Ikeda Shigeo, Kudsk Kenneth A, Le Tho, Zarzaur Ben L, Johnson Cheryl D
Department of Surgery, The University of Wisconsin, Madison, Wisconsin 53792, USA.
Shock. 2003 Jan;19(1):50-4. doi: 10.1097/00024382-200301000-00010.
Clinical and laboratory evidence shows that enteral feeding significantly reduces pneumonia and intra-abdominal abscess formation after celiotomy for severe trauma. Supplementation of total parenteral nutrition (TPN) with glutamine (GLN) supports impaired immunity induced by TPN in several animal and human studies. This work investigates the peritoneal cellular response and polymorphonuclear neutrophil (PMN) bactericidal function after mouse chemical peritonitis after TPN with and without GLN. Thirty-three mice received chow, TPN, or 2% GLN-supplemented TPN (GLN-TPN) for 5 days. All mice then received 2 mL of a 1% glycogen solution intraperitoneally to induce cell exudation, and peritoneal exudative cells (PECs) were recovered 4 h later. Total and differential PEC numbers, as well as PMN phagocytosis, reactive oxygen intermediate production (ROI), CD11b (integrin aM chain) expression, and CD16/32 (Fcgamma II/III receptor) expression were measured. PMN, macrophage, and lymphocyte cell numbers were significantly lower with TPN than with chow or GLN-TPN groups, with no differences between chow and GLN-TPN. TPN significantly lowered peritoneal PMN phagocytosis compared with chow (P < 0.05) and approached significance with GLN-TPN (P = 0.06). There were no significant differences in ROI production or CD11b and CD16/32 expression on peritoneal PMN. GLN supplementation improved the reduction in cell exudation and PMN phagocytosis induced by TPN after chemical peritonitis.
临床和实验室证据表明,肠内营养可显著降低严重创伤剖腹术后肺炎和腹腔内脓肿的形成。在多项动物和人体研究中,添加谷氨酰胺(GLN)的全胃肠外营养(TPN)可改善TPN所致的免疫功能受损。本研究探讨了在小鼠化学性腹膜炎后,给予或不给予GLN的TPN对腹膜细胞反应和多形核中性粒细胞(PMN)杀菌功能的影响。33只小鼠分别接受普通饲料、TPN或添加2% GLN的TPN(GLN-TPN)喂养5天。然后,所有小鼠腹腔内注射2 mL 1%糖原溶液以诱导细胞渗出,4小时后收集腹腔渗出细胞(PEC)。检测PEC总数、分类计数以及PMN吞噬功能、活性氧中间产物生成(ROI)、CD11b(整合素αM链)表达和CD16/32(Fcγ II/III受体)表达。TPN组的PMN、巨噬细胞和淋巴细胞数量显著低于普通饲料组和GLN-TPN组,普通饲料组和GLN-TPN组之间无差异。与普通饲料组相比,TPN显著降低了腹腔PMN的吞噬功能(P < 0.05),与GLN-TPN组相比接近显著差异(P = 0.06)。腹腔PMN的ROI生成、CD11b和CD16/32表达无显著差异。补充GLN可改善化学性腹膜炎后TPN所致的细胞渗出减少和PMN吞噬功能降低。