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Parenteral glutamine supplementation in combination with enteral nutrition improves intestinal immunity in septic rats.
Nutrition. 2015 May; 31(5):766-74.N

Abstract

OBJECTIVES

The gut-associated lymphoid tissue is continuously exposed to antigens in the gut lumen and becomes the first line of defense against enteric bacteria and associated toxin. The aim of this study was to investigate the effects of parenteral glutamine (GLN) supplementation in combination with enteral nutrition (EN) on intestinal mucosal immunity in septic rats by cecal ligation and puncture (CLP).

METHODS

Male Sprague-Dawley rats were randomly assigned into four groups: A sham CLP + EN + saline group (n = 10), a sham CLP + EN + GLN group (n = 10), a CLP + EN + saline group (n = 10), and a CLP + EN + GLN group (n = 10). At 2 h after CLP or sham CLP, all rats in each of the four groups received an identical enteral nutrition solution as their base formula. Then, the rats in the sham CLP + EN + GLN group and CLP + EN + GLN group were given 0.35 g GLN/kg body weight daily for 7 d, all at the same time, via a tail vein injection; whereas those in the sham CLP + EN + saline group and CLP + EN + saline group were daily administered isovolumic sterile 0.9% saline for comparison. All rats in each of the four groups were given 290 kcal/kg body wt/d for 7 d. At the end of the seventh day after the nutritional program was finished, all rats were euthanized and the entire intestine was collected. Total Peyer's patches (PP) cell yield was counted by a hemocytometer. The percentage of PP lymphocyte subsets was analyzed by flow cytometry. The number of intestinal lamina propria IgA plasma cells was determined by the immunohistochemistry technique. The intestinal immunoglobulin A (IgA) levels were assessed by ELISA. PP apoptosis was evaluated by terminal deoxyuridine nick-end labeling.

RESULTS

The results revealed total PP cell yield, the numbers of PP lymphocyte subsets, intestinal lamina propria IgA plasma cells, and intestinal IgA levels in the CLP + EN + GLN group were significantly increased when compared with the CLP + EN + saline group (P < 0.05). On the other hand, the number of TUNEL-stained cells within PPs in the CLP + EN + GLN group was markedly decreased as compared with the CLP + EN + saline group (P < 0.05).

CONCLUSION

The results of this study show that parenteral glutamine supplementation in combination with enteral nutrition may attenuate PP apoptosis, increase PP cell yield and intestinal lamina propria IgA plasma cells, and subsequently improve intestinal mucosal immunity. Clinically, these results suggest therapeutic efforts at improving intestinal immunity may contribute to the prevention and treatment of sepsis.

Authors+Show Affiliations

Department of Emergency and Critical Care Medicine, The Second Affiliated Hospital of Nanchang University, Jiangxi, P.R. China. Electronic address: fanjundoctor@sina.com.Department of Emergency and Critical Care Medicine, The Second Affiliated Hospital of Nanchang University, Jiangxi, P.R. China.Department of Emergency and Critical Care Medicine, The Second Affiliated Hospital of Nanchang University, Jiangxi, P.R. China.Department of Emergency and Critical Care Medicine, The Second Affiliated Hospital of Nanchang University, Jiangxi, P.R. China.Department of Emergency and Critical Care Medicine, The Second Affiliated Hospital of Nanchang University, Jiangxi, P.R. China.Department of Emergency and Critical Care Medicine, The Second Affiliated Hospital of Nanchang University, Jiangxi, P.R. China.Department of Burns, The Northern Hospital, Liaoning, P.R. China.

Pub Type(s)

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

Language

eng

PubMed ID

25837225

Citation

Fan, Jun, et al. "Parenteral Glutamine Supplementation in Combination With Enteral Nutrition Improves Intestinal Immunity in Septic Rats." Nutrition (Burbank, Los Angeles County, Calif.), vol. 31, no. 5, 2015, pp. 766-74.
Fan J, Li G, Wu L, et al. Parenteral glutamine supplementation in combination with enteral nutrition improves intestinal immunity in septic rats. Nutrition. 2015;31(5):766-74.
Fan, J., Li, G., Wu, L., Tao, S., Wang, W., Sheng, Z., & Meng, Q. (2015). Parenteral glutamine supplementation in combination with enteral nutrition improves intestinal immunity in septic rats. Nutrition (Burbank, Los Angeles County, Calif.), 31(5), 766-74. https://doi.org/10.1016/j.nut.2014.11.021
Fan J, et al. Parenteral Glutamine Supplementation in Combination With Enteral Nutrition Improves Intestinal Immunity in Septic Rats. Nutrition. 2015;31(5):766-74. PubMed PMID: 25837225.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Parenteral glutamine supplementation in combination with enteral nutrition improves intestinal immunity in septic rats. AU - Fan,Jun, AU - Li,Guoping, AU - Wu,Lidong, AU - Tao,Shaoyu, AU - Wang,Wei, AU - Sheng,Zhiyong, AU - Meng,Qingyan, Y1 - 2014/12/30/ PY - 2014/06/11/received PY - 2014/11/15/revised PY - 2014/11/29/accepted PY - 2015/4/4/entrez PY - 2015/4/4/pubmed PY - 2016/1/6/medline KW - Enteral nutrition KW - Immunoglobulin A KW - Parenteral glutamine supplementation KW - Peyer's patches KW - Sepsis SP - 766 EP - 74 JF - Nutrition (Burbank, Los Angeles County, Calif.) JO - Nutrition VL - 31 IS - 5 N2 - OBJECTIVES: The gut-associated lymphoid tissue is continuously exposed to antigens in the gut lumen and becomes the first line of defense against enteric bacteria and associated toxin. The aim of this study was to investigate the effects of parenteral glutamine (GLN) supplementation in combination with enteral nutrition (EN) on intestinal mucosal immunity in septic rats by cecal ligation and puncture (CLP). METHODS: Male Sprague-Dawley rats were randomly assigned into four groups: A sham CLP + EN + saline group (n = 10), a sham CLP + EN + GLN group (n = 10), a CLP + EN + saline group (n = 10), and a CLP + EN + GLN group (n = 10). At 2 h after CLP or sham CLP, all rats in each of the four groups received an identical enteral nutrition solution as their base formula. Then, the rats in the sham CLP + EN + GLN group and CLP + EN + GLN group were given 0.35 g GLN/kg body weight daily for 7 d, all at the same time, via a tail vein injection; whereas those in the sham CLP + EN + saline group and CLP + EN + saline group were daily administered isovolumic sterile 0.9% saline for comparison. All rats in each of the four groups were given 290 kcal/kg body wt/d for 7 d. At the end of the seventh day after the nutritional program was finished, all rats were euthanized and the entire intestine was collected. Total Peyer's patches (PP) cell yield was counted by a hemocytometer. The percentage of PP lymphocyte subsets was analyzed by flow cytometry. The number of intestinal lamina propria IgA plasma cells was determined by the immunohistochemistry technique. The intestinal immunoglobulin A (IgA) levels were assessed by ELISA. PP apoptosis was evaluated by terminal deoxyuridine nick-end labeling. RESULTS: The results revealed total PP cell yield, the numbers of PP lymphocyte subsets, intestinal lamina propria IgA plasma cells, and intestinal IgA levels in the CLP + EN + GLN group were significantly increased when compared with the CLP + EN + saline group (P < 0.05). On the other hand, the number of TUNEL-stained cells within PPs in the CLP + EN + GLN group was markedly decreased as compared with the CLP + EN + saline group (P < 0.05). CONCLUSION: The results of this study show that parenteral glutamine supplementation in combination with enteral nutrition may attenuate PP apoptosis, increase PP cell yield and intestinal lamina propria IgA plasma cells, and subsequently improve intestinal mucosal immunity. Clinically, these results suggest therapeutic efforts at improving intestinal immunity may contribute to the prevention and treatment of sepsis. SN - 1873-1244 UR - https://www.unboundmedicine.com/medline/citation/25837225/Parenteral_glutamine_supplementation_in_combination_with_enteral_nutrition_improves_intestinal_immunity_in_septic_rats_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0899-9007(14)00546-2 DB - PRIME DP - Unbound Medicine ER -