Lin Ming-Tsan, Yeh Sung-Ling, Yeh Chiu-Li, Lai Yu-Ni, Chang King-Jen, Lee Po-Huang, Chen Wei-Jao
Department of Primary Care Medicine, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan, ROC.
Shock. 2006 Jan;25(1):56-60. doi: 10.1097/01.shk.0000188711.42895.92.
This study investigated the effect of n-3 fatty acid (FA)-containing parenteral nutrition on the circulatory lymphocyte subpopulation, intracellular cytokine and leukocyte adhesion molecule expression, and phagocytic activity in rats undergoing total gastrectomy. Normal rats with internal jugular catheters were assigned to normal control (NC) and two experimental groups and received total parenteral nutrition (TPN). At the same time, a total gastrectomy was performed in the experimental groups, whereas the NC group underwent a sham operation. The TPN solutions were isonitrogenous and identical in nutrient compositions except for differences in fat emulsion contents. The NC and one of the experimental groups received a soybean oil emulsion (SO), and the other experimental group received 50% soybean oil and 50% fish oil emulsion (FO). Half of the rats in each respective group were sacrificed 1 or 3 days after surgery or the sham operation to examine their immune response. The results showed that the FO group had a higher CD4 proportion and CD4/CD8 ratio than those of the SO and NC groups postoperatively. The phagocytic activity of peritoneal macrophages was higher in the FO group than in the NC group, but no difference was found between the SO and NC groups 3 days after surgery. The intracellular interferon (IFN)-gamma distribution in the FO group was higher than that of the SO group on postoperative days. Leukocyte adhesion molecule expressions and peritoneal monocyte chemotactic protein-1 levels were lower in the FO group than in the SO group on postoperative day 3. These results suggest that parenterally infused FO did not result in immunosuppression. In addition, FO administration promotes lymphocyte Th1 cytokine production, enhances peritoneal macrophage phagocytic activity, and reduces leukocyte adhesion molecule expression in rats with total gastrectomy.
本研究调查了含n-3脂肪酸(FA)的肠外营养对全胃切除大鼠循环淋巴细胞亚群、细胞内细胞因子和白细胞黏附分子表达以及吞噬活性的影响。将经颈内静脉置管的正常大鼠分为正常对照组(NC)和两个实验组,并给予全肠外营养(TPN)。同时,对实验组进行全胃切除术,而NC组进行假手术。TPN溶液除脂肪乳剂含量不同外,氮含量相同且营养成分相同。NC组和其中一个实验组接受大豆油乳剂(SO),另一个实验组接受50%大豆油和50%鱼油乳剂(FO)。每组中一半的大鼠在手术或假手术后1天或3天处死,以检测其免疫反应。结果显示,术后FO组的CD4比例和CD4/CD8比值高于SO组和NC组。FO组腹膜巨噬细胞的吞噬活性高于NC组,但术后3天SO组和NC组之间未发现差异。术后FO组细胞内干扰素(IFN)-γ分布高于SO组。术后第3天,FO组白细胞黏附分子表达和腹膜单核细胞趋化蛋白-1水平低于SO组。这些结果表明,肠外输注FO不会导致免疫抑制。此外,给予FO可促进淋巴细胞Th1细胞因子的产生,增强全胃切除大鼠腹膜巨噬细胞的吞噬活性,并降低白细胞黏附分子的表达。