Shen Rene L, Pontoppidan Peter E L, Rathe Mathias, Jiang Pingping, Hansen Carl Frederik, Buddington Randal K, Heegaard Peter M H, Müller Klaus, Sangild Per T
Section of Comparative Pediatrics and Nutrition, Department of Clinical Veterinary and Animal Science/Nutrition Exercise and Sports, University of Copenhagen, Copenhagen, Denmark;
Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark;
Am J Physiol Gastrointest Liver Physiol. 2016 Aug 1;311(2):G324-33. doi: 10.1152/ajpgi.00373.2015. Epub 2016 Jul 21.
Chemotherapy-induced gastrointestinal (GI) toxicity is a common adverse effect of cancer treatment. We used preweaned piglets as models to test our hypothesis that the immunomodulatory and GI trophic effects of bovine colostrum would reduce the severity of GI complications associated with doxorubicin (DOX) treatment. Five-day-old pigs were administered DOX (1 × 100 mg/m(2)) or an equivalent volume of saline (SAL) and either fed formula (DOX-Form, n = 9, or SAL-Form, n = 7) or bovine colostrum (DOX-Colos, n = 9, or SAL-Colos, n = 7). Pigs were euthanized 5 days after initiation of chemotherapy to assess markers of small intestinal function and inflammation. All DOX-treated animals developed diarrhea, growth deficits, and leukopenia. However, the intestines of DOX-Colos pigs had lower intestinal permeability, longer intestinal villi with higher activities of brush border enzymes, and lower tissue IL-8 levels compared with DOX-Form (all P < 0.05). DOX-Form pigs, but not DOX-Colos pigs, had significantly higher plasma C-reactive protein, compared with SAL-Form. Plasma citrulline was not affected by DOX treatment or diet. Thus a single dose of DOX induces intestinal toxicity in preweaned pigs and may lead to a systemic inflammatory response. The toxicity is affected by type of enteral nutrition with more pronounced GI toxicity when formula is fed compared with bovine colostrum. The results indicate that bovine colostrum may be a beneficial supplementary diet for children subjected to chemotherapy and subsequent intestinal toxicity.
化疗引起的胃肠道毒性是癌症治疗常见的副作用。我们使用断奶前仔猪作为模型来验证我们的假设,即牛初乳的免疫调节和胃肠道营养作用会减轻与阿霉素(DOX)治疗相关的胃肠道并发症的严重程度。给5日龄仔猪注射DOX(1×100mg/m²)或等量生理盐水(SAL),并分别喂食配方奶(DOX-Form组,n = 9,或SAL-Form组,n = 7)或牛初乳(DOX-Colos组,n = 9,或SAL-Colos组,n = 7)。化疗开始5天后对仔猪实施安乐死,以评估小肠功能和炎症指标。所有接受DOX治疗的动物均出现腹泻、生长发育迟缓及白细胞减少。然而,与DOX-Form组相比,DOX-Colos组仔猪的肠道通透性更低,肠绒毛更长,刷状缘酶活性更高,组织白细胞介素-8水平更低(所有P<0.05)。与SAL-Form组相比,DOX-Form组仔猪血浆C反应蛋白显著升高,而DOX-Colos组仔猪则无此现象。血浆瓜氨酸不受DOX治疗或饮食的影响。因此,单剂量DOX可在断奶前仔猪中诱发肠道毒性,并可能导致全身炎症反应。肠道营养类型会影响毒性,与牛初乳相比,喂食配方奶时胃肠道毒性更明显。结果表明,牛初乳可能是接受化疗及随后出现肠道毒性的儿童有益的补充饮食。