Jiang Jian-Wen, Zheng Shu-Sen, Xue Fei, Gao Liang-Hui, Jiang Guo-Ping, Xie Hai-Yang
Department of Hepatobiliary Pancreatic Surgery, Key Lab of Combined Multi-organ Transplantation, Ministry of Public Health, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Hepatobiliary Pancreat Dis Int. 2006 May;5(2):199-204.
Recipients of liver transplantation could have postoperative structural injury and declined absorptive function in the gastrointestinal tract. Glutamine (Gln) is a special nutrient of small intestinal mucosa and of various kinds of cells proliferating rapidly. But Gln could form a kind of poisonous pyroglutamic acid in water solution, which is the limitation of Gln in clinical practice. Glycyl-glutamine (Gly-Gln) is highly soluble and can be hydrolyzed to release glutamine. This study was undertaken to observe the effect of Gly-Gln dipeptide by enteral feeding on the intestinal structure and absorptive function after allogenetic liver transplantation in rats.
Twelve male inbred Lewis rats were selected randomly as donors, and 24 male inbred BN rats as recipients of allogenetic liver transplantation. The recipients were also randomly divided into two groups: control group (ALA group, n=12) and experimental group (GLN group, n=12). In each group, 6 normal BN rats were sampled as the normal parameter on the 3rd preoperative day. The 6 recipients in the control group received alanine 0.6 g/kg daily for 3 days before operation and 7 days after operation by gastric perfusion, and the 6 recipients in the experimental group were given Gly-Gln 0.6 g/kg daily the same way. The 12 BN recipients underwent 3-day fasting (free access to water with 0.23% sodium chloride) and orthotopic liver transplantation in aseptic conditions and were given subcutaneous injection of CsA 2 mg/kg daily after the operation. The 12 BN recipients were sampled on the 8th postoperative day. All of the 24 BN rats were subjected to examination of mucosal structure, activities of Na+-K+-ATP and disaccharidase, and D-xylose absorption test.
The 12 BN recipients were alive after liver transplantation. On the 3rd preoperative day, mucosal structure, activities of Na+-K+-ATP and disaccharidase and D-xylose absorption in the two groups were not significantly different. On the 8th postoperative day, the parameters of the two groups were markedly changed compared with those on the 3rd preoperative day. However, the parameters of GLN group were remarkably higher than those of ALA group.
Enteral feeding of Gly-Gln could improve the structure and absorptive function of the small intestine after liver transplantation in rats.
肝移植受者术后可能出现胃肠道结构损伤及吸收功能下降。谷氨酰胺（Gln）是小肠黏膜及各类快速增殖细胞的特殊营养物质。但Gln在水溶液中可形成一种有毒的焦谷氨酸，这是Gln在临床应用中的局限性。甘氨酰谷氨酰胺（Gly-Gln）溶解性高，可水解释放谷氨酰胺。本研究旨在观察经肠内喂养给予Gly-Gln二肽对大鼠同种异体肝移植术后肠道结构及吸收功能的影响。
随机选取12只雄性近交系Lewis大鼠作为供体，24只雄性近交系BN大鼠作为同种异体肝移植受者。将受者随机分为两组：对照组（ALA组，n = 12）和实验组（GLN组，n = 12）。每组在术前第3天取6只正常BN大鼠作为正常参数对照。对照组的6只受者在术前3天及术后7天每天经胃灌注给予丙氨酸0.6 g/kg，实验组的6只受者以同样方式每天给予Gly-Gln 0.6 g/kg。12只BN受者进行3天禁食（自由饮用含0.23%氯化钠的水），并在无菌条件下进行原位肝移植，术后每天皮下注射环孢素A 2 mg/kg。12只BN受者在术后第8天进行取材。对所有24只BN大鼠进行黏膜结构、Na+-K+-ATP酶和双糖酶活性以及D-木糖吸收试验检测。
12只BN受者肝移植后存活。术前第3天，两组的黏膜结构、Na+-K+-ATP酶和双糖酶活性以及D-木糖吸收情况无显著差异。术后第8天，两组的各项参数与术前第3天相比均有明显变化。然而，GLN组的参数明显高于ALA组。
经肠内喂养给予Gly-Gln可改善大鼠肝移植术后小肠的结构及吸收功能。
