Wang Yi-Yun, Shang Huey-Fang, Lai Yu-Ni, Yeh Sung-Ling
Institute of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan, China.
JPEN J Parenter Enteral Nutr. 2003 Jul-Aug;27(4):235-40. doi: 10.1177/0148607103027004235.
Previous reports have shown that arginine (Arg) enhances phagocytic activity of macrophages and is required for macrophage-mediated toxicity toward tumor cells. Few studies have addressed the importance of Arg supplementation on macrophage and neutrophil function after infection and sepsis. This study examined the effect of Arg-supplemented diets before and Arg-enriched total parenteral nutrition (TPN) after sepsis or both on the phagocytic activity of peritoneal macrophages and blood polymorphonuclear cells in rats with gut-derived sepsis.
Male Wistar rats were assigned to 4 groups. Groups 1 and 2 were fed a semipurified diet, while groups 3 and 4 had part of the casein replaced with 2% of total calories as Arg. After the experimental diets were administered for 10 days, sepsis was induced by cecal ligation and puncture (CLP); at the same time, an internal jugular vein was cannulated. All rats were maintained on TPN for 3 days. Groups 1 and 3 were infused with conventional TPN, while groups 2 and 4 were supplemented with Arg, replacing 10% of total amino acids in the TPN solution. Survival rates were recorded for 3 days after CLP, and all surviving rats were killed 3 days after CLP to examine their immune responses.
Aerobic and anaerobic bacteria colony counts in peritoneal lavage fluid were significantly reduced, and the phagocytic activity of peritoneal macrophages was enhanced in groups 3 and 4 but not in the other 2 groups. There were no significant differences in the phagocytic activities of blood polymorphonuclear cells and survival rates among the 4 groups.
Enteral Arg supplementation before sepsis significantly enhanced peritoneal macrophage phagocytic activity and reduced total bacterial counts in peritoneal lavage fluid. Arg administered before and after CLP seemed to have a synergistic effect on enhancing phagocytic activity and on bacterial clearance. However, IV Arg administration after CLP had no favorable effects on phagocytic activity or survival rates in rats with gut-derived sepsis.
既往报道显示,精氨酸(Arg)可增强巨噬细胞的吞噬活性,且是巨噬细胞介导的肿瘤细胞毒性所必需的。很少有研究探讨补充精氨酸对感染和脓毒症后巨噬细胞及中性粒细胞功能的重要性。本研究检测了脓毒症前补充精氨酸的饮食以及脓毒症后富含精氨酸的全胃肠外营养(TPN)或两者联合对肠道源性脓毒症大鼠腹腔巨噬细胞和血液多形核细胞吞噬活性的影响。
将雄性Wistar大鼠分为4组。第1组和第2组喂食半纯化饮食,而第3组和第4组用占总热量2%的精氨酸替代部分酪蛋白。给予实验饮食10天后,通过盲肠结扎和穿刺(CLP)诱导脓毒症;同时,插入颈内静脉。所有大鼠接受TPN 3天。第1组和第3组输注常规TPN,而第2组和第4组补充精氨酸,替代TPN溶液中10%的总氨基酸。记录CLP后3天的存活率,所有存活大鼠在CLP后3天处死以检测其免疫反应。
第3组和第4组腹腔灌洗液中的需氧和厌氧菌菌落计数显著降低,腹腔巨噬细胞的吞噬活性增强,而其他两组未增强。4组之间血液多形核细胞的吞噬活性和存活率无显著差异。
脓毒症前肠内补充精氨酸可显著增强腹腔巨噬细胞的吞噬活性,并降低腹腔灌洗液中的总细菌计数。CLP前后给予精氨酸似乎对增强吞噬活性和细菌清除具有协同作用。然而,CLP后静脉注射精氨酸对肠道源性脓毒症大鼠的吞噬活性或存活率没有有利影响。