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早期肠内免疫营养对严重烧伤小鼠肠道免疫功能的影响

[Effect of early enteral immune nutrition on immune function of intestine in mice with severe burn].

作者信息

Fan Jun, Meng Qing-Yan, Guo Guang-Hua, Xie Yong, Li Yue, Hu Fu-Sun, Xiu Yi-Ping, Li Tai-Ran, Ma Liang

机构信息

Department of Burns, the General Hospital of Shenyang Military Command, Shenyang 110015, China.

出版信息

Zhonghua Shao Shang Za Zhi. 2009 Apr;25(2):140-3.

PMID:19799042
Abstract

OBJECTIVE

To investigate the effects of early enteral nutrition supplemented with immune nutrient on intestine immune function in mice with severe burn.

METHODS

Twenty-four BALB/c mice were inflicted with 20% TBSA full-thickness scald, then they were randomly divided into EN(with oral administration of common enteral nutrition after 2 hours) and EIN (with oral administration of common enteral nutrition and glutamine, arginine after 2 hours) groups. Another 10 mice were used as the normal control (NC) group. The supplied energy ratio( carbohydrate: fat: protein)in former 2 groups was 82:3:15, and the ratio of energy to nitrogen was 150: 1. The energy requirement of each mouse was calculated according to 732.2 kJ x kg(-1) x d(-1), one third of the requirement was administrated on 1st day, and one half of it on 2nd day, and full energy requirement was started on the 3rd day,and the requirement was divided into 4-6 portions every day. The feed was isocaloric, isonitrogenous, and isovolumic for the 2 experimental groups. All mice were sacrificed and entire small intestine was harvested for determination of intestinal IgA level by ELISA, total Peyer's patches (PP) lymphocytes and their apoptosis ratio, and changes in PP lymphocytes (CD3+, CD4+, CD19+) on 7th day of the experiment.

RESULTS

Compared with those in NC group [(4.5 +/- 0.6) x 10(6), (42 +/- 7) microg/cm, respectively], total PP lymphocytes and intestinal IgA levels in EN and EIN groups obviously decreased [(2.3 +/- 0.4) x 10(6), (35 +/- 6) microg/cm, (3.8 +/- 0. 5) x 10(6), (38 +/- 6), microg/cm, respectively, P < 0.05] , among which the values in EIN group were higher than EN group (P < 0.05). The changes in PP lymphocytes were similar to that of total PP lymphocytes. Compared with that in NC group [(4.8 +/- 2.1)%], the apoptosis ratio of PP lymphocytes in EN and EIN groups significantly increased [(12.7 +/- 2.4)%, (8.0 +/- 1.7)%, respectively, P < 0.05], however the ratio in EIN group was lower than that of EN group (P < 0.05).

CONCLUSIONS

Early enteral nutrition supplemented with immune nutrient can improve intestinal immune function in mice with severe burn.

摘要

目的

探讨早期肠内营养补充免疫营养素对严重烧伤小鼠肠道免疫功能的影响。

方法

将24只BALB/c小鼠造成20%体表面积的全层烫伤,然后随机分为肠内营养组(伤后2小时开始口服普通肠内营养)和免疫增强型肠内营养组(伤后2小时开始口服普通肠内营养并补充谷氨酰胺和精氨酸)。另取10只小鼠作为正常对照组。前两组提供的能量比(碳水化合物∶脂肪∶蛋白质)为82∶3∶15,能量与氮的比值为150∶1。根据732.2 kJ·kg-1·d-1计算每只小鼠的能量需求,第1天给予需求量的三分之一,第2天给予二分之一,第3天开始给予全量,每天将需求量分为4 - 6次给予。两个实验组的饲料等热量、等氮量、等容积。实验第7天处死所有小鼠,取完整小肠,采用ELISA法测定肠道IgA水平,检测派氏结(PP)淋巴细胞总数及其凋亡率,以及PP淋巴细胞(CD3+、CD4+、CD19+)的变化。

结果

与正常对照组相比[分别为(4.5±0.6)×106、(42±7)μg/cm],肠内营养组和免疫增强型肠内营养组的PP淋巴细胞总数和肠道IgA水平明显降低[分别为(2.3±0.4)×106、(35±6)μg/cm,(3.8±0.5)×106、(38±6)μg/cm,P<0.05],其中免疫增强型肠内营养组的值高于肠内营养组(P<0.05)。PP淋巴细胞的变化与PP淋巴细胞总数相似。与正常对照组相比[(4.8±2.1)%],肠内营养组和免疫增强型肠内营养组PP淋巴细胞的凋亡率显著升高[分别为(12.7±2.4)%、(8.0±1.7)%,P<0.05],然而免疫增强型肠内营养组的凋亡率低于肠内营养组(P<0.05)。

结论

早期肠内营养补充免疫营养素可改善严重烧伤小鼠的肠道免疫功能。

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Glutamine granule-supplemented enteral nutrition maintains immunological function in severely burned patients.补充谷氨酰胺颗粒的肠内营养可维持严重烧伤患者的免疫功能。
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