Cholecystokinin Receptors." Critical Care Medicine, vol. 38, no. 7, 2010, pp. 1592-7.
de Haan JJ, Thuijls G, Lubbers T, et al. Protection against early intestinal compromise by lipid-rich enteral nutrition through cholecystokinin receptors. Crit Care Med. 2010;38(7):1592-7.
de Haan, J. J., Thuijls, G., Lubbers, T., Hadfoune, M., Reisinger, K., Heineman, E., Greve, J. W., & Buurman, W. A. (2010). Protection against early intestinal compromise by lipid-rich enteral nutrition through cholecystokinin receptors. Critical Care Medicine, 38(7), 1592-7. https://doi.org/10.1097/CCM.0b013e3181e2cd4d
de Haan JJ, et al. Protection Against Early Intestinal Compromise By Lipid-rich Enteral Nutrition Through Cholecystokinin Receptors. Crit Care Med. 2010;38(7):1592-7. PubMed PMID: 20453642.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Protection against early intestinal compromise by lipid-rich enteral nutrition through cholecystokinin receptors. AU - de Haan,Jacco J, AU - Thuijls,Geertje, AU - Lubbers,Tim, AU - Hadfoune,M'hamed, AU - Reisinger,Kostan, AU - Heineman,Erik, AU - Greve,Jan-Willem M, AU - Buurman,Wim A, PY - 2010/5/11/entrez PY - 2010/5/11/pubmed PY - 2010/7/23/medline SP - 1592 EP - 7 JF - Critical care medicine JO - Crit Care Med VL - 38 IS - 7 N2 - OBJECTIVE: Early gut wall integrity loss and local intestinal inflammation are associated with the development of inflammatory complications in surgical and trauma patients. Prevention of these intestinal events is a potential target for therapies aimed to control systemic inflammation. Previously, we demonstrated in a rodent shock model that lipid-rich enteral nutrition attenuated systemic inflammation and prevented organ damage through a cholecystokinin receptor-dependent vagal pathway. The influence of lipid-rich nutrition on very early intestinal compromise as seen after shock is investigated. Next, the involvement of cholecystokinin receptors on the nutritional modulation of immediate gut integrity loss and intestinal inflammation is studied. DESIGN: Randomized controlled in vivo study. SETTING: University research unit. SUBJECTS: Male Sprague-Dawley rats. INTERVENTIONS: Liquid lipid-rich nutrition or control low-lipid feeding was administered per gavage before hemorrhagic shock. Cholecystokinin receptor antagonists were used to investigate involvement of the vagal antiinflammatory pathway. MEASUREMENTS AND MAIN RESULTS: Gut permeability to horseradish peroxidase increased as soon as 30 mins postshock and was prevented by lipid-rich nutrition compared with low-lipid (p<.01) and fasted controls (p<.001). Furthermore, lipid-rich nutrition reduced plasma levels of enterocyte damage marker ileal lipid binding protein at 60 mins (p<.05). Early gut barrier dysfunction correlated with rat mast cell protease plasma concentrations at 30 mins (rs=0.67; p<.001) and intestinal myeloperoxidase levels at 60 mins (rs=0.58; p<.05). Lipid-rich nutrition significantly reduced plasma rat mast cell protease (p<.01) and myeloperoxidase (p<.05) before systemic inflammation was detectable. Protective effects of lipid-rich nutrition were abrogated by cholecystokinin receptor antagonists (horseradish peroxidase; p<.05 and rat mast cell protease; p<.05). CONCLUSIONS: Lipid-rich enteral nutrition prevents early gut barrier loss, enterocyte damage, and local intestinal inflammation before systemic inflammation develops in a cholecystokinin receptor-dependent manner. This study identifies activation of the vagal antiinflammatory pathway with lipid-rich nutrition as a potential therapy in patients prone to develop a compromised gut. SN - 1530-0293 UR - https://www.unboundmedicine.com/medline/citation/20453642/Protection_against_early_intestinal_compromise_by_lipid_rich_enteral_nutrition_through_cholecystokinin_receptors_ L2 - https://dx.doi.org/10.1097/CCM.0b013e3181e2cd4d DB - PRIME DP - Unbound Medicine ER -