高脂肠内营养可降低胆管结扎并遭受失血性休克大鼠的内毒素、肿瘤坏死因子-α水平及肠道通透性。

High-fat enteral nutrition reduces endotoxin, tumor necrosis factor-alpha and gut permeability in bile duct-ligated rats subjected to hemorrhagic shock.

作者信息

Luyer Misha D P, Buurman Wim A, Hadfoune M'hamed, Jacobs Jan A, Dejong Cornelis H C, Greve Jan Willem M

机构信息

Department of Surgery, Nutrition and Toxicology Research Institute Maastricht (NUTRIM), University of Maastricht, University Hospital, P.O. Box 616, 6200 MD Maastricht, The Netherlands.

出版信息

J Hepatol. 2004 Sep;41(3):377-83. doi: 10.1016/j.jhep.2004.04.026.

DOI:10.1016/j.jhep.2004.04.026

PMID:15336439

Abstract

BACKGROUND/AIMS: Cholestatic patients are prone to septic complications after major surgery due to an increased susceptibility to endotoxin and hypotension. High-fat enteral nutrition reduces endotoxin after hemorrhagic shock. However, it is unknown whether this nutritional intervention is protective in biliary obstruction. We investigated the effect of high-fat enteral nutrition on endotoxin, tumor necrosis factor-alpha (TNF-alpha) and intestinal permeability in cholestatic rats subjected to hemorrhagic shock.

METHODS

Bile duct-ligated (BDL) rats were fasted or fed with low-fat or high-fat enteral nutrition before hemorrhagic shock. Blood and tissue samples were taken after 90 min.

RESULTS

Plasma endotoxin decreased after hemorrhagic shock in BDL-rats fed with high-fat nutrition compared to fasted (P<0.01) and low-fat treated rats (P<0.05). Additionally, circulating TNF-alpha was reduced in BDL-rats pretreated with high-fat nutrition compared to fasted rats (P<0.01). The increased intestinal permeability to macromolecules was reduced by high-fat enteral nutrition, whereas bacterial translocation did not significantly change. Simultaneously, tight junction distribution in ileum and colon was disrupted in non-treated BDL-rats but remained unchanged in high-fat pretreated BDL-rats.

CONCLUSIONS

High-fat enteral nutrition protects against endotoxin-mediated complications independently of intraluminal bile. These results provide a potential new strategy to prevent endotoxin-mediated complications in cholestatic patients undergoing major surgery.

摘要

背景/目的：由于对内毒素和低血压的易感性增加，胆汁淤积患者在大手术后容易发生败血症并发症。高脂肠内营养可降低失血性休克后的内毒素水平。然而，这种营养干预在胆道梗阻中是否具有保护作用尚不清楚。我们研究了高脂肠内营养对失血性休克的胆汁淤积大鼠内毒素、肿瘤坏死因子-α（TNF-α）和肠道通透性的影响。

方法

胆管结扎（BDL）大鼠在失血性休克前禁食或给予低脂或高脂肠内营养。90分钟后采集血液和组织样本。

结果

与禁食（P<0.01）和低脂处理的大鼠（P<0.05）相比，高脂营养喂养的BDL大鼠失血性休克后血浆内毒素降低。此外，与禁食大鼠相比，高脂营养预处理的BDL大鼠循环TNF-α降低（P<0.01）。高脂肠内营养降低了肠道对大分子的通透性增加，而细菌移位没有显著变化。同时，未处理的BDL大鼠回肠和结肠的紧密连接分布被破坏，但高脂预处理的BDL大鼠保持不变。