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Prevention of hemolysis-induced organ damage by nutritional activation of the vagal anti-inflammatory reflex*.
Crit Care Med. 2013 Nov; 41(11):e361-7.CC

Abstract

OBJECTIVES

Acute hemolysis is associated with organ damage, inflammation, and impaired vascular function. Stimulation of the cholecystokinin-1 receptor-dependent vagal anti-inflammatory reflex with lipid-rich enteral nutrition was demonstrated to prevent tissue damage and attenuate inflammation. This study investigates the effects of nutritional activation of the vagal anti-inflammatory reflex on organ integrity, systemic inflammation, and microcirculation during hemolysis.

DESIGN

Prospective randomized controlled study.

SETTING

University research unit.

SUBJECTS

Male Sprague-Dawley rats.

INTERVENTIONS

Intravascular hemolysis was simulated by infusion of prelysed erythrocytes. Animals were fasted or received lipid-rich enteral nutrition. Pegylated (PEG)-CCK9A, A70104 (a cholecystokinin-1 receptor antagonist), and chlorisondamine (a nicotinic acetylcholine receptor antagonist) were applied to investigate involvement of the vagal reflex.

MEASUREMENTS AND MAIN RESULTS

Nutritional intervention reduced hemolysis-related renal tubular cell damage, hepatocyte damage, ileal leakage of horseradish peroxidase, and bacterial translocation compared with food deprivation (all p < 0.05). Also circulating interleukin (IL)-6 levels were decreased by enteral nutrition (p < 0.05). Blockage of the cholecystokinin-1 receptor or the nicotinic acetylcholine receptor reversed the protective nutritional effects compared with vehicle (p < 0.05), whereas PEG-CCK9 mimicked the impact of enteral feeding in fasted animals (p < 0.05). Furthermore, nutritional intervention increased renal, hepatic, and intestinal blood flow compared with fasting (all p < 0.05), as evaluated using fluorescent microspheres.

CONCLUSIONS

Nutritional activation of the vagal anti-inflammatory reflex preserves tissue integrity and attenuates systemic inflammation in a rodent model of acute hemolysis. In addition, lipid-rich nutrition improves renal, hepatic, and intestinal microcirculation. These findings implicate stimulation of the autonomic nervous system by nutritional means as a potential therapy to prevent complications of acute hemolysis. (Crit Care Med 2013; 41:e361-e367).

Authors+Show Affiliations

1Department of Surgery, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands. 2Department of Internal Medicine, Medisch Spectrum Twente, Enschede, The Netherlands. 3Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre+, Maastricht, The Netherlands. 4Department of Surgery, Atrium Medical Center, Heerlen, 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

24105450

Citation

de Haan, Jacco J., et al. "Prevention of Hemolysis-induced Organ Damage By Nutritional Activation of the Vagal Anti-inflammatory Reflex*." Critical Care Medicine, vol. 41, no. 11, 2013, pp. e361-7.
de Haan JJ, Windsant IV, Lubbers T, et al. Prevention of hemolysis-induced organ damage by nutritional activation of the vagal anti-inflammatory reflex*. Crit Care Med. 2013;41(11):e361-7.
de Haan, J. J., Windsant, I. V., Lubbers, T., Hanssen, S. J., Hadfoune, M., Prinzen, F. W., Greve, J. W., & Buurman, W. A. (2013). Prevention of hemolysis-induced organ damage by nutritional activation of the vagal anti-inflammatory reflex*. Critical Care Medicine, 41(11), e361-7. https://doi.org/10.1097/CCM.0b013e31828e9262
de Haan JJ, et al. Prevention of Hemolysis-induced Organ Damage By Nutritional Activation of the Vagal Anti-inflammatory Reflex*. Crit Care Med. 2013;41(11):e361-7. PubMed PMID: 24105450.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevention of hemolysis-induced organ damage by nutritional activation of the vagal anti-inflammatory reflex*. AU - de Haan,Jacco J, AU - Windsant,Iris Vermeulen, AU - Lubbers,Tim, AU - Hanssen,Sebiastiaan J, AU - Hadfoune,M'hamed, AU - Prinzen,Frits W, AU - Greve,Jan-Willem M, AU - Buurman,Wim A, PY - 2013/10/10/entrez PY - 2013/10/10/pubmed PY - 2013/12/25/medline SP - e361 EP - 7 JF - Critical care medicine JO - Crit Care Med VL - 41 IS - 11 N2 - OBJECTIVES: Acute hemolysis is associated with organ damage, inflammation, and impaired vascular function. Stimulation of the cholecystokinin-1 receptor-dependent vagal anti-inflammatory reflex with lipid-rich enteral nutrition was demonstrated to prevent tissue damage and attenuate inflammation. This study investigates the effects of nutritional activation of the vagal anti-inflammatory reflex on organ integrity, systemic inflammation, and microcirculation during hemolysis. DESIGN: Prospective randomized controlled study. SETTING: University research unit. SUBJECTS: Male Sprague-Dawley rats. INTERVENTIONS: Intravascular hemolysis was simulated by infusion of prelysed erythrocytes. Animals were fasted or received lipid-rich enteral nutrition. Pegylated (PEG)-CCK9A, A70104 (a cholecystokinin-1 receptor antagonist), and chlorisondamine (a nicotinic acetylcholine receptor antagonist) were applied to investigate involvement of the vagal reflex. MEASUREMENTS AND MAIN RESULTS: Nutritional intervention reduced hemolysis-related renal tubular cell damage, hepatocyte damage, ileal leakage of horseradish peroxidase, and bacterial translocation compared with food deprivation (all p < 0.05). Also circulating interleukin (IL)-6 levels were decreased by enteral nutrition (p < 0.05). Blockage of the cholecystokinin-1 receptor or the nicotinic acetylcholine receptor reversed the protective nutritional effects compared with vehicle (p < 0.05), whereas PEG-CCK9 mimicked the impact of enteral feeding in fasted animals (p < 0.05). Furthermore, nutritional intervention increased renal, hepatic, and intestinal blood flow compared with fasting (all p < 0.05), as evaluated using fluorescent microspheres. CONCLUSIONS: Nutritional activation of the vagal anti-inflammatory reflex preserves tissue integrity and attenuates systemic inflammation in a rodent model of acute hemolysis. In addition, lipid-rich nutrition improves renal, hepatic, and intestinal microcirculation. These findings implicate stimulation of the autonomic nervous system by nutritional means as a potential therapy to prevent complications of acute hemolysis. (Crit Care Med 2013; 41:e361-e367). SN - 1530-0293 UR - https://www.unboundmedicine.com/medline/citation/24105450/Prevention_of_hemolysis_induced_organ_damage_by_nutritional_activation_of_the_vagal_anti_inflammatory_reflex__ L2 - https://dx.doi.org/10.1097/CCM.0b013e31828e9262 DB - PRIME DP - Unbound Medicine ER -